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Adapting a physical activity intervention for youth in a rural area: A case studyBackground: Physical activity offers children and youth many well-documented positive effects on health. The present study adapted a community-based prevention marketing campaign (CBPM), VERBTM Summer Scorecard (VSS) to promote physical activity among minority youth in rural, southeast Georgia. The purpose of this paper is to describe the adaptation process, emphasizing methods used and lessons learned. Methods: A qualitative study design was used to identify social marketing concepts that informed program adaptation, including two focus groups with 12 children and two focus groups with 14 parents. Qualitative thematic data analysis was used to analyze formative research. The adapted program was implemented for three summers, from 2012 through 2014. A case study of program implementation and lessons learned is provided. Results: Formative research results suggested two changes to VSS that would be required for the program to work in this rural community - a focus on parent-child activities instead of a sole focus on youth and changes to the Scorecard that was used to track physical activity. Over the course of three years of implementation, several lessons were learned about university community partnerships (e.g., the need for a balance of power), having a program champion, and program evaluation. Conclusions: Rural communities are a unique context, with barriers to health promotion efforts that serve to contribute to negative health behaviors and resistance to change. The limited capacity of rural communities to address physical activity makes these barriers difficult to overcome, even during implementation of evidence-based practices.