Parks and Health: Aligning Incentives to Create Innovations in Chronic Disease Prevention

Barrett, Meredith A.; Miller, Daphne; Frumkin, Howard

doi:10.5888/pcd11.130407

Cited by 20 publications

(16 citation statements)

References 7 publications

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“…In addition to this, five of the variables among these ten are related to availability and accessibility of parks and recreation opportunities-percentage of recreational land, intersections per unit land area, mean parcel to park distance, percentage of parcels within one kilometer of a park, and total road length. All five of these align with earlier research in this field that indicates that spending time outside can influence behaviors-including health related behaviors, functions of identity, sense of place, and individual and community well-being [16,44,[70][71][72][73][74][75] Furthermore, this highlights the importance of accessibility to parks and recreation in promoting these behaviors [37,[76][77][78][79][80][81][82]. These finding may provide some confirmatory evidence to framings by earlier authors citing landscape as an explanatory factor for ERBs [1][2][3][4][5].…”

Section: Discussionsupporting

confidence: 83%

An Investigation of Links between Environmentally Responsible Behaviors and Built and Natural Features of Landscape in Central New Jersey

Clark

Jordan

2018

Urban Science

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Responses from Central New Jersey residents (n = 290) to nine survey items about pro-environmental behaviors were analyzed for their connection to survey respondents’ local built and natural landscape characteristics. These nine survey items were of interest due to their clustering in three groups in earlier dimension reduction analysis. Nine logistic regression models (one for each of these items) were built using a suite of built and natural features of landscape at the municipal level—including land use, population density, and access to parks. The logistic regression models using the landscape variables failed to provide effective explanations of engagement in pro-environmental behavior. In total, only ten landscape feature variables—out of a possible thirty-eight -were used in any of the most effective models. The logistic regression model of proper appliance disposal performed best and could correctly classify responses of whether respondents had disposed of an appliance correctly 84% of the time. The rest of the models were of little use. This suggests that there may not be a connection between these built and natural landscape features and these behaviors, or that the study did not look at location at a level that was granular enough to detect any patterns.

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Section: Discussionsupporting

confidence: 83%

An Investigation of Links between Environmentally Responsible Behaviors and Built and Natural Features of Landscape in Central New Jersey

Clark

Jordan

2018

Urban Science

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“…Despite perception of parks as part of healthcare and the growing evidence of parks contributing to physical and mental health ( Bedimo-Rung et al, 2005 , Kaczynski and Henderson, 2007 , Kaczynski and Henderson, 2008 , Cohen et al, 2007 , Cohen et al, 2016 , Maller et al, 2009 ), expenditures on public park facilities and services ($190/person) is small in comparison to the annual amount spent on healthcare ($10,000/person) nationally ( Barrett et al, 2014 ). Redirecting dedicated federal-level health funds (e.g., Prevention and Public Health Fund) specifically toward parks, trails, and open space may be an innovative approach to improve health.…”

Section: Discussionmentioning

confidence: 99%

“…Public perceptions or belief of parks as part of the healthcare system was the primary variable assessed in this study. Respondents from both surveys were asked to indicate their level of agreement with the following statement on a five-point scale from strongly disagree to strongly agree: “Parks, trails, and open space are an essential component of our healthcare system.” This item was derived from policy discussions of health advocates and public health scholars ( Barrett et al, 2014 , Godbey and Mowen, 2010 , Kaczynski and Henderson, 2008 ). For the statewide sample, we compared agreement with this idea/statement across five demographic characteristics: sex, age, race, income, education, and by residency status.…”

Section: Methodsmentioning

confidence: 99%

“…Public parks contribute to numerous physical and mental health outcomes across a range of populations ( Bedimo-Rung et al, 2005 , Kaczynski and Henderson, 2007 ). Emerging evidence and commentary reinforce the notion that these parks are part of the healthcare system and should qualify for public health funding ( Barrett et al, 2014 , Godbey and Mowen, 2010 , Green, 2012 ). However, expenditures on local park and recreation services in America declined sharply during the 2007 to 2009 Great Recession and, since that time, have not recovered at the rate of other social services, including hospitals and health ( United States Census Bureau, 2016 ).…”

Section: Introductionmentioning

confidence: 91%

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“Take in two parks and call me in the morning” – Perception of parks as an essential component of our healthcare system

Mowen

Barrett

Graefe

et al. 2017

Preventive Medicine Reports

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As a feature of the built neighborhood environment, parks have been associated with a range of positive health outcomes. Recognition of these contributions has prompted advocates to suggest parks are a part of our healthcare system. Despite these developments, park investments have declined over the past decade nationally, lagging behind expenditures on other community services such as health. Perhaps the idea of parks as a solution to the nation's health concerns has not diffused across the population. To date, however, public perception of parks' role in healthcare has not been documented. This study responds to this gap by assessing whether parks are perceived as an essential part of the healthcare system. Self-administered surveys were completed by a statewide sample of Pennsylvania adults (2014) and by a sample of primary care clinic visitors in Hershey, Pennsylvania (2015). Participants from both studies were asked the extent they agreed with the following statement: Parks, trails, and open space are an essential component of our healthcare system. Response was also compared across demographic characteristics to assess whether this belief was universally held. Findings indicate 73% of the statewide sample and 68% of the clinical sample agreed parks, trails, and open space are an essential element of the healthcare system. Males, those with lower levels of educational attainment, and rural residents were statistically less likely to agree with this statement. Results indicate widespread belief in parks as an essential part of the healthcare system, suggesting consideration of health-sector investments in these settings.

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“…Parks provide the most readily available access to nature for many individuals living in urban areas [ 12 , 16 ]. As a result, clinicians have been called upon to create community partnerships with parks [ 17 , 18 ]. Termed park prescriptions, these partnerships are growing in number [ 19 ], yet there remains little rigorous clinical research to guide the practice.…”

Section: Introductionmentioning

confidence: 99%

Effect of park prescriptions with and without group visits to parks on stress reduction in low-income parents: SHINE randomized trial

et al. 2018

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IntroductionExposure to nature may reduce stress in low-income parents. This prospective randomized trial compares the effect of a physician’s counseling about nature with or without facilitated group outings on stress and other outcomes among low-income parents.Materials and methodsParents of patients aged 4–18 years at a clinic serving low-income families were randomized to a supported park prescription versus independent park prescription in a 2:1 ratio. Parents in both groups received physician counseling about nature, maps of local parks, a journal, and pedometer. The supported group received additional phone and text reminders to attend three weekly family nature outings with free transportation, food, and programming. Outcomes measured in parents at baseline, one month and three months post-enrollment included: stress (using the 40-point Perceived Stress Scale [PSS10]); park visits per week (self-report and journaling); loneliness (modified UCLA-Loneliness Scale); physical activity (self-report, journaling, pedometry); physiologic stress (salivary cortisol); and nature affinity (validated scale).ResultsWe enrolled 78 parents, 50 in the supported and 28 in the independent group. One-month follow-up was available for 60 (77%) participants and three-month follow up for 65 (83%). Overall stress decreased by 1.71 points (95% CI, -3.15, -0.26). The improvement in stress did not differ significantly by group assignment, although the independent group had more park visits per week (mean difference 1.75; 95% CI [0.46, 3.04], p = 0.0085). In multivariable analysis, each unit increase in park visits per week was associated with a significant and incremental decrease in stress (change in PSS10–0.53; 95% CI [-0.89, -0.16]; p = 0.005) at three months.ConclusionWhile we were unable to demonstrate the additional benefit of group park visits, we observed an overall decrease in parental stress both overall and as a function of numbers of park visits per week. Paradoxically the park prescription without group park visits led to a greater increase in weekly park visits than the group visits. To understand the benefits of this intervention, larger trials are needed.Trial registrationClinicalTrials.gov NCT02623855

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Parks and Health: Aligning Incentives to Create Innovations in Chronic Disease Prevention

Cited by 20 publications

References 7 publications

An Investigation of Links between Environmentally Responsible Behaviors and Built and Natural Features of Landscape in Central New Jersey

An Investigation of Links between Environmentally Responsible Behaviors and Built and Natural Features of Landscape in Central New Jersey

“Take in two parks and call me in the morning” – Perception of parks as an essential component of our healthcare system

Effect of park prescriptions with and without group visits to parks on stress reduction in low-income parents: SHINE randomized trial

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