Park, Rx, Physical Activity and other Health Benefits for Low Income Children

摘要 认识到户外运动有可能改善身心健康以及 认知，公园处方(ParkRx)是为了促进身体活动和接触大自然而开发的 在低收入人群中。在贫困中长大的孩子的成就水平更低，更糟 健康，并经历更大的压力。体力活动和暴露在大自然中都与 减轻压力，改善认知功能。低收入人群花在休闲时间上的时间更少 在体力活动方面，与高收入人群相比，在户外环境中的体力活动时间更少， 可能在一定程度上解释了健康和成就的差异。 PARK处方是对患者进行更多体育活动的正式临床鼓励 在户外。从一开始，ParkRx就被认为是解决运动不足的常识性解决方案 以及增加孩子们在大自然中户外活动的时间。尽管缺乏严谨的 有证据表明它是有效的，ParkRx概念目前正在广泛传播，并已被 受到多个国家组织的拥护。Unity Health是一家获得联邦政府资格的社区卫生中心 华盛顿特区目前正在为其大部分低收入和少数族裔实施公园处方。 这一群体是慢性病、缺乏运动和肥胖的高危人群。与Unity合作 健康，我们建议进行一项随机对照试验(RCT)来前瞻性评估Park Rx的影响 对儿童患者的体力活动以及其他次要健康后果的影响。我们的具体目标是：1) 测试Park Rx是否会增加儿童的公园游客量和加速计测量的体力活动； 2)确定Park Rx对健康的任何生物学影响，包括对高胆固醇血症的影响； 高甘油三酯血症、糖化血红蛋白、超重和肥胖；3)探讨 对心理健康的影响，包括压力和认知功能的测量；以及4)确定 在对Park Rx的依从性和影响力上存在年龄和性别差异。这项研究的结果将 量化Park Rx的有效性，并告知其未来的传播情况。

ABSTRACT Recognizing that outdoor exercise has the potential to improve physical and mental health as well as cognition, Park Prescriptions (ParkRx) was developed to promote both physical activity and exposure to nature among low-income populations. Children who grow up in poverty have lower levels of achievement, worse health, and experience higher stress. Both physical activity and exposure to nature have been associated with stress reduction and better cognitive functioning. That low-income populations spend less of their leisure time in physical activity and less of this physical activity time in outdoor settings than higher income populations, may, in part, explain health and achievement disparities. Park prescriptions are formal clinical encouragements for patients to engage in more physical activity outdoors. From the beginning, ParkRx has been perceived as a common-sense solution to physical inactivity and to increasing the time children might be spending outdoors in nature. In spite of a lack of rigorous evidence that it is effective, the ParkRx concept is currently being widely disseminated and has been embraced by multiple national organizations. Unity Health, a federally qualified community health center in Washington, DC, is currently implementing park prescriptions for its largely low-income and minority population, a group at high risk of chronic diseases, physical inactivity and obesity. In partnership with Unity Health, we propose to conduct a randomized controlled trial (RCT) to prospectively evaluate Park Rx’s impact on physical activity, as well as other secondary health outcomes in pediatric patients. Our specific aims are: 1) to test whether Park Rx will increase park visits and accelerometry-measured physical activity among children; 2) to identify any biological impacts of Park Rx on health, including impact on hypercholesterolemia, hypertriglyceridemia, HbA1C, overweight and obesity, for those patients with relevant diagnoses; 3) to explore impacts on mental health, including stress and measures of cognitive functioning; and 4) to determine whether there are age and gender differences in adherence to and impact of Park Rx. The results of this study will quantify the effectiveness of Park Rx and inform its future dissemination.