Gina M. Besenyi

Exploring the Distribution of Park Availability, Features, and Quality Across Kansas City, Missouri by Income and Race/Ethnicity: an Environmental Justice Investigation

BackgroundParks are key community assets for physical activity, but some evidence suggests these resources are not equitably distributed.PurposeThis study examined disparities by income and race/ethnicity in the availability, features, and quality of parks across Kansas City, Missouri.MethodsAll 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.ResultsLow-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.ConclusionsFuture 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.

Variations in Observed Park Physical Activity Intensity Level by Gender, Race, and Age: Individual and Joint Effects

BACKGROUNDnParks are important settings for physical activity (PA), but few studies have documented the actual behaviors of park users. The purpose of this study was to examine the individual and joint effects of various park user demographic characteristics on observed PA intensity levels.nnnMETHODSnFour parks were observed using the System for Observing Play and Recreation in Communities. Observers recorded the age group, gender, race, and intensity level of all park users in 83 activity areas over two weekends at each park. Logistic regression examined whether male/White, female/White, and male/non-White users were more likely than female/non-White users to be observed engaging in moderate-to-vigorous PA (MVPA) rather than sedentary activity across 4 age groups.nnnRESULTSnIn total, 8612 users were observed during the study. In the child age group, male/White users were significantly more likely to be observed in MVPA than female/non-White users. For teens, female/White and male/White users were less likely to engage in MVPA. For both adults and seniors, female/White and male/White users were more likely to be observed in MVPA.nnnCONCLUSIONnObservations revealed significant differences in intensity levels across gender, age, and race groups. Future interventions should emphasize park design that promotes increased MVPA among diverse groups.

Active commuting influences among adults.

OBJECTIVEnActive commuting (AC) is a behavior with many documented health benefits; however, influences on AC are not well understood. This paper examined a range of influences on self-reported AC behavior.nnnMETHODSnParticipants in Manhattan, KS, responded to an online survey (August-December 2008) with questions about walking, biking and driving patterns, influences on AC (motivators, barriers, self-efficacy, and workplace factors) and demographics. Separate logistic regression models predicted if participants walked, biked, or drove to work at least once/week according to the demographic factors and influences on AC, and significant factors were examined simultaneously in a multivariate logistic model.nnnRESULTSnParticipants (n=375) were primarily young to middle aged adults, female, Caucasian, with at least a high school education, and 24.2% reported AC one or more times per week. Univariate analyses revealed several demographic variables, employment related factors, barriers, and motivators significantly associated with walking, biking, and driving. The multivariate models found multiple significant predictors associated with walking (Nagelkerke R(2)=0.685), biking (Nagelkerke R(2)=0.717), and driving (Nagelkerke R(2)=0.799).nnnCONCLUSIONSnAC is a complex behavior and this study noted a wide range of significant influences. These results provide insight for the development of policies and programs to enhance population level AC.

Development and Testing of a Community Stakeholder Park Audit Tool

BACKGROUNDnParks 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.nnnPURPOSEnThe 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.nnnMETHODSnThe 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.nnnRESULTSnStakeholder 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.nnnCONCLUSIONSnThe 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.

Perceptions of Neighborhood Park Quality: Associations with Physical Activity and Body Mass Index

BackgroundParks are important resources for physical activity (PA), yet few studies have examined how perceptions of park characteristics relate to PA and health.PurposeThis study investigated associations between perceptions of neighborhood park quality and overall moderate-to-vigorous PA (MVPA), park-based PA, and body mass index (BMI).MethodsData were collected via questionnaire from 893 households in Kansas City, Missouri.ResultsThe newly developed neighborhood park quality scale demonstrated good test–retest and internal reliability. Residents’ perceptions of neighborhood park quality were related to PA and health outcomes. Perceiving parks as a benefit was positively related to overall MVPA and park-based PA and negatively related to BMI. Perceptions of well-used parks were positively related to BMI, while perceived cleanliness was negatively related to park-based PA.ConclusionsBetter measuring and understanding how perceptions of local parks are associated with PA and health can improve appreciation of how parks facilitate active living.

Demographic variations in observed energy expenditure across park activity areas

OBJECTIVEnParks are important physical activity (PA) settings, but few studies have examined PA differences between park areas according to multiple user demographic characteristics. This study explored variations in adult/senior and child/teen PA intensity across park settings by gender, age, and race/ethnicity.nnnMETHODSnIn July-August 2009, the System for Observing Play and Recreation in Communities (SOPARC) was used in four parks in Kansas City, Missouri to record park users PA behavior within specific park areas. A total of 8855 observations were recorded. ANCOVAs compared mean energy expenditure (EE) for various demographic groups across the five most-used park target areas for adults/seniors and children/teens.nnnRESULTSnAmong adults/seniors, all sub-samples exhibited higher EE on paved trails (0.086-0.093 kcal/kg/min) and tennis courts (0.086-0.089 kcal/kg/min), than in open spaces, playgrounds, or picnic shelters. Among children/teens, the child, White, and all child/teen sub-samples showed greater EE on playgrounds (0.088-0.089 kcal/kg/min) than in picnic shelters.nnnCONCLUSIONnPark planning and design efforts should consider environmental and programming initiatives to increase intergenerational PA levels within park areas such as playgrounds, open spaces, and picnic shelters.

Differences in youth and adult physical activity in park settings by sex and race/ethnicity.

We examined differences by sex and race/ethnicity in the observed moderate- to vigorous-intensity physical activity (MVPA) of youth and adults in diverse areas of 4 parks in Kansas City, Missouri, in 2009. Male youth were more active on playgrounds and pools or splashpads than female youth. White youth were less active than nonwhite youth in open spaces and on paved trails. Male adults were more active in open spaces than female adults, and white adults were more active on paved trails than nonwhite adults. Understanding variations in MVPA between user groups can inform park design efforts to foster increased activity among all visitors.

Patient web portals, disease management, and primary prevention

Background Efforts aimed at health care reform and continued advances in information technologies have prompted interest among providers and researchers in patient web portals. Patient web portals are password-protected online websites that offer the patients 24-hour access to personal health information from anywhere with an Internet connection. Methods This article, which is based upon bibliographic searches in PubMed, reviews important developments in web portals for primary and secondary disease prevention, including patient web portals tethered to electronic medical records, disease-specific portals, health disparities, and health-related community web portals. Results Although findings have not been uniformly positive, several studies of the effectiveness of health care system patient portals in chronic disease management have shown promising results with regard to patient outcomes. Patient web portals have also shown promising results in increasing adherence with screening recommendations. Racial and ethnic minorities, younger persons, and patients who are less educated or have lower health literacy have been found to be less likely to use patient portals. Conclusion Additional studies are needed of the utility and effectiveness of different elements of web portals for different patient populations. This should include additional diseases and health topics such as smoking cessation and weight management.

Park availability and physical activity, TV time, and overweight and obesity among women: Findings from Australia and the United States.

This study examined relationships between three measures of park availability and self-reported physical activity (PA), television viewing (TV) time, and overweight/obesity among women from Australia and the United States. Having more parks near home was the only measure of park availability associated with an outcome. Australian women (n=1848) with more parks near home had higher odds of meeting PA recommendations and lower odds of being overweight/obese. In the US sample (n=489), women with more parks near home had lower odds of watching >4h TV per day. A greater number of parks near home was associated with lower BMI among both Australian and US women. Evidence across diverse contexts provides support to improve park availability to promote PA and other health behaviors.

Planning for health: a community-based spatial analysis of park availability and chronic disease across the lifespan.

The purpose of this study was to explore the spatial relationship between park availability and chronic health conditions (CHCs) across age groups in Kansas City, MO. Multinomial logistic regression examined the association between having a park within one-half mile from home and the likelihood of having 0, 1, or 2 or more CHCs. Among respondents aged 40-59, those without a park within one-half mile from home were more than twice as likely to have 2 or more CHCs compared to respondents that had a park nearby. Parks may be an important protective factor for chronic diseases, especially among middle-aged adults among whom access to neighborhood recreational environments may be particularly important.