Physical Activity Clinical Trial
Official title:
Promoting Physical Activity In High Poverty Neighborhoods
Encouraging greater levels of physical activity is critical to improving health among Americans, who are largely sedentary. Neighborhood parks are resources for physical activity that are available to most Americans within a couple miles of their homes, yet many residents are unaware of the programs and facilities available. Previous research indicates that park use is related to park programming and outreach. Because funding for parks is limited, low-cost interventions are needed to attract more people to parks to engage in moderate-to-vigorous physical activity. While many community-based organizations would like to invest in efforts that increase physical activity, few low-cost park programs are documented to be both scalable and cost-effective. Effective programs that can be replicated to make population-level impacts are needed. The goal of this study is to develop and test 2 low-cost community-level approaches, free exercise classes vs. a frequent user program, to promoting physical activity, singly and in combination, in 48 park settings in Los Angeles low-income neighborhoods.
While routine physical activity is critical to optimal health, our preliminary studies have
indicated that residents of low-income communities in Los Angeles are less likely to exercise
than those in high-income communities, and they are less likely to use their neighborhood
parks, even when the parks are within walking distance. Parks in low-income neighborhoods
tend to be smaller and serve a greater population density, but even after accounting for the
size and the population served, they are still used less than parks in wealthier
neighborhoods. In our preliminary studies we found that parks in low-income neighborhoods
also had fewer part-time staff and offered fewer programs and organized activities than parks
in higher-income areas, and these factors partly accounted for their lower use. As well,
parks in low-income neighborhoods are often perceived as less safe, a characteristic
associated with lower use 4. Simultaneously, the lack of use and dearth of programming may
contribute to a perception of lack of safety, creating a vicious cycle. Nonetheless, we have
documented that when parks in low-income neighborhoods offer events and activities, they can
be just as busy as parks in higher-income areas. We hypothesize that limited park use in
low-income areas can be attributed to the lack of organized and reliable infrastructure of
activities that meet the needs of local residents and that offering more activities and
programs in parks will increase park use and park-based physical activity.
According to the Task Force on Community Level Preventive Services, community-level campaigns
are both effective and scalable.6 For the past eight years, we have conducted research in
public neighborhood parks and found that these venues offer great potential for increasing
physical activity for populations. Based upon this work, as well as our previous work on the
cost-effectiveness of physical activity interventions, we propose to test community-level
campaigns targeting low-income populations that will be relatively low-cost and easy to
replicate.
The proposed study has three specific aims:
1. Using a full factorial design, compare whether park use and population physical activity
in low-income neighborhoods increase with the availability of a) more organized physical
activity classes, including zumba, line dancing, and aerobics indoors and outdoors,
and/or b) a loyalty program approach that rewards frequent park users.
2. Determine whether either of these two approaches changes the perception of park safety
and neighborhood safety.
3. Identify the cost effectiveness of both approaches in terms of dollars spent to generate
increased physical activity in parks as measured through systematic observation.
Most Los Angeles parks have full-time staff, but their role has become increasingly
administrative. Park staff may not have the time or the skills to lead physical activity
programs and activities nor conduct effective outreach to the community to promote these
activities. Although there is a small literature on "best practices" for parks, there is no
underlying foundation of rigorous scientific research, and there has been no identification
of which park practices, designs, or activities lead to the most physical activity in a
community. Standard practice is currently based primarily on anecdotes, demands of special
interest groups, and the experience of professionals. The science of objectively measuring
physical activity in parks is new, developed only in the past decade. Because neighborhood
parks are settings designed for moderate to vigorous physical activity (MVPA) and are
accessible to 70% of the US population, identifying which programs help populations achieve
physical activity goals at a reasonable cost would be highly useful, particularly for groups
disproportionately affected with chronic diseases that could be reduced with physical
activity. Parks are community resources typically funded by dedicated revenue streams and
fee-based programs, yet park systems frequently lack the tools and resources to either market
programs or measure their reach or effectiveness. Our study will document all the steps
required for implementing and maintaining two physical activity promotion interventions--one
a standard approach offering traditional organized physical activity programs, the other an
innovative application of popular customer loyalty programs. We will determine their impact
on physical activity and their cost-effectiveness.
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