Peter Anthamatten

An assessment of schoolyard renovation strategies to encourage children's physical activity

BackgroundChildren in poor and minority neighborhoods often lack adequate environmental support for healthy physical development and community interventions designed to improve physical activity resources serve as an important approach to addressing obesity. In Denver, the Learning Landscapes (LL) program has constructed over 98 culturally-tailored schoolyard play spaces at elementary schools with the goal to encourage utilization of play spaces and physical activity. In spite of enthusiasm about such projects to improve urban environments, little work has evaluated their impact or success in achieving their stated objectives. This study evaluates the impacts of LL construction and recency of renovation on schoolyard utilization and the physical activity rates of children, both during and outside of school, using an observational study design.MethodsThis study employs a quantitative method for evaluating levels of physical activity of individuals and associated environmental characteristics in play and leisure environments. Schools were selected on the basis of their participation in the LL program, the recency of schoolyard renovation, the size of the school, and the social and demographic characteristics of the school population. Activity in the schoolyards was measured using the System for Observing Play and Leisure Activity (SOPLAY), a validated quantitative method for evaluating levels of physical activity of individuals in play and leisure environments. Trained observers collected measurements before school, during school recess, after school, and on weekends. Overall utilization (the total number of children observed on the grounds) and the rate of activity (the percentage of children observed who were physically active) were analyzed. Observations were compared using t-tests and the data were stratified by gender for further analysis. In order to assess the impacts of LL renovation, recently-constructed LL schoolyards were compared to LL schoolyards with older construction, as well as un-renovated schoolyards.ResultsOverall utilization was significantly higher at LL schools than at un-renovated schools for most observation periods. Notably, LL renovation had no impact on girls utilization on the weekends, although differences were observed for all other periods. There were no differences in rates of activity for any comparison. With the exception of the number of boys observed, there was no statistically significant difference in activity when recently-constructed LL schools are compared to LL schools with older construction dates and there was no difference observed in comparisons of older LL with unrenovated sites.ConclusionsWhile we observed greater utilization and physical activity in schools with LL, the impact of specific features of LL renovation is not clear. However, schoolyard renovation and programs to encourage schoolyard use before and after school may offer a means to encourage greater physical activity among children, and girls in particular. Additional study of schoolyard renovation may shed light on the specific reasons for these findings or suggest effective policies to improve the physical activity resources of poor and minority neighborhoods.

An Assessment of Schoolyard Features and Behavior Patterns in Children's Utilization and Physical Activity

BACKGROUND Careful research that elucidates how behavior relates to design in the context of elementary school grounds can serve to guide cost-efficient design with the goal of encouraging physical activity (PA). This work explores patterns in childrens PA behavior within playground spaces with the specific goal of guiding healthy playground design. METHODS Data on childrens utilization and PA behavior in 6 playgrounds divided into 106 observation zones were collected in 2005 and 2006 at Denver elementary school playgrounds using the System for Observing Play and Leisure Activity in Youth. Analyses of variance and t tests determined whether there were differences in utilization and behavior patterns across observations zones and between genders. RESULTS This study provides evidence that children prefer to use certain types of playground zones and that they are more likely to practice moderate-to-vigorous physical activity (MVPA) in some zones. The authors observed statistically significant differences between genders. Boys were more likely to engage in MVPA in zones without equipment, girls were more likely to use zones with equipment. CONCLUSIONS This work suggests that the inclusion or omission of specific playground features may have an impact on the way that children use the spaces.

An introduction to the geography of health

1. Introduction Section 1: Ecological Approaches to Human Health 2. Ecological Approaches to Human Health and Environmental Change 3. Demographic Change and Emerging and Resurgent Infectious Diseases 4. Environmental Exposures Section 2: Social Approaches to Health and Healthcare 5. Social and Economic Environments 6. Culture and Identity 7. Power and Politics of Health 8. Geographies of Healthcare Section 3: Spatial Approaches to Human Health 9. Cartography and Visualization of Health Data 10. Health and GIS 11. Integrating Approaches to the Study of the Geography of Health

Distance to health services affects local-level vaccine efficacy for pneumococcal conjugate vaccine (PCV) among rural Filipino children

Significance Although pneumococcal conjugate vaccines (PCVs) are widely available in industrialized nations, the cost of these vaccines and the strategy of universal vaccination of infants, as endorsed by the World Health Organization, are daunting obstacles to the adoption of these vaccines in developing countries. Using spatial epidemiological methods to examine the spatial variation in vaccine efficacy (VE) in an 11-valent PCV trial in Bohol, Philippines, we suggest an alternative strategy to universal vaccination. Our main finding suggests that areas with poor access to healthcare have the highest VE. An alternative vaccination strategy could target vaccination to areas where children are most likely to benefit, rather than focus on nationwide immunization. Pneumococcal conjugate vaccines (PCVs) have demonstrated efficacy against childhood pneumococcal disease in several regions globally. We demonstrate how spatial epidemiological analysis of a PCV trial can assist in developing vaccination strategies that target specific geographic subpopulations at greater risk for pneumococcal pneumonia. We conducted a secondary analysis of a randomized, placebo-controlled, double-blind vaccine trial that examined the efficacy of an 11-valent PCV among children less than 2 y of age in Bohol, Philippines. Trial data were linked to the residential location of each participant using a geographic information system. We use spatial interpolation methods to create smoothed surface maps of vaccination rates and local-level vaccine efficacy across the study area. We then measure the relationship between distance to the main study hospital and local-level vaccine efficacy, controlling for ecological factors, using spatial autoregressive models with spatial autoregressive disturbances. We find a significant amount of spatial variation in vaccination rates across the study area. For the primary study endpoint vaccine efficacy increased with distance from the main study hospital from −14% for children living less than 1.5 km from Bohol Regional Hospital (BRH) to 55% for children living greater than 8.5 km from BRH. Spatial regression models indicated that after adjustment for ecological factors, distance to the main study hospital was positively related to vaccine efficacy, increasing at a rate of 4.5% per kilometer distance. Because areas with poor access to care have significantly higher VE, targeted vaccination of children in these areas might allow for a more effective implementation of global programs.

Teaching Geography with 3-D Visualization Technology

Abstract Technology that helps students view images in three dimensions (3-D) can support a broad range of learning styles. “GeoWall systems” are visualization tools that allow scientists, teachers, and students to project stereographic images and view them in 3-D. We developed and presented 3-D visualization exercises in several undergraduate courses. Students in introductory-level classes benefited from the novel presentation of material. Advanced undergraduates and graduate students appreciated the opportunity to analyze the advantages, limitations, and potential applications of the new technology. 3-D visualization technology, which is more affordable and convenient than ever before, may offer an untapped potential in geography instruction at many levels.

Spatial Thinking Concepts in Early Grade-Level Geography Standards

ABSTRACT Research in the cognition and learning sciences has demonstrated that the human brain contains basic structures whose functions are to perform a variety of specific spatial reasoning tasks and that children are capable of learning basic spatial concepts at an early age. There has been a call from within geography to recognize research on spatial cognition in a meaningful way in primary school curriculum. This article utilizes the spatial thinking taxonomy proposed by Gersmehl and Gersmehl (2006) to examine to the extent to which spatial thinking concepts are being practiced in U.S. schools. The National Geography Standards and forty-nine state social studies or geography standards are examined. Using standards as a measure of geography content, it is concluded that while some of spatial thinking concepts appear often in curriculum, others are largely absent. Designing geography standards that address the findings of spatial cognition research may serve as a means of improving geography instruction.

Exploring children’s perceptions of play using visual methodologies

Objective: A great deal of scholarly work has examined the way that physical, social and cultural environments relate to children’s health behaviour, particularly with respect to diet and exercise. While this work is critical, little research attempts to incorporate the views and perspectives of children themselves using visual methodologies. Specifically, we examine: (1) how children conceptualize play; (2) what aspects of play are important to children; and (3) the role that play assumes in guiding children’s activity patterns. Setting: Elementary school classrooms from third and fifth grade were sampled in a low-income, largely Latino/a part of southwest Denver, United States of America (USA), in late spring of 2010. Design: A qualitative study in which each child participated in a ‘photo voice’ survey and an in-class focus group. Method: The authors employed visual methodologies to explore how children conceptualized play. Photo voice surveys were administered in English and Spanish. After analysis of the photo voice surveys, children were invited to discuss their photos and drawings in small focus groups conducted in the classroom. All children who completed the survey participated in the focus groups. Results: Children in this study group conceptualized play largely in unstructured form. Family and school were important themes to emerge from the analysis of the data. Conclusion: Visual methods can clarify social-cultural dimensions of interactions between people and places, which can serve to inform research on health behaviours from children’s perspectives. Such methodologies are particularly important for research that focuses on the construction of physical environments for children.

State Geography Standards in 2004

On January 8,2002, George W. Bush signed into law the No Child Left Behind Act, which (among other things) mandated the development of state performance standards in each of the core disciplines named in the legislation. Another part of the legislation links federal funding to school performance, as measured by achievement tests based on those standards (Rosenthal2002,8). The primary goal of these standards is to provide a clear educational target for students and teachers, and thus to maintain a minimum level of excellence. While tensions remain within some states about the purpose, nature, and scope of educational standards (Marin 2001), they have become an important component of education in the United States. Bearing in mind the complicated and often highly-politicized process of producing standards for social studies, and particularly in the case of the often marginalized subject of geography, reviewing state standards provides a good indication of the state of geography in K 12 education. Unfortunately, standards frequently present teachers with a complicated and often vague mass of information that they must incorporate into their curriculum and lesson plans. To help teachers with this process, the Association of American Geographers has been developing the ArgWorld materials for middle and secondary schools. Throughout the project, the ARGWorld authors and editors kept a close eye on the parallel development of state standards. At least three times a year, we convened a discussion group to report on the fit between the materials being produced and the standards that had been released in that time. Then, after the materials were published, we prepared a careful summary review of each state’s standards; that is the work described in this article.

Using Photography to Visualize Children's Culture of Play: A Socio-Spatial Perspective

Visual methodologies have great potential to offer insight into childrens culture and how it shapes childhood. We explore childrens culture of play in an urban, low‐income neighborhood using photographs as a means of encouraging participatory research with elementary school students. Focus group interviews were conducted to validate childrens perspectives on play, and all data were analyzed inductively using open coding to develop categories and emergent themes. Findings suggest that adults often define the physical boundaries of play, but children were largely able to determine the nature of their activities. Childrens culture of play in this study highlighted issues of power and privilege, while concurrently emphasizing the socio‐spatial nature of childhood.

PS2-20: Obesity Mapping in Colorado: A Novel System for Monitoring and Tracking BMI.

Background/Aims There has been a marked increase in obesity prevalence in the US and around the world over the last twenty years. The causes of the rise in obesity involve many interrelated environmental and socioeconomic factors. Because interventions to address the obesity epidemic often occur at the community level, better surveillance data are needed to monitor obesity within communities. The only available community-level BMI data are from self-reports, provided by the Behavioral Risk Factor Surveillance System (BRFSS). Methods We have piloted a system for the collection of BMI data from multiple healthcare providers in Colorado (Kaiser Permanente Colorado, Denver Health, Children’s Hospital Colorado and High Plains Community Health Center). BMI information, objectively measured during routine care and collected in Electronic Medical Records (EMR), is combined with geocoded residence address and other demographic variables. These data, combined in a manner to protect confidentiality, is then linked with built and social environment data from the Colorado Department of Public Health and Environment (CDPHE) and public data sources collected by the University of Colorado Denver (UCD). The surveillance system utilizes the HMORN Virtual Data Warehouse (VDW) data framework, including the VDW vitals and enrollment tables. Results The BMI database will be available through a regional data sharing network, moving data from participating sites to a central data coordinating center (CDPHE) and to UCD for mapping and analysis. The network will enable users to both share data and perform queries within a single software environment. We intend to use the data model to track patients’ BMI over time and by county, census tract and block group geographies, and link BMI data with built and social environment data. We also intend to generate maps of BMI by census tract and block group and overlay built and social environment data to explore correlations between BMI and environmental factors. Conclusions Using the underlying framework of the VDW, we have created a multi-site regional data sharing network in Colorado for tracking individual patient-level BMI data, overlaid with built and social environment information.