BACKGROUND: Understanding the perceived health benefits of being active on recreational trails may provide useful information to policymakers regarding the benefits of local trails to rural community members. The purpose of this study was to determine the perceived health benefits among users of recreational trails in a rural Tennessee county. METHODS: Self-report surveys were accessed by McMinn County trail users via a QR code on signage (12 signs) placed along the community trail system or via a link shared through local social media pages. The 13-item Perceived Health Outcomes of Recreation Scale (PHORS) was used to assess perceived health benefits of leisure-time trail use related to three subdomains: 1) improved condition (IMPV), 2) prevention of worse condition (PREV), and 3) realization of a satisfying psychological experience (PSYC). Answer options for the survey range from “1 = never like me” to “7 = very much like me”. Independent t-tests and ANOVA were used to compare perceived health benefits of trail use by gender, age (18-34, 35-44, 45-64, 65+), primary trail activity (walking, running, cycling), and primary trail used (Eureka, Athens Regional, or Veterans). RESULTS: Of the 116 respondents included in the analysis, most were female (68.1%), white (92.2%), and college graduates (63.8%). The mean age of respondents was 46.2±15.2 yrs of age with a mean body mass index of 28.1±5.8 kg/m2. They averaged 10.9±7.6 days per month on the trails and the primary trail activity was walking (64.7%). Perceived health outcomes did not differ between females and males (IMPV: 6.64 vs 6.41, PREV: 6.07 vs 5.98, and PSYC: 6.08 vs 5.77). Those 65+ had a significantly higher PSYC score than those 45-64 (M=6.44 vs 5.66, p=.03). Cyclists, although not significant, scored higher on all PHORS subdomains compared to walkers and runners. Those who primarily used the Eureka trail had a significantly greater IMPV score than Athens Regional trail users (M=6.68 vs 6.32, p=.03). CONCLUSIONS: Perceived health benefits of recreational trail users was high with minimal differences by gender, age, primary trail activity, or primary trail. These high scores likely reflect the importance trails have for improving health in rural areas with less accessibility to exercise opportunities. Future research should investigate if perceived health benefits of trail use in rural areas are associated with measured health outcomes.

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