Longitudinal associations with changes in outdoor recreation area use for physical activity during a community-based intervention

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.

An ecological momentary assessment study of physical activity behaviors among mothers of toddlers from low-income households

Background

Mothers of young children from low-income communities may be vulnerable to barriers associated with low physical activity. The purpose of this study was to examine associations between home environment factors and maternal physical activity among mothers of toddlers.

Methods

Mothers of toddlers (n = 200) recruited from low-income communities simultaneously wore an ankle-placed accelerometer and were given a personal digital assistant for ecological momentary assessment. Mothers received randomly prompted questions about their current environment, activity, and social setting several times a day over eight consecutive days. Data were analyzed using linear mixed-effects regression models with random intercepts; within-group and between-group relations between physical activity and environment factors were disaggregated.

Results

Within-group relations included higher physical activity counts for specific mothers with television off versus on (95% CI = 130.45, 199.17), children absent versus present (95% CI = 82.00, 3.43), engaging with a child versus not (95% CI = 52.66, 127.63), and outside versus inside location (95% CI = 277.74, 392.67). Between-group relations included higher physical activity on average when other adults were absent versus present (95% CI = − 282.63, − 46.95). Recruitment site (urban vs. semi-urban) significantly moderated the within-group relation between being outside versus inside and activity count (β = − 243.12, 95% CI = − 358.74, − 127.47), and showed stronger relations among urban mothers (β = 440.33, 95% CI = 358.41, 522.25), than semi-urban (β = 190.37, 95% CI = 109.64, 271.11). Maternal body weight significantly moderated the within-group relation between being located outside versus inside the home and activity count (β for interaction = − 188.67, 95% CI = − 308.95, − 68.39), with a stronger relation among mothers with normal weight (β = 451.62, 95% CI = 345.51, 557.73), than mothers with overweight/obesity (β = 271.95, 95% CI = 204.26, 339.64).

Conclusions

This study highlights home environmental factors, including screen time, the presence of others (adults and children), and location (i.e., outside versus inside) that may relate to maternal physical activity behaviors. Understanding factors associated with physical activity could reduce physical activity disparities.

Trial registry ClinicalTrials. NCT02615158, April 2006

Impact of Different Types of Physical Activity in Green Urban Space on Adult Health and Behaviors: A Systematic Review

This systematic review aimed to investigate the type of physical activity carried out in green urban spaces by the adult population and to value its impact on the population’s health. Additionally, another purpose was to examine if the presence of outdoor gyms in green urban spaces can promote participation in physical activity among adults. Searches of electronic databases, with no time restrictions and up to June 2020, resulted in 10 studies meeting the inclusion criteria. A quantitative assessment is reported as effect size. Many people practiced walking activity as a workout, which showed improvements in health. Walking is the most popular type of training due to its easy accessibility and it not requiring equipment or special skills. Outdoor fitness equipment has been installed in an increasing number of parks and has become very popular worldwide. Further, outdoor fitness equipment provides free access to fitness training and seems to promote physical activity in healthy adults. However, other studies about outdoor fitness equipment efficiency are needed. People living near to equipped areas are more likely to perform outdoor fitness than those who live further away. The most common training programs performed in green urban spaces included exercises with free and easy access, able to promote physical health and perception.

Inequities and inequalities in outdoor walking groups: a scoping review

Background

Outdoor walking groups are widely-used programmes aimed at improving physical activity and health outcomes. Despite being promoted as accessible and inclusive, emerging work highlights participation biases based on gender, age and socioeconomic status, for example. To explicate the impact of outdoor walking groups on physical activity inequities, we conducted a scoping review of published outdoor walking group literatures. Specifically, we critically examined: (a) equity integration strategies; (b) intervention reach; (c) effectiveness; and (d) potential social determinants of engagement relating to the World Health Organization’s conceptual framework.

Methods

Arksey and O’Malley’s scoping review protocol was used to develop a comprehensive search strategy and identify relevant academic and grey literatures, which were screened using pre-defined inclusion and exclusion criteria. Data were organised by Cochrane PROGRESS-Plus equity characteristics and a narrative summary was presented for each thematic area.

Findings

Sixty-two publications were included. Key findings were: (a) some evidence of targeted intervention trials. Large-scale national programmes were tailored to regional activity and health needs, which may contribute toward addressing inequities. However, participant demographics seldom informed reported analyses; (b) participation was more likely among white, more socioeconomically advantaged, middle-to-older aged, female and able-bodied adults; (c) positive physical and psychological outcomes were unlikely to extend along social gradients; and (d) interventions primarily addressed intermediary determinants (e.g. psychosocial barriers; material resource). Social capital (e.g. friend-making) was identified as potentially important for addressing physical activity inequalities.

Conclusions

The published literature on outdoor walking groups leaves unanswered questions regarding participation inequalities, with implications for future physical activity promotion. Currently, participation in outdoor walking groups is typically more prevalent among advantaged subpopulations. We make recommendations for research and practice to address these issues, as well as aid the translation of existing knowledge into practice. We advocate increased focus on the social determinants of engagement. A more consistent approach to collecting and analysing participant socio-demographic data is required. Our findings also support recommendations that appropriate tailoring of universal programmes to community needs and embedding strategies to increase social cohesion are important in developing equitable programmes.

Objectively measured active travel and uses of activity-friendly neighborhood resources: Does change in use relate to change in physical activity and BMI?

Few studies examine how objectively measured use of local physical activity resources contributes to objectively-measured healthy physical activity and weight changes over time. We utilized objective measures to test whether changes in active travel and uses of three physical activity (PA) resources–parks, recreation centers, and transit– related to changes in PA and BMI. Adults (n = 536) in Salt Lake City, UT, wore accelerometer and GPS units in 2012 and 2013, before and after neighborhood rail completion. Regression outcomes included accelerometer counts per minute (cpm), MVPA (moderate-to-vigorous activity minutes/10 h accelerometer wear) and measured BMI; key predictors were changes in active travel and PA resource uses (former and new uses). Significant results (all p < 0.05) showed that increased active travel related to increased total PA (59.86 cpm and 8.50 MVPA); decreased active travel related to decreased MVPA (− 3.01 MVPA). Poorer outcomes were seen after discontinuing use of parks (− 36.29 cpm, − 5.73 MVPA, and + 0.44 BMI points), recreation centers (− 6.18 MVPA), and transit (− 48.14 cpm, − 5.43 MVPA, and + 0.66 BMI). Healthier outcomes were seen after commencing use of parks (29.83 cpm, 5.25 MVPA), recreation centers (44.63 cpm) and transit (38.44 cpm, 4.17 MVPA, and − 0.56 BMI). Transit and park/recreational center uses were unrelated, although park users were more likely to be recreation center users. Active travel and use of three neighborhood PA resources relate to healthy activity and could be fostered by policy and design.

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GPS & accelerometer measures show active travel changes relate to PA changes.

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Increasing park, recreation center, or transit uses relates to more PA.

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Decreasing park, recreation center, or transit uses relates to less PA.

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Changing transit use does not change park or recreation use, and vice versa.

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Policy should enhance active transportation and tie it to recreation options.