Search

INTRODUCTION: Adverse childhood experiences (ACEs) are strongly correlated with many of the most common causes of preventable illness, preventable death, and health disparities. In January 2020, California launched the first statewide initiative to integrate ACE screening throughout its Medicaid system. A key element of the initiative was the California ACEs Learning and Quality Improvement Collaborative, a 48-clinic, 16-month learning collaborative. This evaluation aimed to determine whether developing a trauma-informed environment of care was associated with uptake of ACE screening. METHODS: Participants included 40 of 48 clinics that participated in the statewide learning collaborative. Clinics completed an assessment of progress in 5 essential components of trauma-informed health care at baseline and 1-year follow-up. Clinics tracked data on ACE screens completed on an ongoing basis and submitted data quarterly. A hierarchical linear model was used to examine the association between change in readiness for trauma-informed health care and change in quarterly screens. RESULTS: Readiness for trauma-informed health care increased for all participating clinics over the course of the learning collaborative. The average number of quarterly screens also increased, with considerable variability among clinics. Clinics with larger increases in readiness for trauma-informed health care had larger increases in quarterly screens. DISCUSSION: The findings align with long-standing recommendations for trauma screening to occur in the context of trauma-informed environments of care. CONCLUSION: A trauma-informed clinic is the foundation for successful adoption of ACE screening. ACE screening initiatives should include education and sufficient support for clinics to embrace a trauma-informed systems change process.

Purpose: This study described the use of dog parks in several diverse locations and explored the contribution dog parks made to physical activity of the dog owners. Method: The Systematic Observation of Play and Recreation in Communities (SOPARC) tool was used to count the number and characteristics of people using parks. Observations were conducted 4 times per day, 4 days per week during for 1 week in 6 urban/suburban parks during different seasons. Collection sites included 3 dog parks in Chapel Hill/Durham, NC; 2 dog parks in Los Angeles, CA; and 1 dog park in Philadelphia, PA. Interviews at the NC and PA parks were conducted among 604 adults. Results: We counted 2,124 people (11.9%) in the dog park area compared with 15,672 people in the remaining park areas. Based on observations, dog park visitors were more likely to be female and White or Other race/ethnicity compared with Hispanics, and were less likely to be children or engaged in walking or vigorous activity. Park interviews revealed that compared with other park activities, reporting walking/watching a dog at the park was more common among those who visited the park more frequently (= 1 time per week), stayed at the park for a shorter time (= 1 hr), or visited the park alone. Conclusion: Although dog parks may be an important destination for dog owners and contribute to physical activity, the contribution of dog parks to participants' moderate-to-vigorous physical activity was limited.

Background: Parks present opportunities for recreational physical activity and mental relaxation; however, they are underutilized. Methods: The authors examined how changes in management directly and indirectly impacted park use. Using a national sample of 169 parks sampled from 25 cities, the authors linked park management reported via surveys with systematic direct observation of park use, park-based physical activity, and park conditions observed during the spring/summers of 2014 and 2016. The authors used structural equation modeling to estimate longitudinal pathways from changes in park management and conditions to changes in park use. Results: Increases in subsidized meal offerings and greater use of marketing to promote park events predicted increased person-hours of total weekly park use. Pathways predicting park use varied across user and activity type. Conclusion: The authors' findings suggest that changing park management practices combined with park conditions may promote park use. [ABSTRACT FROM AUTHOR]

Routine physical activity is important for everyone, and most urban areas have an infrastructure of neighborhood parks that are intended to serve as a setting for recreation and leisure. However, parks are not used proportionally by all age groups, genders, and socioeconomic groups. This paper explores factors associated with park use by different age and gender groups in low-income neighborhoods in Los Angeles, CA. We found that women's visits to parks generally centered around children, whereas men's visits were more likely to be associated with their own physical activity. Barriers for seniors are associated with limited facilities and programming that meet their needs. Park managers should consider park renovations that include social meeting places, comfortable sitting areas, and walking paths to better serve women and seniors. [ABSTRACT FROM AUTHOR]

BACKGROUND: Previous studies indicate that the design of streets and sidewalks can influence physical activity among residents. Park features also influence park use and park-based physical activity. Although individuals can walk on streets and sidewalks, walking loops in parks offer a setting to walk in nature and to avoid interruptions from traffic. OBJECTIVES: Here we describe the use of walking loops in parks and compare the number of park users and their physical activity in urban neighborhood parks with and without walking loops. METHODS: We analyzed data from the National Study of Neighborhood Parks in which a representative sample of neighborhood parks (n = 174) from 25 U.S. cities with > 100,000 population were observed systematically to document facilities and park users by age group and sex. We compared the number of people and their physical activity in parks with and without walking loops, controlling for multiple factors, including park size, facilities, and population density. RESULTS: Overall, compared with parks without walking loops, on average during an hourly observation, parks with walking loops had 80% more users (95% CI: 42, 139%), and levels of moderate-to-vigorous physical activity were 90% higher (95% CI: 49, 145%). The additional park use and park-based physical activity occurred not only on the walking loops but throughout the park. CONCLUSIONS: Walking loops may be a promising means of increasing population level physical activity. Further studies are needed to confirm a causal relationship. http://dx.doi.org/ 10.1289/EHP293, Introduction The importance of increasing physical activity and preventing chronic disease is highlighted in the recent Step it Up! Campaign, which is the Surgeon General's Call to Action to Promote [...]

Objectives. Parks provide places for people to experience nature, engage in physical activity, and relax. We studied how residents in low-income, minority communities use public, urban neighborhood parks and how parks contribute to physical activity. Methods. In 8 public parks, we used direct observation to document the number, gender, race/ethnicity, age group, and activity level of park users 4 times per day, 7 days per week. We also interviewed 713 park users and 605 area residents living within 2 miles of each park. Results. On average, over 2000 individuals were counted in each park, and about two thirds were sedentary when observed. More males than females used the parks, and males were twice as likely to be vigorously active. Interviewees identified the park as the most common place they exercised. Both park use and exercise levels of individuals were predicted by proximity of their residence to the park. Conclusions. Public parks are critical resources for physical activity in minority communities. Because residential proximity is strongly associated with physical activity and park use, the number and location of parks are currently insufficient to serve local populations well. doi: 10.2105/AJPH.2005.072447