Promoting Small Business Support of Youth Physical Activity in Low-Income, Minority Neighborhoods: Protocol for a Randomized Controlled Trial

Abstract

Background An unacceptably high percentage of our nation’s low-income, minority youth (age<18 years) are not regularly physically active. One reason for this could be their lack of access to quality youth physical activity opportunities (YPAOs). Our previous research found that small businesses (<500 employees), which represent over 99.64% (27.9/28.0 million businesses in United States) of all employers, are powerful resources for creating and improving YPAOs. In accordance with the socioecological model and established philanthropic principles, we developed an alpha version of an intervention (alpha-i) for increasing small businesses’ involvement with YPAOs. Objective The aims of this proposed study are to (1) create a beta version (beta-i) of the intervention and (2) conduct a pilot study of its impact on small business support for YPAOs and YPAO utilization by the youth in low-income, minority neighborhoods. Methods The alpha-i will be refined using information from focus groups and surveys conducted with small business owners and managers, YPAO providers, and parents and guardians of the youths from low-income, predominantly minority neighborhoods. A cluster randomized controlled trial will then be conducted for 1 year to examine the effects of the refined intervention (beta-i) on small business support for YPAOs in 10 low-income, minority neighborhoods. The control group of neighborhoods (n=10) will be provided with a standard practice intervention. The primary outcome for aim 2 will be the percentage of small businesses not supporting YPAOs at baseline that subsequently provide support for YPAOs at follow-up. We also will consider the US dollar equivalent of all types of support (monetary, goods/services, and time) donated for YPAOs by small businesses. In addition, we will examine the impact of the increased small business support for YPAOs on YPAO utilization by the youth. Results As of May 1, 2019, all YPAOs and small businesses in the study neighborhoods have been identified, and surveys have begun with these groups. In addition, 9 focus groups were completed, and the data have been transcribed. We anticipate that manuscripts regarding these aspects of the study will be submitted in fall 2019. Conclusions The proposed study is significant because it will provide evidence that an easily replicated approach can be used to increase small business support for YPAOs and that this support results in greater use of the YPAOs by youth. A logical next step will be to determine if YPAO changes resulting from increased small business support positively influence youth physical activity levels. ClinicalTrial ClinicalTrials.gov NCT03936582; https://clinicaltrials.gov/ct2/show/NCT03936582. International Registered Report Identifier (IRRID) DERR1-10.2196/13141

Perspectives on Engagement With Youth Physical Activity Opportunities in Low-Income, African American, Urban Neighborhoods

“…Focus groups with small business representatives, parents/ guardians of youth, and YPAO providers were formatively used to refine a proposed intervention to increase small businesses' involvement with YPAOs in low-income, African American neighborhoods. 35 Four major themes related to engagement with YPAOs including: 1) exposure/access, 2) parent buy-in/accountability, 3) technology, and 4) sense of community emerged across all focus groups. There were also three minor themes including liability, advertising and schools.…”

“…14,18,33 Moreover, the presence of YPAOs varies between neighborhoods, with economically disadvantaged and minority neighborhoods (collectively, underserved neighborhoods) having significantly fewer YPAOs than more affluent neighborhoods. 34,35 This deficiency, along with concerns about transportation and YPAO expenses, are expressed significantly more often by parents of minority youth than parents of non-minority youth. 3,17,20,23 The limited number of YPAOs and associated expenses have been cited as critical barriers to reversing physical inactivity among low-income, minority youth.…”

“…39,40 However, small businesses have not, even though they represent a powerful force that, if utilized effectively, could have a dramatic and lasting impact on the quantity and quality of YPAOs and ultimately, physical activity and health in underserved neighborhoods. 35 Small businesses (<500 employees) represent 99.7% (22 million) of all U.S. businesses with total revenues typically exceeding 1 trillion dollars annually. 41 More than one-fifth of small businesses are minority-owned with revenues totaling nearly $700 billion.…”