Measurement of park and recreation environments that support physical activity in low-income communities of color: highlights of challenges and recommendations

Unearthing Inequities in the Relationship between Multiple Sociodemographic Factors and Diverse Elements of Park Availability and Quality in a Major Southern Metropolitan Region

Parks are critical components of healthy communities. This study explored neighborhood socioeconomic and racial/ethnic inequalities in park access and quality in a large U.S. southeastern metropolitan region. A total of 241 block groups were examined, including 77 parks. For each block group, we obtained multiple sociodemographic indicators, including unemployment rate, education level, renter-occupied housing, poverty rate, and racial/ethnic minority composition. All parks were mapped using geographical information systems and audited via the Community Park Audit Tool to evaluate their features and quality. We analyzed seven diverse elements of park quality (transportation access, facility availability, facility quality, amenity availability, park aesthetics, park quality concerns, and neighborhood quality concerns), as well as an overall park quality score by calculating the mean for all parks within each block group. The mean percent of residents below 125% of the poverty level and the percentage of renter-occupied housing units were significantly higher among block groups with any parks in comparison to block groups with no parks. In addition, there were significant positive associations between park transportation access scores and both the percentage of residents with less than high school education and the percent identifying as non-Hispanic white. Moreover, there was a significant negative association between park amenity availability and the block group's unemployed population. Further, a significant negative association between park aesthetics and the population with a lower than high school education percentage was observed. Revealed differences in park availability, park acreage, and park quality dimensions emphasized the need for targeted policy, programmatic, and infrastructure interventions to improve park access and quality and address health disparities.

If You Build It Will They Come? Park Upgrades, Park Use and Park-Based Physical Activity in Urban Cape Town, South Africa-The SUN Study

The development and upgrade of recreational public spaces are key government strategies to increase opportunities for physical activity (PA) and enhance social interaction and community cohesion. This study aimed to evaluate differences in park use and park-based PA in recently upgraded/developed parks (intervention, n = 4) against established parks (control, n = 4) and in regional parks in high- and low-income settings (n = 2). Additionally, associations between target area features, park use and PA were identified. Direct observation of park use and attributes was conducted using the System for Observing Play and Recreation in Communities (SOPARC) over four months. Despite more park users in intervention parks (2519 vs. 1432), control park visitors were 48% more likely to be engaged in PA (p < 0.001). Similarly, while high-income park users attracted more visitors (2135 vs. 1111), they were 79% less likely to be engaged in any PA compared with low-income park visitors. The likelihood of both use of and PA by gender and age differed by features. Active recreation features in intervention parks attracted more users than the same features in control parks. In this study, upgraded or newly developed parks attracted more visitors but not necessarily overall greater levels of physical activity.

The Effectiveness of Interventions to Increase Participation and Physical Activities in Parks: A Systematic Review of the Literature

Although a variety of interventions in many countries have been developed to increase park use and to improve public participation in physical activities in parks, knowledge of their overall effectiveness is lacking. A systematic literature review was undertaken to further understand the effectiveness of various interventions that aim to increase the use of parks and physical activity participation in parks. This systematic review utilized the standard Preferred Reporting Items for Systematic Reviews and Meta-Analysis procedure, and of the 3801 studies identified, 60 studies were reviewed in-depth, with 44 studies assessed for quality of evidence and risk of bias. Most of the 44 reviewed studies found that various interventions had positive impacts on park use and physical activity participation in parks. Interventions were classified into both demand and supply, with more studies focusing on the supply side. The strongest evidence on the effectiveness of various interventions was found for park prescriptions; safe access to parks; playgrounds, and park renovation and renewal/design. However, the assessment of quality of evidence and risk of bias showed that most studies suffer from potential biases and evidence weaknesses, suggesting a need to further establish external validity.

Mental Health and Recreation Opportunities

The environment has direct and indirect effects on mental health. Previous studies acknowledge that the poor design of communities and social environments leads to increased psychological distress, but methodological issues make it difficult to draw clear conclusions. Recent public health, leisure and recreation studies have tried to determine the relationship between recreation opportunities and mental health. However, previous studies have heavily focused on individual contexts rather than national or regional levels; this is a major limitation. It is difficult to reflect the characteristics of community environments effectively with such limited studies, because social environments and infrastructure should be analyzed using a spatial perspective that goes beyond an individual’s behavioral patterns. Other limitations include lack of socioeconomic context and appropriate data to represent the characteristics of a local community and its environment. To date, very few studies have tested the spatial relationships between mental health and recreation opportunities on a national level, while controlling for a variety of competing explanations (e.g., the social determinants of mental health). To address these gaps, this study used multi-level spatial data combined with various sources to: (1) identify variables that contribute to spatial disparities of mental health; (2) examine how selected variables influence spatial mental health disparities using a generalized linear model (GLM); (3) specify the spatial variation of the relationships between recreation opportunities and mental health in the continental U.S. using geographically weighted regression (GWR). The findings suggest that multiple factors associated with poor mental health days, particularly walkable access to local parks, showed the strongest explanatory power in both the GLM and GWR models. In addition, negative relationships were found with educational attainment, racial/ethnic dynamics, and lower levels of urbanization, while positive relationships were found with poverty rate and unemployment in the GLM. Finally, the GWR model detected differences in the strength and direction of associations for 3109 counties. These results may address the gaps in previous studies that focused on individual-level scales and did not include a spatial context.

Associations between the physical environment and park-based physical activity: A systematic review

BACKGROUND

With an increase in the evidence for the associations between park-based physical activity (PA) and physical environments (especially park and neighborhood environments), researchers face an important challenge in interpreting and summarizing the evidence to develop environmental change interventions. An updated review is needed to better inform policymaking and environmental interventions. The current study aimed to systematically review the research on the associations of park-based PA with park and neighborhood environmental characteristics.

METHODS

We targeted English peer-reviewed articles from 5 electronic databases using keywords related to park-based PA, park environments, and neighborhood environments. Of the 4071 identified papers, 25 studies published between 2008 and 2016 met all the eligibility criteria and were included in this review.

RESULTS

The characteristics of physical environment that received consistent support included paths/trails, lighting, and incivilities (e.g., broken glasses and litter). Mixed findings were revealed for 6 park environmental factors (unspecified active facilities, playgrounds and skating areas, fitness stations, picnic areas, greenness, and park size) and 2 neighborhood environmental factors (park density and park proximity).

CONCLUSION

It can be concluded that paths/trails, lighting, and incivilities are 3 key physical environmental attributes of park-based PA. Given the inconsistent findings on park and neighborhood environmental factors, more robust designs such as prospective investigation are required.

Children's attitudes towards animals are similar across suburban, exurban, and rural areas

The decline in the number of hours Americans spend outdoors, exacerbated by urbanization, has affected people’s familiarity with local wildlife. This is concerning to conservationists, as people tend to care about and invest in what they know. Children represent the future supporters of conservation, such that their knowledge about and feelings toward wildlife have the potential to influence conservation for many years to come. Yet, little research has been conducted on children’s attitudes toward wildlife, particularly across zones of urbanization. We surveyed 2,759 4–8th grade children across 22 suburban, exurban, and rural schools in North Carolina to determine their attitudes toward local, domestic, and exotic animals. We predicted that children who live in rural or exurban areas, where they may have more direct access to more wildlife species, would list more local animals as “liked” and fewer as “scary” compared to children in suburban areas. However, children, regardless of where they lived, provided mostly non-native mammals for open-ended responses, and were more likely to list local animals as scary than as liked. We found urbanization to have little effect on the number of local animals children listed, and the rankings of “liked” animals were correlated across zones of urbanization. Promising for conservation was that half of the top “liked” animals included species or taxonomic groups containing threatened or endangered species. Despite different levels of urbanization, children had either an unfamiliarity with and/or low preference for local animals, suggesting that a disconnect between children and local biodiversity is already well-established, even in more rural areas where many wildlife species can be found.

Intrapersonal and Environmental Barriers to Physical Activity Among Blacks and Latinos

OBJECTIVE

To understand perceived barriers and facilitators to physical activity (PA) among at-risk African American and Hispanic adolescents and adults in a low-income community.

DESIGN

Qualitative research was conducted in 2014-2015 using focus groups and a sociodemographic survey.

SETTING

Three high schools in South Los Angeles, California.

PARTICIPANTS

Eight high school-aged adolescent focus groups (n = 64) and 8 adult focus groups (n = 47).

PHENOMENON OF INTEREST

Perceived barriers and facilitators to PA among predominantly obese and overweight African American and Hispanic adolescents and adults.

ANALYSIS

Groups were audio recorded, transcribed, coded, and analyzed using an inductive approach.

RESULTS

Participants reported that PA resources were available on school campuses (eg, sports teams) and in the community (eg, sidewalks, local parks, fitness classes). Key barriers to PA were intrapersonal (lack of motivation and time constraints) and environmental (safety concerns), whereas facilitators included interpersonal factors (social support). Participants provided valuable insights, including recommendations to increase noncompetitive programs at schools, develop shared-use agreements, and address safety concerns at local parks and public recreational spaces.

CONCLUSIONS AND IMPLICATIONS

The findings suggest that future efforts to promote PA among at-risk minority groups should address intrapersonal and social environmental factors. Community-based programmatic and policy recommendations are provided.

The Relationship between Social Cohesion and Urban Green Space: An Avenue for Health Promotion

Social cohesion involves the interpersonal dynamics and sense of connection among people. Increased social cohesion can be associated with various physical and psychological health benefits. The presence of urban green spaces can encourage positive social interactions that cultivate social cohesion in ways that enhance health and well-being. Urban green spaces have also been linked to positive health behaviors and outcomes including increased physical activity and social engagement. Understanding the relationship between social cohesion and urban green space is important for informing holistic approaches to health. In this article, we discuss how positive interactions in urban green space can catalyze social cohesion, social capital and critical health-promoting behaviors that may enhance psychological health and well-being. We also summarize the strengths and limitations of previous studies and suggest directions for future research.

A Meta-analysis of the Literature on the Association of the Social and Built Environment With Obesity: Identifying Factors in Need of More In-Depth Research

Objective:

This study aims to identify groups of the social and built environment factors that have been studied substantially along with factors that need further attention, to guide the research, designing, and planning of the social and built environment for reducing obesity prevalence.

Data Source:

A systematic search of literature was undertaken from PubMed, Google Scholar, and Web of Knowledge.

Study Inclusion and Exclusion Criteria:

Keyword combination of “built environment,” “social environment,” and “obesity” were used to expand the search scope. Exclusion criteria included (1) any article with less than 50 citations from 2005 to 2010, and those with less than 25 citations from 2011 to 2015. In this way we included the most prominent peer-reviewed studies published in recent years while excluding less influential publications; (2) any article published in a language other than English; (3) literature review articles; (4) any article studying health outcomes not obesity related. We included research on eating behaviors since the studies contributed profoundly to food environment research.

Data Synthesis:

A meta-analysis of 153 empirical studies, selected from 2005 to 2015 based on a series of criteria, was conducted using factor analysis. The exploratory factor analysis was undertaken to group the prevalence and use of the social and built environment factors associated with obesity.

Results:

The findings suggested that the research community has gained a substantial understanding of the D variables of the built environment, including density, diversity, design, distance to transit, and destination access. Factors concerning different age groups, minority populations, groups with low socioeconomic status, food environment, and street-level urban design features have been less examined.

Conclusions:

The findings are important to guide future research directions, giving more attention to the factors in need of more in-depth research.

Assessing the Relationship Between a Composite Score of Urban Park Quality and Health

Introduction

Walkable access to parks, sufficient park acreage, and investments in park and recreation resources are 3 indicators of quality city park systems. Few studies, however, have examined the collective effects of these indicators on public health outcomes.

Methods

Combining 3 nationwide public data sets, this study modeled the relationships between a composite score of urban park system quality effects on physical activity and self-reported health while controlling for demographic and lifestyle variables. Data were obtained from the Centers for Disease Control and Prevention’s 500 Cities Project, the Trust for Public Land’s City Park Facts Report, and the US Census Bureau.

Results

Regression analyses indicated that the composite park quality score was significantly related to both physical activity levels and physical health across a sample of 59 cities. Higher scores were associated with fewer physically inactive residents but were not significantly associated with better physical health.

Conclusion

Assessing the collective contribution of park access, park acreage, and investment suggests that improvements to a city’s composite score may correspond with greater physical activity, but more research is needed to establish the long-term relationships between park system quality and physical health.

Shared use agreements and leisure time physical activity in North Carolina public schools

Although increasing community access to public schools through shared use agreements (SUAs) has been a recommended strategy for promoting physical activity (PA) among national, state and local organizations, empirical evidence examining the efficacy of SUAs is limited. This study examined the degree of usage and production of PA among schools with shared use, and how variation in PA output is related to characteristics of the school, type of activity, facility type, and when activity occurs. Data were collected in 20 schools across North Carolina using System for Observing Play and Recreation in Communities (SOPARC) and Structured Physical Activity Surveys (SPAS) to assess PA in school athletic facilities during out of school time. Findings indicated that although schools had a policy of shared or open use, most facilities were empty during non-school hours. Hierarchal linear regression models also showed that formal programming was positively associated with both use and PA levels. Given the abundance of empty facilities, community groups in need of space to facilitate structured PA programs should pursue avenues of sharing facilities with public schools. Furthermore, to increase the efficacy of shared use, structured physical activity programs may be needed. Future studies are encouraged to further explore the effects of the specific types of shared use programs on PA production as well other aspects of the built environment surrounding schools.

A longitudinal examination of improved access on park use and physical activity in a low-income and majority African American neighborhood park

This study sought to evaluate the impact of street crossing infrastructure modifications on park use and park-based physical activity in a low-income and African American community. A five-lane major highway created an access barrier between low-income housing units and the local neighborhood park in Columbia, Missouri. The installation of a signalized pedestrian crosswalk provided an opportunity to conduct a natural experiment to examine the effect of improved safe access upon community active living behaviors. Direct observation using SOPARC was collected prior to the crosswalk instillation in June 2012, after the crosswalk installation in June 2013 and again as a follow up in June 2014 during the same two-week period to assess changes in total park use and total energy expenditure by age, gender and race/ethnicity. Analysis of covariance models, controlling for temperature examined changes in total counts and total energy expenditure using pairwise Sidak post-hoc comparisons. Total park use increased from 2012 (n=2080) to 2013 (n=2275) and remained constant in 2014 (n=2276). However, despite increases in safe access and overall park use, there was a significant decrease in total energy expenditure following the installation of the crosswalk that was sustained in 2014. This study shows that increasing safe access to parks primarily positively influences park use but not park-based physical activity. While improved safe access is encouraging greater park use, there is a need for future research to examine additional factors such as social support, programming and environmental changes to engage community members in park-based physical activity.

The First National Study of Neighborhood Parks: Implications for Physical Activity

INTRODUCTION

An extensive infrastructure of neighborhood parks supports leisure time physical activity in most U.S. cities; yet, most Americans do not meet national guidelines for physical activity. Neighborhood parks have never been assessed nationally to identify their role in physical activity.

METHODS

Using a stratified multistage sampling strategy, a representative sample of 174 neighborhood parks in 25 major cities (population >100,000) across the U.S. was selected. Park use, park-based physical activity, and park conditions were observed during a typical week using systematic direct observation during spring/summer of 2014. Park administrators were interviewed to assess policies and practices. Data were analyzed in 2014-2015 using repeated-measure negative binomial regressions to estimate weekly park use and park-based physical activity.

RESULTS

Nationwide, the average neighborhood park of 8.8 acres averaged 20 users/hour or an estimated 1,533 person hours of weekly use. Walking loops and gymnasia each generated 221 hours/week of moderate to vigorous physical activity. Seniors represented 4% of park users, but 20% of the general population. Parks were used less in low-income than in high-income neighborhoods, largely explained by fewer supervised activities and marketing/outreach efforts. Programming and marketing were associated with 37% and 63% more hours of moderate to vigorous physical activity/week in parks, respectively.

CONCLUSIONS

The findings establish national benchmarks for park use, which can guide future park investments and management practices to improve population health. Offering more programming, using marketing tools like banners and posters, and installing facilities like walking loops, may help currently underutilized parks increase population physical activity.

Examining the role of urban street design in enhancing community engagement: A literature review

Streets are an integral part of the built environment with the capacity to promote community engagement, as one aspect of health and well-being. However, there have been few attempts to synthesize published studies and interventions to gain a broader understanding of what street design features hinder or facilitate community engagement. Data was extracted from 30 eligible articles into 16 key topic areas or themes. The most frequent topic areas were 'Aesthetics and Upkeep' (18), 'Access to Resources/Facilities' (15), 'Security and Safety' (15), and 'Walkability' (14). This review advances our understanding of how streets can be designed to enhance community engagement.

PARCS: A Safety Net Community-Based Fitness Center for Low-Income Adults

BACKGROUND

Physical activity (PA) and fitness are critical to maintaining health and avoiding chronic disease. Limited access to fitness facilities in low-income urban areas has been identified as a contributor to low PA participation and poor fitness.

OBJECTIVES

This research describes community-based fitness centers established for adults living in low-income, urban communities and characterizes a sample of its members.

METHODS

The community identified a need for physical fitness opportunities to improve residents' health. Three community high schools were host sites. Resources were combined to renovate and staff facilities, acquire equipment, and refer patients to exercise. The study sample included 170 members older than age 18 who completed demographic, exercise self-efficacy, and quality of life surveys and a fitness evaluation. Neighborhood-level U.S. Census data were obtained for comparison.

RESULTS

The community-based fitness centers resulted from university, public school, and hospital partnerships offering safe, accessible, and affordable exercise opportunities. The study sample mean body mass index was 35 + 7.6 kg/m(2) (class II obesity), mean age was 50 ± 12.5 years, 66% were Black, 72% were female, 66% completed some college or greater, and 71% had an annual household income of less than $25,000 and supported 2.2 dependents. Participants had moderate confidence for exercise participation and low fitness levels. When compared with census data, participants were representative of their communities.

CONCLUSION

This observational study reveals a need for affordable fitness centers for low-income adults. We demonstrate a model where communities and organizations strategically leverage resources to address disparities in physical fitness and health.

Racial-Ethnic Variation in Park Use and Physical Activity in the City of Los Angeles

Racial-ethnic disparities in physical activity present important challenges to population health. Public parks provide access to free or low-cost physical activity opportunities, but it is unclear to what extent parks are utilized by various race-ethnic groups in diverse urban settings. Here, we examine racial ethnic differences in park use and physical activity among adult residents (n = 7506) living within 1 mi of 50 parks in the city of Los Angeles. In multivariate analyses, we find few differences among race-ethnic groups in terms of their frequency of having visited the park in the past 7 days; however, we find numerous differences in how the groups used the park and in their levels of physical activity: Blacks and English-speaking Latinos were less likely than whites to report being physically active, exercising in the park, and exercising outside the park; Spanish-speaking Latinos were equally likely as whites to report exercising in park but less likely to report exercising outside the park and more likely to report using the parks for social interactions; Asians/Pacific Islanders (PI)/others were more likely than whites to report visiting the park in the past 7 days and using the parks for social interactions. Urban parks appear to be an important resource for physical activity and socialization, in particular among Spanish-speaking Latino and Asians/PI groups. Additional efforts may be needed for other racial-ethnic minorities to experience the same benefits.

A systematic review of physical activity interventions among African American adults: evidence from 2009 to 2013

This review extends findings from four previous reviews of physical activity (PA) interventions among African Americans (AA) and includes papers published between January 2009 and August 2013. Eligible papers were retrieved using strategies employed in previous reviews. Overall, 16 relevant papers were identified, including four pilot studies and 12 full trials. Interventions were based on a variety of behavioural sciences theories. The most common setting for interventions was churches. Most interventions lasted >6 months; few interventions included >6 months of post-intervention follow-up. Overall, studies identified within-group differences showing positive improvements in PA, and most studies showed statistically significant between-group differences in at least one measure of PA. A quality score was used to rate various elements of the studies and provide a numerical assessment of each paper; scores ranged from 3 to 10 out of 13 possible points. The current review indicates a continued need for studies that use objective PA measures, assess long-term intervention impact, provide specific PA goals for interventions, include more attention to strategies that can increase retention and adherence among AA study participants, include AA men and determine the independent and synergistic effects of individual and environmental (socio-cultural and built) change strategies.

Community members' assessment of the physical activity environments in their neighborhood parks: utility of the community stakeholder park audit tool

OBJECTIVE

This study engaged community members to describe physical activity (PA) environments in parks and to examine if the PA environment in parks was related to the economic characteristics of households near parks.

METHOD

Twenty-four Bridgeport, adult residents examined the PA environments in 21 Bridgeport, Connecticut, parks using the Community Stakeholder Park Audit Tool (CPAT) during the summer, 2013. ESRI's Geographical Information System was used to identify the economic characteristics (i.e., median household income, percentage of households below the poverty line; from 2010 Census data) of households within 0.5 miles of a park. Descriptive and inferential statistics were used to analyze CPAT data.

RESULTS

A negative association was identified between the parks' PA area and safety scores (p = .012). Positive associations were identified between the parks' PA area and amenities scores (p < .001), access and amenities scores (p = .006), and park safety concern and surrounding safety concern scores (p < .001). There were no significant associations between park environment indices and the economic characteristics of households less than 0.5 miles from parks. Community members recommended several strategies to enhance PA environments in parks.

CONCLUSIONS

The findings highlight the utility of CPAT for enabling community members identify opportunities to enhance PA environments in parks.

Positive Action for Today's Health (PATH): Sex differences in walking and perceptions of the physical and social environment

Research indicates that people from low socioeconomic and ethnic minority backgrounds disproportionately fail to meet the weekly national recommendations for physical activity. Perceptions of environmental factors may be significant barriers to walking in communities experiencing high rates of crime and poverty and may impact women and men differently. The present study investigated sex differences in the impact of perceptions of the environment and overall neighborhood quality on walking in an underserved population. Participants were 195 African American women and 95 African American men. Baseline data indicated that women reported greater concerns about safety, poorer perceptions of aesthetics, and lower neighborhood satisfaction than men. Regression analyses showed that perceptions of access to places for walking significantly predicted walking for both women and men and that sex moderated the effect of neighborhood satisfaction. These results suggest that interventions focused on building accessibility to places for walking while also addressing social environmental concerns are needed in high crime communities.

In an urban neighborhood, who is physically active and where?

Previous research has shown differences in adult physical activity (PA) levels within urban population, in what types of activities they participated, and where they were active. A sample of 514 urban Philadelphia adult residents was surveyed about level and location of PA. A majority (55.6%) of survey participants reported being vigorously or moderately active or walking enough to meet PA guidelines. A significantly higher proportion of men (vs. women), younger (vs. older) adults and people who were employed (vs. unemployed) met the PA guidelines. Most participants (87.5%) reported walking at least once within the previous week, while 79.3% reported engaging in moderate or vigorous activity. Of the participants who reported being moderately or vigorously active, 64.0% were physically active in indoors only, 22.6% were active in outdoors only, and 13.4% were active in both indoors and outdoors. Significantly fewer black women were active outdoors, compared to all other race/sex combinations (odds ratio = 0.43, p-value < 0.01). In this diverse sample of urban residents, outdoor PA was significantly less frequently reported than indoor PA, particularly for Black women. These findings could help inform urban PA interventions.

Exploring the distribution of park availability, features, and quality across Kansas City, Missouri by income and race/ethnicity: an environmental justice investigation

BACKGROUND

Parks are key community assets for physical activity, but some evidence suggests these resources are not equitably distributed.

PURPOSE

This study examined disparities by income and race/ethnicity in the availability, features, and quality of parks across Kansas City, Missouri.

METHODS

All parks and census tracts (CTs) were mapped using geographical information systems, and park features and quality were determined via audits. Multivariate analyses of covariance analyzed differences in park availability, features, and quality across low-, medium-, and high-income and race/ethnicity CT tertiles.

RESULTS

Low-income CTs contained significantly more parks, but also had fewer parks with playgrounds and more quality concerns per park. High minority CTs had more parks with basketball courts, but fewer parks with trails. Medium-income CTs contained more aesthetic features per park.

CONCLUSIONS

Future research should examine policies that contribute to and that might rectify disparities in park features and quality, especially in low-income and high minority areas.

Does availability of physical activity and food outlets differ by race and income? Findings from an enumeration study in a health disparate region

BACKGROUND

Low-income, ethnic/racial minorities and rural populations are at increased risk for obesity and related chronic health conditions when compared to white, urban and higher-socio-economic status (SES) peers. Recent systematic reviews highlight the influence of the built environment on obesity, yet very few of these studies consider rural areas or populations. Utilizing a CBPR process, this study advances community-driven causal models to address obesity by exploring the difference in resources for physical activity and food outlets by block group race and income in a small regional city that anchors a rural health disparate region. To guide this inquiry we hypothesized that lower income and racially diverse block groups would have fewer food outlets, including fewer grocery stores and fewer physical activity outlets. We further hypothesized that walkability, as defined by a computed walkability index, would be lower in the lower income block groups.

METHODS

Using census data and GIS, base maps of the region were created and block groups categorized by income and race. All food outlets and physical activity resources were enumerated and geocoded and a walkability index computed. Analyses included one-way MANOVA and spatial autocorrelation.

RESULTS

In total, 49 stores, 160 restaurants and 79 physical activity outlets were enumerated. There were no differences in the number of outlets by block group income or race. Further, spatial analyses suggest that the distribution of outlets is dispersed across all block groups.

CONCLUSIONS

Under the larger CPBR process, this enumeration study advances the causal models set forth by the community members to address obesity by providing an overview of the food and physical activity environment in this region. This data reflects the food and physical activity resources available to residents in the region and will aid many of the community-academic partners as they pursue intervention strategies targeting obesity.

Assessing urban walking trail use and changes in the trail environment using systematic observational protocols

This study evaluated the extent to which two systematic observation protocols which were modified for underserved communities (low income, minorities) could be utilized to reliably assess (a) use of walking trails and (b) physical environmental features of these trails. This study was a supplement to the Positive Action for Today's Health (PATH) walking trial. The modified tools were shown to be reliable methods for (a) measuring trail use and (b) assessing physical features of the trail in underserved environments. Reliability data for measuring trail use were found to be high (ICC=.98, p<.01). Reliabilities for measuring features of the trail ranged from fair to highly reliable (κ=.77-1.00; ICC=.34-1.00). The observation tools that were customized for this study were shown to be reliable instruments for measuring trail use and assessing physical features of walking trails in underserved communities.

A framework for understanding modifications to measures for diverse populations

OBJECTIVE

Research on health disparities and determinants of health disparities among ethnic minorities and vulnerable older populations necessitates use of self-report measures. Most established instruments were developed on mainstream populations and may need adaptation for research with diverse populations. Although information is increasingly available on various problems using these measures in diverse groups, there is little guidance on how to modify the measures. A framework of issues to consider when modifying measures for diverse populations is presented.

METHODS

The authors describe reasons for considering modifications, the types of information that can be used as a basis for making modifications, and the types of modifications researchers have made. Recommendations are made to test modified measures to assure their appropriateness, and suggestions are provided on reporting modifications in publications using the measures.

DISCUSSION

The issues open a dialogue about what appropriate guidelines would be for researchers adapting measures in studies of ethnically diverse populations.

Development and testing of a community stakeholder park audit tool

BACKGROUND

Parks are valuable community resources, and auditing park environments is important for understanding their influence on physical activity and health. However, few tools exist that engage citizens in this process.

PURPOSE

The purpose of this study was to develop a user-friendly tool that would enable diverse stakeholders to quickly and reliably audit community parks for their potential to promote physical activity. A secondary aim was to examine community stakeholders' reactions to the process of developing and using the new tool.

METHODS

The study employed a sequential, multiphase process including three workshops and field testing to ensure the new instrument was the product of input and feedback from a variety of potential stakeholders and was psychometrically sound. All study stages, including data collection and analysis, occurred in 2010.

RESULTS

Stakeholder recommendations were combined with reviews of existing instruments to create the new Community Park Audit Tool (CPAT). The CPAT contains four sections titled Park Information, Access and Surrounding Neighborhood, Park Activity Areas, and Park Quality and Safety. Inter-rater analyses demonstrated strong reliability for the vast majority of the items in the tool. Further, stakeholders reported a range of positive reactions resulting from their engagement in the project.

CONCLUSIONS

The CPAT provides a reliable and user-friendly means of auditing parks for their potential to promote physical activity. Future use of the CPAT can facilitate greater engagement of diverse groups in evaluating and advocating for improved parks and overall healthy community design.

Environmental perceptions and objective walking trail audits inform a community-based participatory research walking intervention

BACKGROUND

Given the documented physical activity disparities that exist among low-income minority communities and the increased focused on socio-ecological approaches to address physical inactivity, efforts aimed at understanding the built environment to support physical activity are needed. This community-based participatory research (CBPR) project investigates walking trails perceptions in a high minority southern community and objectively examines walking trails. The primary aim is to explore if perceived and objective audit variables predict meeting recommendations for walking and physical activity, MET/minutes/week of physical activity, and frequency of trail use.

METHODS

A proportional sampling plan was used to survey community residents in this cross-sectional study. Previously validated instruments were pilot tested and appropriately adapted and included the short version of the validated International Physical Activity Questionnaire, trail use, and perceptions of walking trails. Walking trails were assessed using the valid and reliable Path Environmental Audit Tool which assesses four content areas including: design features, amenities, maintenance, and pedestrian safety from traffic. Analyses included Chi-square, one-way ANOVA's, multiple linear regression, and multiple logistic models.

RESULTS

Numerous (n = 21) high quality walking trails were available. Across trails, there were very few indicators of incivilities and safety features rated relatively high. Among the 372 respondents, trail use significantly predicted meeting recommendations for walking and physical activity, and MET/minutes/week. While controlling for other variables, significant predictors of trail use included proximity to trails, as well as perceptions of walking trail safety, trail amenities, and neighborhood pedestrian safety. Furthermore, while controlling for education, gender, and income; for every one time per week increase in using walking trails, the odds for meeting walking recommendations increased 1.27 times, and the odds for meeting PA recommendation increased 3.54 times. Perceived and objective audit variables did not predict meeting physical activity recommendations.

CONCLUSIONS

To improve physical activity levels, intervention efforts are needed to maximize the use of existing trails, as well as improve residents' perceptions related to incivilities, safety, conditions of trail, and amenities of the walking trails. This study provides important insights for informing development of the CBPR walking intervention and informing local recreational and environmental policies in this southern community.

Physical activity patterns by campus housing status among African American female college students

Physical activity protects against heart disease, diabetes, high blood pressure, obesity, and cancer. Fewer than 40% of African American women obtain recommended amounts of physical activity. Healthy Campus 2010 identifies physical activity as a top priority for improving the health of college students. However, during college, women tend to reduce their levels of physical activity. This study examines the relationship between campus housing and physical activity behaviors in a sample of African American female college students (N = 138). Participants who lived on campus were significantly more likely to meet the recommended amounts of both moderate and vigorous physical activity than students who lived off campus (44% vs. 19%). The results demonstrate the importance of campus fitness resources in explaining the role that the built environment can play in increased physical activity among this population. Recommendations for the use of the campus's built environment and fitness resources are provided.