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

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 Work San Antonio Metropolitan Health District San Antonio Texas 1

Co Authors

• Maggie Thompson, M.S

Program Manager, CPPW [email protected]

• Jeremy Beer, M.P.H

Health Program Specialist, CPPW [email protected]

• Park User Survey Data from St Mary’s University-Drs. Pallansch & Nivin

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Presenter Disclosures

Mary Thomas The following personal financial relationships with commercial interests relevant to this presentation existed during the past 12 months:

“No relationships to disclose” 3

Learning Objectives

• • • 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 4

San Antonio Council Districts 1-10 6

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

Bexar County 2010 Population by Race/Ethnicity 7% 4% 30% 59% Total 1.7 Million Hispanic White NH African Am.

Other 7 Population Source: U.S. Census Bureau, 2010

Bexar County 2010 Age Distribution

Age 80 to 84 yrs Age 70 to 74 yrs Age 60 to 64 yrs Age 50 to 54 yrs Age 40 to 44 yrs Age 30 to 34 yrs Age 20 to 24 yrs Age 10 to 14 yrs Age 0 to 4 yrs 75000 Female 25000 Population Source: U.S. Census Bureau, 2010 25000 Male 75000 8

Bexar County - Educational Attainment

35% 30% 25% 20% 15% 10% 5% 0% Less than high school diploma High school graduate, GED Some college Bachelor's degree or higher Population Source: U.S. Census Bureau, 2010 9

2010 Household Income Bexar County

Above$ 150,000 $100,000 to $149,999 $75,000 to $99,999 $50,000 to $74,999 $25,000-$49,999 Less than $25,000 0% 5% 10% 15% 20% Population Source: U.S. Census Bureau, 2010 25% 30% 10

33% Obesity in Bexar County One in 3 children Two in 3 adults Children Adults 32% 67% 68% Healthy Weight Unhealthy weight Fitnessgram data 2009-10 Normal weight Overweight/Obesity BRFSS 2010

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VISION

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

Changes in Built Environment : San Antonio Parks

• Fitness equipment installed in 28 parks • Trail Accessibility Information (TAI) posts (133) installed in 31 parks 13

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.

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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

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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

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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%

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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

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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

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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

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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

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HETAP AND TAI POST

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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

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

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Limitations for use of Fitness Stations

• Vandalism • Lack of shade limit usage in hot climate • Need for water fountains • Safety issues

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Acknowledgement with thanks to

• John Berlanga, Senior Management Analyst, Metro Health • Dr. Anil Mangla, Epidemiologist, Metro Health • Dr. Isabela Lucas, Technical Consultant ICF Macro

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For more information

Mary Thomas, Senior Management Analyst, San Antonio Metropolitan Health District, San Antonio TX [email protected]

210 207 5371

Any Questions ?