Changing the Playing Field: Built Environment and Policy Initiatives to Promote Physical Activity

1. Changing the Playing Field: Built Environment and Policy Initiatives to Promote Physical Activity American Public Health Association Annual meeting San Francisco 2012

2. Increasing Access to Physical Activity Options in Health Disparity Areas in San Antonio Parks MARY THOMAS M.B.& B.S., M.P.H.Communities Putting Prevention to WorkSan Antonio Metropolitan Health DistrictSan Antonio Texas 1

3. Co Authors Maggie Thompson, M.S Program Manager, CPPW maggie.thompson@sanantonio.gov Jeremy Beer, M.P.H Health Program Specialist, CPPW Jeremy.beer@sanantonio.gov Park User Survey Data from St Mary’s University-Drs. Pallansch & Nivin 2

4. Presenter Disclosures The following personal financial relationships with commercial interests relevant to this presentation existed during the past 12 months: Mary Thomas “No relationships to disclose” 3

5. Describe the park facilities and changes in built environment which increase physical activity options in San Antonio parks. Discuss the benefits to residents in providing access to fitness stations and trails in health disparity areas. Discuss the barriers in using the park facilities and fitness stations Learning Objectives 4

6. San Antonio Council Districts 1-10 6

7. Demography of Bexar County Population: 1.7 million Multicultural: 59% Hispanic 30% non-Hispanic 7% Afro Americans 3% Asians South & Westside population:80% Hispanic Northeast & North central: 30% Hispanic Persons below 45 years: 79% Some population have greater burden of health problems One in three children and two in three adults are of unhealthy weight 6

8. Bexar County 2010 Population by Race/Ethnicity Total 1.7 Million 7 Population Source: U.S. Census Bureau, 2010

9. Bexar County 2010 Age Distribution Female Male 8 Population Source: U.S. Census Bureau, 2010

10. Bexar County - Educational Attainment Population Source: U.S. Census Bureau, 2010 9

11. 2010 Household Income Bexar County Population Source: U.S. Census Bureau, 2010 10

12. Obesity in Bexar CountyOne in 3 children Two in 3 adults Children Adults Fitnessgram data 2009-10 BRFSS 2010 11

13. VISION Promote physical activity options by increasing access in parks in San Antonio to reduce obesity 12

14. Changes in Built Environment : San Antonio Parks • Fitness equipment installed in 28 parks • Trail Accessibility Information (TAI) posts (133) installed in 31 parks 13

15. Fitness Equipment or stations Stationary -Stretches pushups squats core and balance exercises Movable – use body weight to do leg press, chest press, rowing machine, cardio walker. 14

16. Fitness Stations Goal: To provide access to physical activity options in parks for the residents in areas with health disparities Partnership with Parks & Rec department Target areas with health disparity Promotion by flyers and news papers People friendly with easy to use instructions 15

17. Fitness station and Park Use evaluation by Surveys -2011 • Survey using questionnaires in14 parks • 8 parks with fitness stations and • 6 parks without fitness stations • 504 respondents 16 117

18. Survey Findings-Park Users Reason to be in parks: Personal Exercise 56%, Relaxation 22% Age of park users: Most below 45, average 26-35 years Frequency of visits : 3 or more times per week-63% Facility used: Walking trails 54% , bike trails 40% 17

19. Survey Findings-Park Users 73% Exercised longer than 30 minutes 60% exercised 4-7 days per week 36% engaged in vigorous exercise Time in park: More than 30 minutes-83% 43% lived within 3 miles -88% used cars 18

20. Survey Findings-Fitness Stations 54% spent more time after installation 80% found equipment easy to use Barriers for use of fitness stations 53% no water fountains 17% safety issues 14% stray dog problem 19

21. Discussion-Findings • Residents use parks for personal exercise and relaxation • Installation of fitness stations increased time spent in parks for most persons and some increase in Physical Activity levels • Park users are over all satisfied with access and ease of use of fitness stations 20

22. Trail Assessment • High Efficiency Trail Assessment Process (HETAP) used to assess trail characteristics • Purpose: provide park users information regarding length, width, elevation, running slopes, surface type • 101 miles assessed in 31 parks 21

23. HETAP AND TAI POST 22

24. The Trails Accessibility Information (TAI) includes the trail name, length, elevation change, permitted uses, grade, cross slope, width and surface type (TAI post example, right). Distance assessed 101 miles Number of parks 31 Number of TAI posts 133 23

25. Benefits to Residents • Access to park facilities –walking trails and fitness stations increase Physical Activity options in parks • Fitness equipment provides free access to good gym equipment • Equipment is user friendly with clear instructions 24

26. Limitations for use of Fitness Stations Vandalism Lack of shade limit usage in hot climate Need for water fountains Safety issues 25

27. Acknowledgement with thanks to • John Berlanga, Senior Management Analyst, Metro Health • Dr. Anil Mangla, Epidemiologist, Metro Health • Dr. Isabela Lucas, Technical Consultant ICF Macro 26

28. For more information Mary Thomas, Senior Management Analyst, San Antonio Metropolitan Health District, San Antonio TX mary.thomas@sanantonio.gov 210 207 5371

29. Any Questions ?