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Ganzar LA, Burford K, Salvo D, Spoon C, Sallis JF, Hoelscher DM. Development, scoring, and reliability for the Microscale Audit of Pedestrian Streetscapes for Safe Routes to School (MAPS-SRTS) instrument. BMC Public Health 2024; 24:722. [PMID: 38448838 PMCID: PMC10916041 DOI: 10.1186/s12889-024-18202-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 02/24/2024] [Indexed: 03/08/2024] Open
Abstract
BACKGROUND Active commuting to school can be a meaningful contributor to overall physical activity in children. To inform better micro-level urban design near schools that can support active commuting to school, there is a need for measures that capture these elements. This paper describes the adaptation of an observational instrument for use in assessing micro-scale environments around urban elementary schools in the United States. METHODS The Micro-scale Audit of Pedestrian Streetscapes for Safe Routes to School (MAPS-SRTS) was developed from existing audit instruments not designed for school travel environments and modifications for the MAPS-SRTS instrument include the structure of the audit tool sections, the content, the observation route, and addition of new subscales. Subscales were analyzed for inter-rater reliability in a sample of 36 schools in Austin, TX. To assess reliability for each subscale, one-way random effects single-measure intraclass correlation coefficients (ICC) were used. RESULTS Compared to the 30 original subscales, the adapted MAPS-SRTS included 26 (86.6%) subscales with revised scoring algorithms. Most MAPS-SRTS subscales had acceptable inter-rater reliability, with an ICC of 0.97 for the revised audit tool. CONCLUSIONS The MAPS-SRTS audit tool is a reliable instrument for measuring the school travel environment for research and evaluation purposes, such as assessing human-scale determinants of active commuting to school behavior and documenting built environment changes from infrastructure interventions.
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Affiliation(s)
- Leigh Ann Ganzar
- Michael and Susan Dell Center for Healthy Living, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health Austin Campus, Austin, TX, 78701, USA.
| | - Katie Burford
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, 722 West 168th Street, New York, NY, 10031, US
| | - Deborah Salvo
- Department of Kinesiology and Health Education, College of Education, The University of Texas in Austin, Austin, TX, USA
| | - Chad Spoon
- University of California San Diego, La Jolla, CA, USA
| | - James F Sallis
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, CA, USA
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
| | - Deanna M Hoelscher
- Michael and Susan Dell Center for Healthy Living, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health Austin Campus, Austin, TX, 78701, USA
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2
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Sanz-Mas M, Ubalde-López M, Borràs S, Brugueras S, Continente X, Daher C, Marí-Dell'Olmo M, López MJ. Adapting Schools to Climate Change with Green, Blue, and Grey Measures in Barcelona: Study Protocol of a Mixed-Method Evaluation. J Urban Health 2024; 101:141-154. [PMID: 38236429 PMCID: PMC10897086 DOI: 10.1007/s11524-023-00814-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/07/2023] [Indexed: 01/19/2024]
Abstract
Under the framework of the Urban Innovative Actions program of the European Commission, in 2020, 11 primary schools in Barcelona were transformed into climate shelters by implementing green, blue, and grey measures. Schoolyards were also opened to the local community to be used during non-school periods. Here we present the study protocol of a mixed-method approach to evaluate the effectiveness of the interventions in terms of improving environmental quality and health for users. We evaluated school level through the following: (1) quantitative pre-post quasi-experimental study, and (2) qualitative evaluation. The quantitative study included measures of (a) environmental variables (collected via low-cost and non-low-cost sensors), (b) students' health and well-being (collected via health questionnaires, attention levels test, and systematic observations), and (c) teachers' health and well-being (collected via thermal comfort measurements and health questionnaires). The qualitative methods evaluated the perceptions about the effects of the interventions among students (using Photovoice) and teachers (through focus groups). The impact of the interventions was assessed at community level during summer non-school periods through a spontaneous ethnographic approach. Data collection started in August 2019 and ended in July 2022. The evaluation provides the opportunity to identify those solutions that worked and those that need to be improved for future experiences, as well as improve the evaluation methodology and replication for these kinds of interventions.
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Affiliation(s)
- Marta Sanz-Mas
- Agència de Salut Pública de Barcelona (ASPB), Pl. Lesseps 1, 08023, Barcelona, Spain
- Departament de Ciències Experimentals i de La Salut (DCEXS), Universitat Pompeu Fabra, Doctor Aiguader 88, 08003, Barcelona, Spain
| | - Mònica Ubalde-López
- Departament de Ciències Experimentals i de La Salut (DCEXS), Universitat Pompeu Fabra, Doctor Aiguader 88, 08003, Barcelona, Spain
- ISGlobal, Barcelona Institute for Global Health, Doctor Aiguader 88, 08003, Barcelona, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Av. Monforte de Lemos 3-5, Pabellón 11, Planta 0, 28029, Madrid, Spain
| | - Sílvia Borràs
- ISGlobal, Barcelona Institute for Global Health, Doctor Aiguader 88, 08003, Barcelona, Spain
| | - Sílvia Brugueras
- Agència de Salut Pública de Barcelona (ASPB), Pl. Lesseps 1, 08023, Barcelona, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Av. Monforte de Lemos 3-5, Pabellón 11, Planta 0, 28029, Madrid, Spain
| | - Xavier Continente
- Agència de Salut Pública de Barcelona (ASPB), Pl. Lesseps 1, 08023, Barcelona, Spain.
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Av. Monforte de Lemos 3-5, Pabellón 11, Planta 0, 28029, Madrid, Spain.
- Institut de Recerca Sant Pau (IR SANT PAU), Sant Quintí 77-79, 08041, Barcelona, Spain.
| | - Carolyn Daher
- Departament de Ciències Experimentals i de La Salut (DCEXS), Universitat Pompeu Fabra, Doctor Aiguader 88, 08003, Barcelona, Spain
- ISGlobal, Barcelona Institute for Global Health, Doctor Aiguader 88, 08003, Barcelona, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Av. Monforte de Lemos 3-5, Pabellón 11, Planta 0, 28029, Madrid, Spain
| | - Marc Marí-Dell'Olmo
- Agència de Salut Pública de Barcelona (ASPB), Pl. Lesseps 1, 08023, Barcelona, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Av. Monforte de Lemos 3-5, Pabellón 11, Planta 0, 28029, Madrid, Spain
- Institut de Recerca Sant Pau (IR SANT PAU), Sant Quintí 77-79, 08041, Barcelona, Spain
| | - María José López
- Agència de Salut Pública de Barcelona (ASPB), Pl. Lesseps 1, 08023, Barcelona, Spain
- Departament de Ciències Experimentals i de La Salut (DCEXS), Universitat Pompeu Fabra, Doctor Aiguader 88, 08003, Barcelona, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Av. Monforte de Lemos 3-5, Pabellón 11, Planta 0, 28029, Madrid, Spain
- Institut de Recerca Sant Pau (IR SANT PAU), Sant Quintí 77-79, 08041, Barcelona, Spain
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3
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Karaba Bäckström M, Lundgreen E, Slaug B. Mitigating the effects of climate change in children's outdoor play environments. Scand J Occup Ther 2024; 31:1-13. [PMID: 38014493 DOI: 10.1080/11038128.2023.2275697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Accepted: 10/23/2023] [Indexed: 11/29/2023]
Abstract
BACKGROUND For many children, public playgrounds represent environments that are playful and important in developing good health. Without efforts to facilitate climate change adaptation of outdoor playgrounds there may be a negative impact on children's health and well-being. AIM With a special focus on play value, to explore the reasoning and described strategies among professionals responsible for development, planning and solutions concerning outdoor playgrounds in the context of climate change. MATERIALS AND METHODS Eight semi-structured interviews were held with purposefully selected interviewees. Analysis was conducted with manifest content analysis. RESULTS Four themes with supporting categories; 1: a new design paradigm for outdoor play environments, 2: a need for updated regulation- and security guidelines for outdoor play environments, 3: nature-based play environments are more climate change resilient, and 4: maintenance and construction of nature-based outdoor play environments. The findings showed an overall awareness and a will to use innovative and nature-based strategies and planning to deal with climate change implications for outdoor play environments. CONCLUSIONS AND SIGNIFICANCE The findings suggest that the strategies employed lean towards implementation of increased ecosystem services and natural elements. Ensuring strengthened resilience against hazardous climate change effects may positively facilitate diverse play activities with high play value.
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Affiliation(s)
| | | | - Björn Slaug
- Faculty of Medicine, Lund University, Lund, Sweden
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4
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Haakenstad MK, Butcher MB, Noonan CJ, Fyfe-Johnson AL. Outdoor Time in Childhood: A Mixed Methods Approach to Identify Barriers and Opportunities for Intervention in a Racially and Ethnically Mixed Population. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:7149. [PMID: 38131701 PMCID: PMC10743276 DOI: 10.3390/ijerph20247149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 10/25/2023] [Accepted: 11/20/2023] [Indexed: 12/23/2023]
Abstract
A growing body of literature suggests that outdoor time is beneficial for physical and mental health in childhood. Profound disparities exist in access to outdoor spaces (and the health benefits thereof) for children in communities of color. The objectives of this research were to: (1) identify challenges and solutions to outdoor time for children; (2) assess the importance of outdoor time for children; and (3) evaluate results stratified by race/ethnicity. Using a convergent mixed methods approach, we conducted a thematic analysis from 14 focus groups (n = 50) with outdoor educators, parents with children attending outdoor preschools, and community members with children. In addition, 49 participants completed a survey to identify challenges and solutions, perceived importance, and culturally relevant perspectives of outdoor time. The main challenges identified for outdoor time were safety concerns, inclement weather, lack of access to outdoor spaces, and parent work schedules. The primary proposed solution was integrating outdoor time into the school day. Nearly all participants, independent of racial identity, reported that outdoor time improved physical and mental health. Overall outdoor time was lower in participants from communities of color (~8 h/week) compared to their White counterparts (~10 h/week). While 50% of people of color (POC) reported that outdoor time was an important cultural value, only 18% reported that people in their respective culture spent time outside. This work contributes to accumulating knowledge that unique barriers to outdoor time exist for communities of color, and the children that live, learn, and play in these communities. Increasing outdoor time in school settings offers a potential solution to reduce identified barriers and to promote health equity in childhood.
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Affiliation(s)
- Magdalena K. Haakenstad
- Institute for Research and Education to Advance Community Health, Elson S. Floyd College of Medicine, Washington State University, Seattle, WA 98101, USA; (M.K.H.); (C.J.N.)
| | - Maria B. Butcher
- Elson S. Floyd College of Medicine, Washington State University, Spokane, WA 99202, USA;
| | - Carolyn J. Noonan
- Institute for Research and Education to Advance Community Health, Elson S. Floyd College of Medicine, Washington State University, Seattle, WA 98101, USA; (M.K.H.); (C.J.N.)
| | - Amber L. Fyfe-Johnson
- Institute for Research and Education to Advance Community Health, Elson S. Floyd College of Medicine, Washington State University, Seattle, WA 98101, USA; (M.K.H.); (C.J.N.)
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5
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Jabeen A, Afzal MS, Pathan SA. A Review of the Role of Built Environment and Temperature in the Development of Childhood Obesity. Cureus 2023; 15:e49657. [PMID: 38161805 PMCID: PMC10756253 DOI: 10.7759/cureus.49657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/29/2023] [Indexed: 01/03/2024] Open
Abstract
The burden of obesity is rising globally and is studied widely, yet the evidence for the association of environmental factors (both built and natural) with childhood obesity remains inconsistent. A relation with temperature as a proxy for natural environmental factors for obesity has not been reviewed previously. The purpose of this review was to assimilate updated evidence on environmental factors of childhood obesity. Three databases, MEDLINE (Medical Literature Analysis and Retrieval System Online), Web of Science, and Cochrane, were searched for articles related to the effect of built environment and temperature on childhood obesity in 6-12-year-olds published in the last five years. Twelve studies were identified: four longitudinal and eight cross-sectional. The studies were appraised using the National Institute of Health Quality (NIH) Assessment Tool. A review of included studies showed that built environmental features like higher residential and population density, higher intersection density, more playgrounds, and all park features like the presence or availability of parks, high number of parks, proximity to parks, and an increased park land area, showed a protective association against childhood obesity while land use mix showed a promoting association for the development of childhood obesity. Inconclusive evidence was observed for other built environmental features. The search strategy did not retrieve any literature published in the past five years studying the association between temperature and the development of childhood obesity. Standardization of definitions of exposure and outcome measures is recommended. Further research studying the relationship between environmental temperature and the development of childhood obesity is recommended.
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Affiliation(s)
- Atika Jabeen
- Public Health, London School of Hygiene & Tropical Medicine, University of London, London, GBR
- Emergency Department, Hamad Medical Corporation, Doha, QAT
| | | | - Sameer A Pathan
- Emergency Department, Hamad Medical Corporation, Doha, QAT
- Emergency Medicine, Blizard Institute, Queen Mary University of London, London, GBR
- Emergency Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, AUS
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6
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Husain S, Morales KH, Williamson AA, Mayne SL, Fiks AG, Basner M, Dinges DF, Zemel BS, Mitchell JA. The neighborhood environment and sleep health in adolescents. Sleep Health 2023; 9:512-518. [PMID: 37391278 PMCID: PMC10524795 DOI: 10.1016/j.sleh.2023.05.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 04/17/2023] [Accepted: 05/13/2023] [Indexed: 07/02/2023]
Abstract
OBJECTIVE Neighborhood-level factors, including education, health and environment, and socioeconomic exposures, are important contextual determinants of child health. We explored whether these factors, measured via the Childhood Opportunity Index 2.0, were associated with sleep health in adolescents. METHODS Actigraphy was used to assess sleep duration, timing, and efficiency among 110 adolescents in eighth (13.9 (0.4)) and ninth (14.9 (0.4)) grade. Home addresses were geocoded and linked to Childhood Opportunity Index 2.0 scores (including 3 subtype scores and the 29 individual factor Z-scores). Mixed-effects linear regression was used to determine associations between the Childhood Opportunity Index 2.0 scores and the sleep outcomes, adjusting for sex, race, parent education, household income, school grade and weeknight status. Interactions were also tested by school grade, weeknight status, sex, and race. RESULTS No associations were observed between overall or subtype scores with sleep outcomes in adolescents. However, we detected associations between select individual Childhood Opportunity Index 2.0 Z-scores, spanning health & environment and education domains, and sleep outcomes. For example, greater fine particulate matter was associated with later timing of sleep onset and offset; ozone concentration was associated with earlier sleep onset and offset; greater exposure to extreme temperature was associated with later sleep onset and offset and increased odds of optimal sleep efficiency. CONCLUSIONS Specific neighborhood factors indexed by the Childhood Opportunity Index 2.0 were associated with sleep health among adolescents. In particular, neighborhood air quality measures were associated with sleep timing and efficiency, warranting further investigation.
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Affiliation(s)
- Sana Husain
- Division of Gastroenterology, Hepatology and Nutrition, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Knashawn H Morales
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Ariel A Williamson
- Center for Pediatric Clinical Effectiveness, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA; Sleep Center, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA; Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA; Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA; Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Stephanie L Mayne
- Center for Pediatric Clinical Effectiveness, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA; Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Alexander G Fiks
- Center for Pediatric Clinical Effectiveness, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA; Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Mathias Basner
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - David F Dinges
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Babette S Zemel
- Division of Gastroenterology, Hepatology and Nutrition, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA; Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Jonathan A Mitchell
- Division of Gastroenterology, Hepatology and Nutrition, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA; Center for Pediatric Clinical Effectiveness, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA; Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
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7
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Koepp AE, Lanza K, Byrd-Williams C, Bryan AE, Gershoff ET. Ambient Temperature Increases and Preschoolers' Outdoor Physical Activity. JAMA Pediatr 2023; 177:539-540. [PMID: 36939692 PMCID: PMC10028534 DOI: 10.1001/jamapediatrics.2023.0067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 12/29/2022] [Indexed: 03/21/2023]
Abstract
This cross-sectional study evaluates the association of high outdoor temperatures with children’s engagement in physical activity during play.
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Affiliation(s)
- Andrew E. Koepp
- Department of Human Development and Family Sciences, University of Texas at Austin, Austin, Texas
| | - Kevin Lanza
- Michael and Susan Dell Center for Healthy Living at The University of Texas Health Science Center, Houston School of Public Health Austin Campus, Austin, Texas
| | - Courtney Byrd-Williams
- Michael and Susan Dell Center for Healthy Living at The University of Texas Health Science Center, Houston School of Public Health Austin Campus, Austin, Texas
| | - Amy E. Bryan
- Department of Human Development and Family Sciences, University of Texas at Austin, Austin, Texas
| | - Elizabeth T. Gershoff
- Department of Human Development and Family Sciences, University of Texas at Austin, Austin, Texas
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Guo C, Lanza K, Li D, Zhou Y, Aunan K, Loo BPY, Lee JKW, Luo B, Duan X, Zhang W, Zhang Z, Lin S, Zhang K. Impact of heat on all-cause and cause-specific mortality: A multi-city study in Texas. ENVIRONMENTAL RESEARCH 2023; 224:115453. [PMID: 36773641 DOI: 10.1016/j.envres.2023.115453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 02/05/2023] [Accepted: 02/08/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Studies on the health effects of heat are particularly limited in Texas, a U.S. state in the top 10 highest number of annual heat-related deaths per capita from 2018 to 2020. This study assessed the effects of heat on all-cause and cause-specific mortality in 12 metropolitan statistical areas (MSAs) across Texas from 1990 to 2011. METHODS First, we determined the heat thresholds for each MSA above which the relation between temperature and mortality is linear. We then conducted a distributed lag non-linear model for each MSA, followed by a random effects meta-analysis to estimate the pooled effects for all MSAs. We repeated this process for each mortality cause and age group to achieve the effect estimates. RESULTS We found a 1 °C temperature increase above the heat threshold is associated with an increase in the relative risk of all-cause mortality of 0.60% (95%CI [0.39%, 0.82%]) and 1.10% (95%CI [0.65%, 1.56%]) for adults older than 75. For each MSA, the relative risk of mortality for a 1 °C temperature increase above the heat threshold ranges from 0.10% (95%CI [0.09%, 0.10%]) to 1.29% (95%CI [1.26%, 1.32%]). Moreover, elevated temperatures showed a slight decrease in cardiovascular mortality (0.37%, 95%CI [-0.35%, 1.09%]) and respiratory disease (1.97%, 95%CI [-0.11%, 4.08%]), however this effect was not considered statistically significant.. CONCLUSION Our study found that high temperatures can significantly impact all-cause mortality in Texas, and effect estimates differ by MSA, age group, and cause of death. Our findings generate critical information on the impact of heat on mortality in Texas, providing insights for policymakers on resource allocation and strategic intervention to reduce heat-related health effects.
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Affiliation(s)
- Chunyu Guo
- Department of Economics, School of Art and Science, University at Albany, State University of New York, Albany, NY, USA
| | - Kevin Lanza
- Department of Epidemiology, Human Genetics, & Environmental Sciences, School of Public Health in Austin, The University of Texas Health Science Center at Houston, Austin, TX, USA
| | - Dongying Li
- Department of Landscape Architecture and Urban Planning, Texas A&M University, College Station, TX, USA
| | - Yuyu Zhou
- Department of Geological and Atmospheric Sciences, Iowa State University, Ames, IA, USA
| | - Kristin Aunan
- CICERO Center for International Climate Research, N-0318, Oslo, Norway
| | - Becky P Y Loo
- Department of Geography, Faculty of Social Sciences, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Jason Kai Wei Lee
- Heat Resilience and Performance Centre, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Campus for Research Excellence and Technological Enterprise (CREATE), Singapore
| | - Bin Luo
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, Gansu, China
| | - Xiaoli Duan
- School of Energy and Environmental Engineering, University of Science and Technology Beijing, Beijing, China
| | - Wangjian Zhang
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Zhengjun Zhang
- Department of Statistics, University of Wisconsin-Madison, WI, USA
| | - Shao Lin
- Department of Environmental Health Sciences, School of Public Health, University at Albany, State University of New York, Rensselaer, NY, 12144, USA
| | - Kai Zhang
- Department of Environmental Health Sciences, School of Public Health, University at Albany, State University of New York, Rensselaer, NY, 12144, USA.
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9
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Stowell JD, Sun Y, Spangler KR, Milando CW, Bernstein A, Weinberger KR, Sun S, Wellenius GA. Warm-season temperatures and emergency department visits among children with health insurance. ENVIRONMENTAL RESEARCH, HEALTH : ERH 2023; 1:015002. [PMID: 36337257 PMCID: PMC9623446 DOI: 10.1088/2752-5309/ac78fa] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 05/17/2022] [Accepted: 06/15/2022] [Indexed: 01/25/2023]
Abstract
High ambient temperatures have become more likely due to climate change and are linked to higher rates of heat-related illness, respiratory and cardiovascular diseases, mental health disorders, and other diseases. To date, far fewer studies have examined the effects of high temperatures on children versus adults, and studies including children have seldom been conducted on a national scale. Compared to adults, children have behavioral and physiological differences that may give them differential heat vulnerability. We acquired medical claims data from a large database of commercially insured US children aged 0-17 from May to September (warm-season) 2016-2019. Daily maximum ambient temperature and daily mean relative humidity estimates were aggregated to the county level using the Parameter-elevation Relationships on Independent Slopes dataset, and extreme heat was defined as the 95th percentile of the county-specific daily maximum temperature distribution. Using a case-crossover design and temperature lags 0-5 days, we estimated the associations between extreme heat and cause-specific emergency department visits (ED) in children aged <18 years, using the median county-specific daily maximum temperature distribution as the reference. Approximately 1.2 million ED visits in children from 2489 US counties were available during the study period. The 95th percentile of warm-season temperatures ranged from 71 °F to 112 °F (21.7 °C to 44.4 °C). Comparing 95th to the 50th percentile, extreme heat was associated with higher rates of ED visits for heat-related illness; endocrine, nutritional and metabolic diseases; and otitis media and externa, but not for all-cause admissions. Subgroup analyses suggested differences by age, with extreme heat positively associated with heat-related illness for both the 6-12 year (odds ratio [OR]: 1.34, 95% confidence interval [CI]: 1.16, 1.56) and 13-17 year age groups (OR: 1.55, 95% CI: 1.37, 1.76). Among children with health insurance across the US, days of extreme heat were associated with higher rates of healthcare utilization. These results highlight the importance of individual and population-level actions to protect children and adolescents from extreme heat, particularly in the context of continued climate change.
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Affiliation(s)
- Jennifer D Stowell
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, United States of America
| | - Yuantong Sun
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, United States of America
| | - Keith R Spangler
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, United States of America
| | - Chad W Milando
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, United States of America
- Optum Labs Visiting Scholar, Eden Prairie, MN, United States of America
| | - Aaron Bernstein
- Boston Children’s Hospital, Boston, MA, United States of America
| | - Kate R Weinberger
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Shengzhi Sun
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, United States of America
- Optum Labs Visiting Scholar, Eden Prairie, MN, United States of America
| | - Gregory A Wellenius
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, United States of America
- Optum Labs Visiting Scholar, Eden Prairie, MN, United States of America
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10
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Heat-Resilient Schoolyards: Relations Between Temperature, Shade, and Physical Activity of Children During Recess. J Phys Act Health 2023; 20:134-141. [PMID: 36640783 DOI: 10.1123/jpah.2022-0405] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 11/03/2022] [Accepted: 11/07/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Extreme heat may discourage physical activity of children while shade may provide thermal comfort. The authors determined the associations between ambient temperature, shade, and moderate to vigorous physical activity (MVPA) of children during school recess. METHODS Children aged 8-10 (n = 213) wore accelerometers and global positioning system monitors during recess at 3 school parks in Austin, Texas (September-November 2019). Weather data originated from 10 sensors per park. The authors calculated shade from imagery using a geographic information system (GIS) and time-matched physical activity, location, temperature, and shade data. The authors specified piecewise multilevel regression to assess relations between average temperature and percentage of recess time in MVPA and shade. RESULTS Temperature ranged 11 °C to 35 °C. Each 1 °C higher temperature was associated with a 0.7 percentage point lower time spent in MVPA, until 33 °C (91 °F) when the association changed to a 1.5 lower time (P < .01). Each 1 °C higher temperature was associated with a 0.3 percentage point higher time spent under shade, until 33 °C when the association changed to a 3.4 higher time (P < .001). At 33 °C or above, the direct association between shade and MVPA weakened (P < .05), with no interaction effect above 33 °C (P > .05). Children at the park with the most tree canopy spent 6.0 percentage points more time in MVPA (P < .01). CONCLUSIONS Children engage in less MVPA and seek shade during extreme heat and engage in more MVPA in green schoolyards. With climate change, schools should consider interventions (eg, organizing shaded play, tree planting) to promote heat safe MVPA.
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Khader Y, Wang C, Guo X, Xu H, Qin Z, Tao L. Effects of Greenness on Myopia Risk and School-Level Myopia Prevalence Among High School-Aged Adolescents: Cross-sectional Study. JMIR Public Health Surveill 2023; 9:e42694. [PMID: 36622746 PMCID: PMC9871879 DOI: 10.2196/42694] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 11/26/2022] [Accepted: 11/28/2022] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Myopia is a serious public health issue. High school-aged adolescents in Beijing have an alarming prevalence of myopia. Therefore, determining myopia protective factors is essential. Green space has a certain association with myopia protective factors that can protect against myopia. OBJECTIVE This study aims to examine the effects of green space around schools on individual myopia risk in high school-aged adolescents and the school-level myopia prevalence. METHODS Green space was measured using the normalized difference vegetation index (NDVI). A total of 13,380 samples of 51 high schools were selected from a 2021 Beijing Municipal Health Commission survey. Adolescent myopia was defined as a spherical equivalent of ≤-1.00 diopters in the worse eye. Generalized linear mixed models with a binomial error structure were used to analyze the effects of the NDVI on personal myopia risk and adjust them by other factors, such as demographics, exposure time, and outdoor exercise. The effects of the NDVI on school-level myopia prevalence with adjusted demographics and the relative position factors of trees were analyzed through quasibinomial regression. RESULTS The overall prevalence of myopia was 80.61% (10,785/13,380, 95% CI 79.93%-81.27%). Although with a 0.1 increase in the 500 and 1000 m buffer NDVIs adjusted by demographic and other factors, the high school-aged personal myopia risk significantly dropped by 16% (odds ratio [OR] 0.84, 95% CI 0.73-0.97) and 12% (OR 0.88, 95% CI 0.79-0.99), respectively. However, only the adjusted 500 m buffer NDVI (by demographics and the position of trees) with a 0.1 increase significantly reduced the school-level myopia prevalence by 15% (OR 0.85, 95% CI 0.74-0.98). Subgroup analysis showed that the adjusted effects of the 500 m buffer NDVI are significant in schoolgirls (OR 0.82, 95% CI 0.72-0.93), juniors (OR 0.82, 95% CI 0.72-0.94), the Han nationality (OR 0.84, 95% CI 0.72-0.97), 1-year exposure (OR 0.84, 95% CI 0.71-0.99) and 3-year exposure (OR 0.78, 95% CI 0.65-0.94). CONCLUSIONS The greenness of a 500 m buffer around schools is associated with a lower personal myopia risk among adolescents and a lower prevalence of myopia in schools. With regard to prevention and control activities, green space within a 500 m buffer around schools is suggested as an independent protective factor for adolescent myopia.
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Affiliation(s)
| | - Cheng Wang
- Research Institute of Forestry, Chinese Academy of Forestry, Beijing, China
| | - Xin Guo
- Institute of School Health, Beijing Center for Disease Prevention and Control, Beijing, China.,School of Public Health, Capital Medical University, Beijing, China
| | - Huiyu Xu
- Institute of School Health, Beijing Center for Disease Prevention and Control, Beijing, China.,School of Public Health, Capital Medical University, Beijing, China
| | - Zihao Qin
- Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia
| | - Liyuan Tao
- Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, China.,Medical Examination Centre, Peking University Third Hospital, Beijing, China
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Guimarães ES, Sá AA, Soares RC, Bandeira PFR, Moreira H, Guimarães JRS, de Lima Júnior FDÓ, Gabriel RCD. Classification of the Effort Index and Biomechanical Overload in Natural Trails of UNESCO Global Geoparks-A Network Perspective of Trails of the Araripe UGG (NE Brazil). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14297. [PMID: 36361174 PMCID: PMC9658445 DOI: 10.3390/ijerph192114297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 10/16/2022] [Accepted: 10/24/2022] [Indexed: 06/16/2023]
Abstract
Natural trails in UNESCO Global Geopark territories show strong salutogenic, inclusive and interactive characteristics as potentials and opportunities for ecosystem health. It is essential to provide information to inform the hiker as to the characteristics of the environment and the attractions and challenges of the route. Based on a network analysis methodology we aimed to identify the indicators of centrality and strength of connection in order to classify the effort index and biomechanical overload of the Araripe UNESCO Global Geopark trails in Brazil. The results showed strong connection and centrality of the variables related to the biomechanical overload in the effort index. In the trail of Pontal de Cruz the altimetric variation and the surface of the ground are highlighted in the biomechanical overload that presented a horizontal course equivalent 2.6 times larger than the presented distance. In Sítio Fundão trail, the surface of the ground also stood out, increasing the exposure in 36% of the presented distance. On the Missão Velha Waterfall trail, the variable that stood out was the biomechanical overload on the knee, equivalent to a horizontal increase of 28% of the measured distance. The methodology presented sought to optimise the mapping, management and consolidation of a network of natural trails aggregated to a high geotouristic, scientific, educational, cultural and well-being potential as presented in the Araripe UGG territory.
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Affiliation(s)
- Eduardo S. Guimarães
- Department of Sport Sciences, Exercise and Health, UTAD—University of Trás-os-Montes and Alto Douro, Quinta de Prados, 5000-801 Vila Real, Portugal
- Department of Physical Education, URCA—Universidade Regional do Cariri, Araripe UNESCO Global Geopark, Rua Cel. Antônio Luiz 1161, Crato 63105-000, CE, Brazil
| | - Artur A. Sá
- Department of Geology, UTAD—University of Trás-os-Montes and Alto Douro, Quinta de Prados, 5000-801 Vila Real, Portugal
| | - Rafael C. Soares
- Araripe UNESCO Global Geopark, URCA—Universidade Regional do Cariri, Rua Carolino Sucupira, Crato 63105-000, CE, Brazil
| | - Paulo Felipe R. Bandeira
- Motor Evaluation Study, Application and Research Group—GEAPAM, URCA—Universidade Regional do Cariri, Rua Cel. Antônio Luis 1161, Crato 63105-000, CE, Brazil
| | - Helena Moreira
- Department of Sport Sciences, Exercise and Health, Research Center in Sports Sciences, Health Sciences and Human Development (CIDESD) and Centre for the Research and Technology of Agro-Environmental and Biological Sciences (CITAB), University of Trás-os-Montes and Alto Douro, Quinta de Prados, 5000-801 Vila Real, Portugal
| | - Jaqueliny R. S. Guimarães
- Department of Medicine, URCA—Universidade Regional do Cariri, Rua Cel. Antônio Luiz 1161, Crato 63105-000, CE, Brazil
| | - Francisco do Ó de Lima Júnior
- Department of Economics, URCA—Universidade Regional do Cariri, Araripe UNESCO Global Geopark, Rua Cel. Antônio Luiz 1161, Crato 63105-000, CE, Brazil
| | - Ronaldo C. D. Gabriel
- Department of Sport Sciences, Exercise and Health, Centre for the Research and Technology in Agro-Environmental and Biological Sciences (CITAB), University of Trás-os-Montes and Alto Douro, Quinta de Prados, 5000-801 Vila Real, Portugal
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Loebach J, Cox A. Playing in ' The Backyard': Environmental Features and Conditions of a Natural Playspace Which Support Diverse Outdoor Play Activities among Younger Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12661. [PMID: 36231961 PMCID: PMC9565111 DOI: 10.3390/ijerph191912661] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 09/16/2022] [Accepted: 09/21/2022] [Indexed: 06/16/2023]
Abstract
Outdoor play in nature-rich spaces has been associated with healthy development among young children. The diverse play opportunities afforded to children by natural playspaces can scaffold health benefits, appreciation of nature, and pro-environmental behaviors into adulthood. Environmental features and conditions of outdoor playspaces significantly influence the diversity and quality of play opportunities. Understanding how the physical environment can support high-quality play experiences can inform the design of stimulating, health-promoting playscapes for children. An observational behavior mapping framework was utilized to examine the environmental features of The Backyard, a large natural playscape, associated with play activities among young children. The Tool for Observing Play Outdoors was used to capture outdoor play types OPT), along with associated behavioral and environmental data, during seven days of field observation. While the playspace supported most OPTs, Physical and Exploratory play were most prevalent. Associations with activity intensity and risk play are also presented. Loose parts, particularly natural loose parts, were highly involved in most OPTs, but especially associated with Exploratory play. Ground topography showed some association with several OPTs and warrants further investigation. The environmental features of The Backyard supported an abundant and diverse range of outdoor play activities for young children and families.
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Affiliation(s)
- Janet Loebach
- Department of Human Centered Design, Cornell University, Ithaca, NY 14853, USA
| | - Adina Cox
- Department of Landscape Architecture, Iowa State University, Ames, IA 50011, USA
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Poulos A, Wilson K, Lanza K, Vanos J. A direct observation tool to measure interactions between shade, nature, and children's physical activity: SOPLAY-SN. Int J Behav Nutr Phys Act 2022; 19:127. [PMID: 36175908 PMCID: PMC9524068 DOI: 10.1186/s12966-022-01355-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 08/23/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Most physical activity (PA) during school occurs at recess; however, recess PA may be influenced by children's thermal comfort and interaction with nature, neither of which have concurrently been measured reliably in previous studies. This study tests the reliability of SOPLAY-SN, an adaption of the validated System for Observing Play and Leisure Activity in Youth (SOPLAY) to measure Shade and Nature (SN) alongside PA, and associations between children's PA and interaction with shade and nature during recess to highlight the utility of the tool. METHODS Interactions with shade and nature were measured using systematic direct observation at two playgrounds (primary-grade = ages 5-8, upper-grade = ages 9-12) during recess at an elementary school in Phoenix, Arizona (USA). Pairs conducted observations over four warm days (primary = 29-34 °C, upper-grade = 32-36 °C) in May 2021 (N = 179 scans). Intraclass correlation coefficients (ICC) were used to calculate inter-rater reliability. Mean counts, frequencies, and Kendall rank correlation coefficient tests were used to assess relations between PA level and interactions with shade and nature. RESULTS Reliability was good for sedentary behavior (ICC = 0.98); light PA (LPA; ICC = 0.80) and moderate-to-vigorous PA (MVPA; ICC = 0.94); shade interaction (ICC = 0.95); and nature interaction (ICC = 0.80) and average agreement was good (86% overall PA, 88% shade, 90% nature). Most (60%) primary-grade children were observed in the shade, with 64% under a covered play structure where children were mainly (47%) sedentary. Of the 11% of primary-grade students observed interacting with nature, 90% occurred in a grass field with trees. Among upper-grade children, 23% were observed in the shade with 53% in grass fields where 48% of play was light. Few (7%) upper-grade children were observed interacting with nature, with most instances (76%) in a grass field with trees. Among primary-grade children, shade was correlated with sedentary behavior (τb = 0.63, p < .05); LPA (τb = 0.39, p < .05); MVPA (τb = 0.56, p < .05); and nature interactions with sedentary behavior (τb = 0.16, p < .05). Among upper-grade children, shade was correlated with sedentary behavior (τb = 0.27, p < .05) and LPA (τb = 0.21, p < .05). CONCLUSIONS SOPLAY-SN is a reliable tool for measuring children's interaction with shade and nature and participation in PA. Understanding how shade and nature impact movement during recess can inform playground design for children's health and well-being.
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Affiliation(s)
- Allison Poulos
- College of Health Solutions, Arizona State University, Phoenix, AZ, USA.
| | - Kylie Wilson
- College of Health Solutions, Arizona State University, Phoenix, AZ, USA
| | - Kevin Lanza
- School of Public Health, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Jennifer Vanos
- School of Sustainability, Arizona State University, Tempe, AZ, USA
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15
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Lanza K, Gohlke J, Wang S, Sheffield PE, Wilhelmi O. Climate change and physical activity: ambient temperature and urban trail use in Texas. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2022; 66:1575-1588. [PMID: 35622168 PMCID: PMC9135991 DOI: 10.1007/s00484-022-02302-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 03/18/2022] [Accepted: 04/30/2022] [Indexed: 06/15/2023]
Abstract
Individuals in the USA are insufficiently active, increasing their chronic disease risk. Extreme temperatures may reduce physical activity due to thermal discomfort. Cooler climate studies have suggested climate change may have a net positive effect on physical activity, yet research gaps remain for warmer climates and within-day physical activity patterns. We determined the association between ambient temperatures (contemporary and projected) and urban trail use in a humid subtropical climate. At a trail in Austin, TX, five electronic counters recorded hourly pedestrian and cyclist counts in 2019. Weather data were acquired from World Weather Online. Generalized additive models estimated the association between temperature and trail counts. We then combined the estimated exposure-response relation with weather projections from climate models for intermediate (RCP4.5) and high (RCP8.5) emissions scenarios by NASA NEX-GDDP. From summer to autumn to spring to winter, hourly trail counts shifted from bimodal (mid-morning and early-evening peaks) to one mid-day peak. Pedestrians were more likely to use the trail between 7 and 27 °C (45-81°F) with peak use at 17 °C (63°F) and cyclists between 15 and 33 °C (59-91°F) with peak use at 27 °C (81°F) than at temperature extremes. A net decrease in trail use was estimated by 2041-2060 (RCP4.5: pedestrians = - 4.5%, cyclists = - 1.1%; RCP8.5: pedestrians = - 6.6%, cyclists = - 1.6%) and 2081-2100 (RCP4.5: pedestrians = - 7.5%, cyclists = - 1.9%; RCP8.5: pedestrians = - 16%, cyclists = - 4.5%). Results suggest climate change may reduce trail use. We recommend interventions for thermal comfort at settings for physical activity.
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Affiliation(s)
- Kevin Lanza
- Department of Epidemiology, Human Genetics, and Environmental Sciences, UTHealth School of Public Health in Austin, 1616 Guadalupe St, Suite 6.300, Austin, TX, 78701, USA.
| | - Julia Gohlke
- Department of Population Health Sciences, Virginia Polytechnic Institute and State University, 205 Duck Pond Drive, Blacksburg, VA, 24061, USA
| | - Suwei Wang
- Department of Population Health Sciences, Duke University, 215 Morris Street, Durham, NC, 27701, USA
| | - Perry E Sheffield
- Departments of Environmental Medicine and Public Health and Pediatrics, Icahn School of Medicine at Mount Sinai, 1 Gustave L Levy Pl, EMPH Box 1057, New York, NY, 10029, USA
| | - Olga Wilhelmi
- Research Applications Laboratory, National Center for Atmospheric Research, P.O. Box 3000, Boulder, CO, 80307, USA
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Romanello M, McGushin A, MacGuire FA, Sly PD, Jennings B, Requejo J, Costello A. Monitoring climate change and child health: The case for putting children in all policies. J Paediatr Child Health 2021; 57:1736-1740. [PMID: 34792235 PMCID: PMC8751624 DOI: 10.1111/jpc.15757] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 09/15/2021] [Indexed: 11/27/2022]
Abstract
Climate change is threatening the health of current and future generations of children. The most recent evidence from the Lancet Countdown: Tracking Progress on Health and Climate Change finds declining trends in yield potential of major crops, rising heatwave exposures, and increasing climate suitability for the transmission of infectious diseases, putting at risk the health and wellbeing of children around the world. However, if children are considered at the core of planning and implementation, the policy responses to climate change could yield enormous benefits for the health and wellbeing of children throughout their lives. Child health professionals have a role to play in ensuring this, with the beneficiaries of their involvement ranging from the individual child to the global community. The newly established Children in All Policies 2030 initiative will work with the Lancet Countdown to provide the evidence on the climate change responses necessary to protect and promote the health of children.
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Affiliation(s)
- Marina Romanello
- Institute for Global HealthUniversity College LondonLondonUnited Kingdom
| | - Alice McGushin
- Institute for Global HealthUniversity College LondonLondonUnited Kingdom
| | | | - Peter D Sly
- Children's Health and Environment Program, Child Health Research CentreThe University of QueenslandBrisbaneQueenslandAustralia
| | - Bethany Jennings
- Institute for Global HealthUniversity College LondonLondonUnited Kingdom
| | - Jennifer Requejo
- Division of Data, Analytics, Planning and MonitoringUnited Nations Children's FundNew YorkNew YorkUnited States
| | - Anthony Costello
- Institute for Global HealthUniversity College LondonLondonUnited Kingdom
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Lanza K, Durand CP, Alcazar M, Ehlers S, Zhang K, Kohl HW. School Parks as a Community Health Resource: Use of Joint-Use Parks by Children before and during COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18179237. [PMID: 34501821 PMCID: PMC8430500 DOI: 10.3390/ijerph18179237] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 08/27/2021] [Accepted: 08/27/2021] [Indexed: 01/01/2023]
Abstract
Parks are settings for physical activity that can support the physical and mental health of children during the COVID-19 pandemic. We determined the impact of the pandemic on the use of joint-use parks outside of school hours by children in Austin, TX, United States. In autumn of 2019 and autumn of 2020 (i.e., before and during the COVID-19 pandemic), we used an adapted version of the System for Observing Play and Recreation in Communities to observe whether children aged 1-12 participated in physical activity (i.e., sedentary, light and moderate, vigorous) at three parks located at schools serving mostly economically disadvantaged Latinx families. In 2020, we also observed whether children maintained social distance and wore face coverings. Results of negative binomial regression modeling revealed the pandemic was associated with a 46% [95% CI: 20-63%] and 62% [95% CI: 39-76%] decrease in the number of girls and boys at parks, respectively, and a 42% [95% CI: 16-59%] and 60% [95% CI: 36-75%] decrease in the number of girls and boys engaging in physical activity, respectively (p < 0.01). In total, 60.6% of girls and 73.6% of boys were not social distancing, and 91.8% of the time no children wore masks. Interventions should be considered to safely reintroduce children to parks for health benefits during pandemics.
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Affiliation(s)
- Kevin Lanza
- Michael and Susan Dell Center for Healthy Living, School of Public Health in Austin, The University of Texas Health Science Center at Houston, Austin, TX 77030, USA;
- Correspondence:
| | - Casey P. Durand
- Michael and Susan Dell Center for Healthy Living, Department of Health Promotion & Behavioral Sciences, School of Public Health in Houston, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA;
| | - Melody Alcazar
- Parks and Recreation Department, Austin, Austin, TX 78704, USA; (M.A.); (S.E.)
| | - Sierra Ehlers
- Parks and Recreation Department, Austin, Austin, TX 78704, USA; (M.A.); (S.E.)
| | - Kai Zhang
- Department of Environmental Health Sciences, School of Public Health, University at Albany, State University of New York, Rensselaer, NY 12144, USA;
| | - Harold W. Kohl
- Michael and Susan Dell Center for Healthy Living, School of Public Health in Austin, The University of Texas Health Science Center at Houston, Austin, TX 77030, USA;
- Department of Epidemiology, Human Genetics, and Environmental Sciences, School of Public Health in Austin, The University of Texas Health Science Center at Houston, Austin, TX 78701, USA
- Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, TX 78712, USA
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