Skip to main content
NIHPA Author Manuscripts logoLink to NIHPA Author Manuscripts
. Author manuscript; available in PMC: 2015 Jul 1.
Published in final edited form as: Prev Med. 2014 Mar 25;64:14–19. doi: 10.1016/j.ypmed.2014.03.019

Involving Community Stakeholders to Increase Park Use and Physical Activity

Kathryn Pitkin Derose a,, Terry Marsh b, Mark Mariscal c, Sophia Pina-Cortez d, Deborah A Cohen e
PMCID: PMC4066457  NIHMSID: NIHMS579616  PMID: 24674853

Abstract

Objective

To describe implementation of a randomized controlled trial of community-based participatory research (CBPR) approaches to increase park use and physical activity across 33 diverse neighborhoods in Los Angeles.

Methods

Fifty parks were randomly assigned based on park size, facilities and programs, and neighborhood socio-demographic characteristics to: park director (PD, 17 parks); PD and park advisory board of interested community members (PD+PAB, 16 parks); and no-intervention control (17 parks) arms. Between 2007 and 2012, PDs and PABs from the 33 intervention parks participated in community engagement, baseline assessment, marketing training, intervention design and implementation, and follow-up assessment.

Results

Intervention parks (PD and PD+PAB) invested in new and diversified signage, promotional items, outreach or support for group activities like fitness classes and walking clubs, and various marketing strategies. Scaling up CBPR methods across parks in 33 diverse neighborhoods was challenging. Working with departmental management and established structures for community input (PABs) and park policy (PDs) facilitated implementation and sustainability.

Conclusion

Scaling up CBPR methods across diverse communities involved tradeoffs. CBPR is useful for tailoring research and enhancing community impact and sustainability, but more work is needed to understand how to conduct multi-site trials across diverse settings using CBPR.

(MeSH Headings): Community-Based Participatory Research, Exercise, Recreation

INTRODUCTION

Engaging in regular physical activity contributes to various positive health outcomes, including longevity, increased quality of life, and reduced incidence of cardiovascular diseases, diabetes, depression, and certain cancers, and the prevention of obesity (U.S. Department of Health and Human Services, 1996). However, 58% of children, 92% of adolescents, and 95% of adults do not meet current physical activity recommendations (Troiano et al., 2008). The rising burden of chronic conditions demands new physical activity interventions that are scalable across communities and populations.

Public parks and recreational facilities provide infrastructure and, often, programming for promoting community physical activity. Several studies have used natural experiments to examine whether park structural (new or refurbished facilities) and programming modifications influence park use and physical activity. Although these studies find some evidence that park renovations are related to increased park use and park-based physical activity (Tester and Baker, 2009; Veitch et al., 2012), park programming also appears important, particularly for populations that typically underutilize parks (Tester and Baker, 2009). In addition, because previous studies of renovations have not used randomized design and have included few parks, conclusions on effectiveness are limited. More rigorous designs with larger numbers of parks would elucidate the potential of park modifications to increase community physical activity.

Partnering with local communities in developing appropriate strategies could yield more effective and, ultimately, more sustainable interventions. Community-based participatory research (CBPR) has the potential to help design community-appropriate physical activity interventions, but few such interventions have been published (Arredondo et al., 2013; Pazoki et al., 2007; Suminski et al., 2009). CBPR is intended to enhance community participation in research and foster community strengths and problem-solving abilities with the goal of taking action (Minkler, 2000). CBPR is used to enhance the quality, outcomes, and/or sustainability of the study or intervention overall; however, given the intensive partnering needed for a CBPR approach, it is often challenging to scale up this approach across multiple and diverse communities.

This manuscript describes implementation of a randomized trial of park-level interventions that incorporated CBPR into the randomization process and explores the lessons learned in scaling up CBPR methods across 33 diverse neighborhoods. The goals of the overall study were to examine how public parks influence physical activity and determine whether population-level physical activity could be enhanced through involving diverse communities in scientific and systematic park assessments to guide modification of park programs and facilities. Our in-depth description in this manuscript of how we involved community stakeholders – and the lessons learned in the process – can inform others desiring to work with parks to influence physical activity as well as those wanting to better understand how CBPR processes can be scaled up in a randomized, controlled, community trial.

METHODS

Study Setting

Los Angeles offers an ideal setting for developing and testing park-based interventions across diverse neighborhoods. According to the 2010 U.S. Census, the population of the City of Los Angeles is: 48.9% Latino, 28.7% non-Latino white, 11.3% Asian, and 9.6% black. As of 2013, the city had more than 430 public parks serving a population that exceeded 3.8 million. Approximately 180 of these parks had a recreation center, which means that they had a building, programming, and staff (including a park director or PD). Each PD reports to a district supervisor, from one of three regions of the city. The Los Angeles Department of Recreation and Parks (LARAP) General Manager is appointed by the Mayor to have overall authority over the department and its budget, but each PD has a discretionary budget that includes part time salaries and expense money. PDs can supplement their budgets by fundraising and collecting fees for participation in park-organized programs. In addition, most parks have park advisory boards (PABs), which include interested community stakeholders who act in an advisory capacity to the PD. The PAB structure was initiated by LARAP in 1998 to incorporate community input into local park operations.

Community Partners

LARAP was an important partner in the overall study, and played a valuable role in all stages of the research and in using results for policy and programs. At the individual park level, we worked with PDs and PABs in survey adaptation, data collection and interpretation, and intervention design and implementation. Finally, we employed bilingual community health promoters (promotoras in Spanish), contracted through a minority health organization, and other community members at the PD+PAB parks, as data collectors. The promotoras helped refine data collection instruments in English and Spanish, provided important on-going feedback throughout the data collection process that helped the project adjust to changing field conditions, and mentored local community data collectors.

Park Sample

Using a list of parks provided by LARAP and US Census data on population race-ethnicity within a 1-mile radius surrounding the park, we selected 51 parks in neighborhoods either predominated by one of four race-ethnic groups (Latinos, African Americans, Asians, and whites) or in mixed race-ethnicity neighborhoods. Parks were randomized to PD, PD+PAB, or control, based on their park size, number of facilities and programs offered by the park, and the socio-demographic characteristics of the population in a 1-mile radius. The PAB in one park randomized to the PD+PAB group later voted not to participate, leaving us with 50 study parks. The overall study was conducted 2007–2012; park baseline assessments were conducted between April 28, 2008 and March 20, 2010 and follow-up assessments (in same season for each park, two years later) between April 27, 1010 and April 2, 2012.

Community Engagement and Intervention Processes

Table 1 provides an overview of how we involved LARAP management, PDs, and PABs throughout the research process and in the development of park-specific interventions. The overall study intended to test park-based interventions developed by various community stakeholders after reviewing and interpreting park-specific baseline data. Involving community stakeholders in all phases of the research, including intervention development, was a key aspect of the intervention and not just a way to implement the study or intervention. We documented the processes through systematic notes at all meetings with the PDs and PABs and focused discussion at team meetings.

Table 1.

Overview of community engagement, assessment, and action processes conducted with Los Angeles parks (2007–2012)

Step Activities Description
1. Planning Met with LARAP management, 33 PDs & 16 PABs Discussed purpose of project, plans for data collection, park-specific questions*
2. Baseline Assessment Measured park use and physical activity; interviewed 50 PDs Used SOPARC for park observations, interviews with random sample of park users and neighborhood residents; one-on-one interviews with park directors to explore their perspectives on park, how to increase physical activity
3. Park-specific Interpretation* Discussed results with LARAP management, 33 PDs & 16 PABs Presented customized report for each park on all data collected; interpreted what results mean for how best to increase park use and physical activity; brainstormed about park actions in outreach and programming
4. Marketing Resources* Provided marketing training (5 sessions), modest resources, and on-site consultation to 33 PDs (some PAB members) Marketing consultant provided group training sessions for PDs and PAB members and on-site consultation to each park; project also provided $4000 to each park to use in purchasing resources for outreach and programming
5. Park Action* 33 PDs & 16 PABs decided what to do to increase park use and physical activity Purchases in signage, promotional items, and equipment or personnel for group activities were made to increase outreach and programming
6. Follow-up Assessment Measured park use and physical activity; interviewed 50 PDs Used same methods as baseline, during same time of year, 2 years post baseline
7. Park-specific Feedback Provided park-specific results Provided customized report for each park on all data collected.
8. Interpretation of final results Presented preliminary results to LARAP management, then 50 PDs Provided overall results first to LARAP management and then to all PDs (including control parks)
*

These were only done in the PD and PD+PAB parks as part of the “intervention”

Planning

We met with LARAP management throughout the overall study to obtain input and troubleshoot issues as they arose. The LARAP General Manager first sent each PD a letter that encouraged participation in the overall study. Next, we set up individual meetings with each PD to discuss the purpose of the overall study and review the basic components and logistics of participation. In the PD+PAB condition, we also conducted similar meetings with the PABs. At these PAB and PD meetings, we reviewed data collection instruments and solicited input from the PAB and/or PD, including additional park-specific questions they wanted to add; these questions were finalized through additional follow-up.

Baseline assessment

Our measurement of park use and physical activity served not only to assess intervention effectiveness, but also to obtain in-depth information that was then provided back to each park and interventions were developed accordingly. Our assessment methods have been described in detail elsewhere (Cohen et al., 2013). Briefly, we conducted both systematic observations of parks using the System for Observing Play and Recreation in Communities (SOPARC) (McKenzie et al., 2006) and interviewer-administered surveys of park users and neighborhood residents [75 systematically-selected park users (Cohen et al., 2006) and 75 neighborhood residents from randomly selected households within 1 mile of each park]. Community-based promotoras conducted these observations and interviews, and, in the PD+PAB parks, community members were invited to assist with data collection (as paid positions). In addition, each park director completed a questionnaire about park staffing, resources, programming, and PAB size and activities (meetings, fundraising, etc.).

Concurrent to baseline data collection, we also conducted individual, qualitative interviews with all PDs to obtain important contextual information about each park and PDs’ motivations and perceptions of their roles, how they managed their own facility, and their perspectives of how parks can increase community physical activity. One issue identified through these interviews, which, as a result, became a focus for our intervention efforts, was the need for training on outreach and marketing of park programs (Marsh et al., 2012).

Park-specific interpretation

After the baseline assessment, we followed a series of steps to engage PDs and PABs in interpreting results and planning park-specific intervention activities. First, we prepared 33 park-specific PowerPoint presentations with simple graphs of all observation and survey results and met individually with 17 PDs and as a group with 16 PABs and their PDs to review each park’s results. PDs often invited other park staff to attend these meetings. In these meetings, we discussed possible interpretations of the data and brainstormed about how to draw more community members to the park and increase physical activity. We conducted additional follow-up with the PDs and PABs as they developed their park-specific plans.

Marketing Resources

Given the PDs’ request for more training on outreach and marketing, we hired a parks and recreation marketing consultant to provide training and on-site consultation to all 33 parks and provided modest resources ($4000 per park) to use in outreach and marketing programs. The 33 PDs and PAB members in the 16 PD+PAB parks were invited to attend five training sessions on outreach, the importance of visibility and excellent customer service, and how to use special events to promote routine activities and programs. The trainings lasted approximately 2 hours each and were held during the day at a participating park or at LARAP headquarters and the project provided lunch.

The marketing consultant also made a personal visit to each of the 33 intervention parks and, after touring the facilities, made park-specific recommendations on how to improve the park image, use park events to market their park programs and services, and use the $4000 to attract more park users.

Park Action

Each park developed their own plans for how to increase park use and physical activity and how they would spend the $4000 outreach and marketing funds, and, if necessary, the project team provided input to help maintain focus on increasing park use and physical activity. The research project coordinator tracked specific expenditures per park and interfaced with LARAP to address any obstacles encountered in obtaining purchases or implementing plans. The PAB president approved the PD+PAB park plans, as did the PD in PD parks. Regional supervisors provided LARAP approval, and final approval was given by the study principal investigator.

Follow-up Assessment

We conducted follow-up park assessments using the same methods as at baseline and during the same season, two years after baseline. We also conducted follow-up qualitative interviews with each PD, to obtain contextual information about each park; these interviews explored similar topics to the baseline PD interviews, but also asked specifically about changes in the past two years regarding facilities, programming, marketing and outreach, staffing and customer service, overall approaches to park operations, and any challenges encountered in trying to implement the changes. Furthermore, among those PDs in the intervention parks, we asked for feedback on the marketing training and support. We were able to complete follow-up interviews with 49 of the 50 PDs (33 of 34 intervention parks). To analyze these process-related data, we extracted PD comments from interview notes and placed them into a data display matrix (Ryan and Bernard, 2000; Ryan and Bernard, 2003), with each park a separate row and the interview topics explored across the columns. This approach allowed us to compare intervention parks’ actions to those of control parks and to summarize PD feedback on the marketing training and consultation.

Park-specific feedback; Interpretation of final results

At the end of the overall study, we provided a customized report to each park (n=50) and presented overall preliminary results to LARAP management and all 50 PDs for feedback before finalizing results. Prior to follow-up, we interacted with control park PDs only as needed to carry out the data collection activities. We did not invite control PDs to review the survey instruments or add any questions, we did not provide them with baseline results, and they did not receive any marketing training or resources.

RESULTS

Park Descriptions

Table 2 provides an overview of the diversity of the participating parks. Neighborhoods were diverse in race-ethnicity as well as poverty levels and population density. The parks themselves varied in size and somewhat in the number of sports fields and facilities. There was less variation in full-time staff, but a large range in part-time staff. From the observational data, we see that the parks also varied widely on number of park users. Park users tended to be male and Latino, but with a considerable range across parks in terms of race-ethnicity.

Table 2.

Characteristics of study parks at baseline (2008–2010) across diverse neighborhoods in Los Angeles (N=50)

Mean Range
Park Neighborhoods
Percent of households in poverty 23.6 2.8 – 42.5
Percent Latino 48.8 3.2 – 96.3
Percent Black 12.6 0.1 – 60.0
Percent White 26.2 0.7 – 90.7
Percent Asian/Pacific Islander 9.9 0.2 – 54.3
Percent Other 2.5 0.4 – 8.3
Population within 1 mile of park 39,370 5,075 – 125,201
Park Characteristics
Acres 13.0 0.8 – 64
Number of target areas observed 34 12 – 78
Number of sports fields 2.3 0 – 6
Number of facilities 10.1 4 – 17
Number of full-time staff 2.3 1 – 4
Number of part-time staff 13.3 3 – 50
Number of PAB members 6.6 0 – 23
Number of unique programs per year 9.9 0 – 14
Number of participants in park programs per year 1,604 48 – 24,710
Percent with after school program 70% NA
Percent in residential areas 54% NA
Park Observations (7 days, 4 observation periods per day per park)
Number of park users observed per park 2,082 145 – 4,635
Number of observed park users per acre per park 263.4 39.6 – 919.6
Percent male users 62.0 41.9 – 75.2
Percent Latino users 57.5 5.3 – 99.7
Percent White users 20.7 0.1 – 90.8
Percent Black users 14.8 0.0 – 74.4
Percent Asian/other users 7.0 0.0 – 84.5
Number of observed organized activity sessions per park 15.0 1.0 – 54.6
Number of observed supervised activity sessions per park 23.9 5.0 – 87.6
Percentage of park areas that were observed accessible 89.7 71.8 – 99.2
Percentage of park common areas that were observed empty 60.7 41.7 – 88.4

Derived from 2000 Census; based on a 1-mile radius from the park recreation center address.

Common areas include sports fields, playgrounds, gym, basketball courts and sport-specific areas.

Types of Park Actions Implemented

Intervention parks implemented a variety of strategies, and one way to categorize them is in how they spent the funds (Table 3). Nearly all intervention parks (32 of 34) opted for new signage, which included: banners announcing programs, enclosed bulletin board and message centers with more detailed program listings and announcements; signage and floor mats to indicate rec center entrance and office locations; and walking path signs providing mileage and encouraging messages. Over half of the intervention parks invested in promotional incentives and/or outreach or support for group activities. The promotional incentives included take home items (e.g., water bottles, reusable bags, key chains) with park name and messaging and targeted emails about upcoming programs. The group activities included new classes (e.g., zumba, Aztec dance, yoga, boxing, and martial arts) as well as walking clubs, jazz clubs, and drum circles. Intervention parks also implemented a variety of new strategies to improve outreach and marketing, such as getting patrons’ feedback and collecting emails at park events, using web-based sports league and class registration to increase their electronic databases (for marketing future programs), buying staff t-shirts with the park name, and developing stronger connections with schools, churches, and local businesses where they could distribute flyers about park programs.

Table 3.

Marketing expenditures across Los Angeles intervention parks (n=33), by category (2009–2011)

Category Examples Percent of total expenses across all parks Total dollar amount spent across all parks Number of parks that spent in this category
Signage Banners, bulletin boards, floor mats, staff t-shirts, table covers, bubba kegs, clipboards, staff aprons, walking path signage 51% $68,000 32
Promotional incentives Water bottles, bags, key chains, targeted emails 21% $27,000 18
Group activities Hiring instructors, class and activity materials, equipment for park events 28% $37,000 20
TOTAL $132,000

In comparing intervention park actions to any changes in facilities, programming, and marketing in the control parks, we found similarities and differences. Some control parks also reported having used banners to announce programs, but other signage was limited. Control parks also tended to report more cuts or no changes in programming, whereas the intervention parks reported increased programming, particularly among adults. Marketing strategies reported by control parks were overall less varied and made less use of web-based technologies than among intervention parks.

Feedback on Marketing Training

Among the in-person group workshops, webinars, and marketing consultation at each park, the PDs expressed more uniformly positive views on the in-person workshops with other PDs. Only one PD (of 34) reported not attending any workshops (this was due to a PD change so that the PD interviewed was not at the park when the workshops were conducted); most reported attending all or nearly all the five workshops. The positive and negative aspects of the workshops and exemplary quotations from the PDs are given in Table 4. The most frequently mentioned positive aspects of the workshops were: 1) interacting with other PDs and hearing what other parks were doing in terms of marketing; 2) getting ideas from a marketing professional that encouraged the PDs to “step outside the box”; and 3) feeling encouraged and supported in their jobs as recreation professionals. A small number of PDs felt they were already implementing many of the same marketing strategies and one PD expressed frustration that only ideas were discussed rather than “practical solutions.”

Table 4.

Exemplary Los Angeles park director feedback on marketing training (n=33), by theme (2010–2012)

THEME EXEMPLARY PARTICIPANT COMMENTS
Interacting with other PDs “What helped most was listening to other park directors about how they advertise their programs and see what groups to market to. I got direction on where to start.”
“I particularly liked hearing what other directors were doing and how it was working.”
Getting ideas from marketing professional “I got a lot out of it. Every time I was assigned [to attend], I went. I got more methods on how to interact with staff to make things more efficient and productive and get the message out into the community. Brainstorming was good because different stuff works in different communities.”
“I liked [the trainer’s] enthusiasm. I also liked her ability to get us to think about ways to reach out and find out what the community wants and then how to implement those ideas. I did a drum circle and marimba band concert and put out questionnaires and mailing list sign-ups and got new people to sign up each time.”
Feeling encouraged as recreation professional “The energy that [the trainer] brought made the directors feel better about their jobs. I found the sessions empowering. It is important to hear that it is ok to step outside the box and that trial and error is ok, that I don’t have to succeed in everything tried at the park.”
“It was sanity wise to get to work with others and exchange ideas with people like myself. We are recreation! Many are older and don’t see the importance of this [marketing].”
Already implementing marketing strategies “I come from a PR/marketing background, so I was familiar with the topics covered. But these activities confirmed what we were already doing.”
Marketing ideas were not practical “The ideas were not the most practical. [The trainer] suggested that we do some searching for funding matches and grant writing, potentially good ideas but I just don’t have the experience or time and got no guidance on how to do it. I found it frustrating that it was just ideas that were discussed rather than practical solutions.”

Lessons Learned about Engaging Stakeholders

We worked with various types of community stakeholders, and scaling up CBPR methods across 33 distinct parks and neighborhoods was challenging. We could not do the in-depth approach that many CBPR projects take, which often work in fewer communities. And a certain amount of standardization needed to occur – for example, the survey instrument comprised a core set of items that were the same across all parks and communities; specific questions that individual parks wanted to add were only used in those specific parks. In addition, we provided similar marketing resources across all intervention parks, although precisely what exactly each park did with these resources was largely at their discretion.

Another challenge was that although we invited PAB and other community members to help with data collection and invited PAB members to attend the marketing training sessions, relatively few accepted. The community data collectors, which we had in 7 of the 16 PD+PAB parks, had to be available for a full week of data collection. Similarly, the marketing training occurred during the weekday to accommodate the PDs, who need to be at their parks during the busy afternoon and evening hours. Meetings with PABs to get input on instruments and later to present findings occurred in the evening so that members could attend.

Our decision to work with an existing structure to obtain broader community input and use this in our randomized design presented challenges but also had its advantages. Some parks did not have a PAB when we started the overall study, and PDs indicated that maintaining these voluntary advisory bodies was often difficult. Additionally, PAB members tended to be very involved in the park or particular programs, not necessarily representative of the community at large, and some members did not want to attract more users to the park. Nevertheless, creating new structures for broad community involvement across 16 distinct neighborhoods would have presented substantial logistical and methodological challenges. Further, working with established structures of community stakeholders could help sustain efforts to promote park use and physical activity beyond the grant period.

Involving LARAP management throughout the overall study also enhanced sustainability and enabled the department to use results to advocate for the need for parks and programming, particularly in low-income areas of the city. Specifically, LARAP used overall study results during internal budget discussions with the LA City Mayor and his budget team, as well as during public discussions regarding City budget deliberations in 2012 and 2013. LARAP has also shared findings with park staff more broadly (not just participating parks) and with staff of the 15 City Council members.

DISCUSSION

Effective, scalable, community-based interventions that facilitate regular physical activity are needed to improve health across diverse populations. An estimated 70% of persons in the US live within walking distance to a park (Godbey et al., 1992) and parks appear to play a critical role in facilitating physical activity in minority communities (Godbey et al., 2005; Tinsley et al., 2002). But there is a little evidence base about what kinds of park-based interventions are effective. We used a CBPR approach that involved a parks and recreation department of a large urban metropolitan area, PDs and PAB members, and community data collectors to see if working collaboratively with PDs and PABs to develop park-specific outreach and programming interventions could increase park use and physical activity. As we describe in detail elsewhere (Cohen et al., 2013), both approaches (PD and PD+PAB) significantly increased park use and levels of park-based physical activity. In this article, we provide an overview of the community engagement, assessment, and action processes involved in these approaches as well as the lessons learned that can inform park-based efforts to increase community physical activity as well as more generally the science and practice of CBPR approaches across diverse communities.

Both of the approaches we took – working with PDs and working with PDs and their PABs – are different ways of involving community stakeholders in the research endeavor. Our research question was whether involving stakeholders in park assessment and development of park interventions could lead to increased park use and physical activity. But, ultimately, our goal was to increase local capacity to address an important health issue, similar to what others have suggested is a goal of community interventions (Trickett et al., 2011).

Our analysis of park actions implemented and the feedback from the PDs suggest that local capacity to market park programs and other activities with the local community was indeed enhanced through marketing training and modest funds. The fact that the marketing training itself resulted from requests from the PDs is also important – i.e., it came from a felt need. We found a basic level of marketing and outreach that is standard across parks (e.g., sharing flyers at schools, banners announcing programs); however intervention parks implemented a more diversified set of strategies after the marketing training, consultation, and support. Moreover, a number of PDs who participated in the trainings expressed an added benefit from interacting with their peers on these issues and getting encouragement about the importance of their roles. This might have been particularly important given that during our five year study, all 50 parks suffered substantial budget cuts, resulting in reductions in staffing and operating hours and affecting morale.

Nevertheless, our stakeholder engagement may have been limited by the fact that PABs and PDs did not choose the goal of the overall study. Some CBPR studies start with more strongly felt community needs – e.g., addressing urban environmental health problems – and take a more explicit social justice and advocacy orientation (Minkler, 2010). Not all PAB members and PDs were interested in increasing park use and, in fact, some felt that they needed to protect the park from becoming too busy and overrun. In addition, we met with each PAB on average only 4 times throughout the overall study to discuss the purpose, review data collection procedures and instruments, review and interpret results, and devise intervention strategies. We had additional meetings and contacts with the PDs to discuss overall study logistics, PD roles and perspectives, and park programming and other intervention activities. Limiting the number of meetings with the PABs was influenced by the fact that many meet only quarterly.

Despite the limitations, working with established community structures that are consistent across diverse communities enabled us to carry out this randomized controlled trial (RCT) across 50 diverse parks and thus provides lessons for others desiring to scale up CBPR methods. As interest in CBPR’s usefulness for improving intervention outcomes, particularly among racial-ethnic minorities, has increased, there have been calls for more rigorous designs such as RCTs (De las Nueces et al., 2012; Viswanathan et al., 2004). Scaling up CBPR approaches across diverse communities and types of organizational partners will likely require making decisions about what components of CBPR are essential to include and what types of standardization in the CBPR approach and the intervention are necessary across communities. Since CBPR is often proposed as a way to tailor research to specific communities, this standardization, necessary for a scientific evaluation, could undermine the very advantage that CBPR offers.

It has been suggested that CBPR approaches should focus on standardizing intervention function (what the intervention is trying to do) rather than form (i.e., components of the intervention)(Hawe et al., 2004). Precisely how to do this is conceptualized by Katz et al (2011) in the Multisite Translational Community Trial (mTCT). Nevertheless, the mTCT model has been criticized as “a truncated instrumental conception of CBPR” – i.e., CBPR in service of the RCT rather than CBPR as a “worldview” (Trickett, 2011, 2012). Tension therefore exists as to whether CBPR is scalable across diverse contexts or more appropriately used as a way to tailor research to unique settings to improve the quality and/or impact of scientific research.

Work therefore remains in understanding how to bring more rigor without undermining CBPR’s tenets. One challenge is how to balance science with practice in ways that lead to actionable research findings. Nevertheless, partnerships with diverse stakeholders that involve meaningful participation in various stages of research can facilitate the design of better and more sustainable interventions.

Highlights.

  • Working with community stakeholders can inform effective park-based interventions

  • Enhancing local capacity to address community health can promote sustainability

  • Established community infrastructure can facilitate partnering but has limitations

  • Work remains on balancing science and practice in community-based interventions

Acknowledgments

The overall study and preparation of this manuscript were funded by Grant No. R01HL083869 from the National Heart, Lung, and Blood Institute (NHLBI). Manuscript contents are solely the responsibility of the authors and do not necessarily represent the official views of NHLBI. We thank other collaborators at the Los Angeles Department of Recreation and Parks and in particular: Jon Kirk Mukri, General Manager; Kevin Regan, Assistant General Manager; and Charles Singer, Superintendent of Recreation and Parks Operations. We also acknowledge the important role played by the promotoras (bilingual community health promoters) from AltaMed Health Services in helping to collect the data and Stephanie Williamson of RAND in managing the data.

Abbreviations

CBPR

community-based participatory research

LARAP

Los Angeles Department of Recreation and Parks

PD

park director

PAB

park advisory board

SOPARC

System for Observing Play and Recreation in Communities

Footnotes

Conflict of Interest Statement

The authors declare that there are no conflicts of interest.

Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

Contributor Information

Kathryn Pitkin Derose, Email: derose@rand.org.

Terry Marsh, Email: tmarsh@rand.org.

Mark Mariscal, Email: mark.mariscal@lacity.org.

Sophia Pina-Cortez, Email: sophia.pinacortez@lacity.org.

Deborah A. Cohen, Email: dcohen@rand.org.

References

  1. Arredondo E, Mueller K, Mejia E, Rovira-Oswalder T, Richardson D, Hoos T. Advocating for environmental changes to increase access to parks: Engaging promotoras and youth leaders. Health Promot Pract. 2013;14:759–66. doi: 10.1177/1524839912473303. [DOI] [PubMed] [Google Scholar]
  2. Cohen DA, Han B, Derose KP, Williamson S, Marsh T, McKenzie TL. Physical activity in parks: A randomized controlled trial using community engagement. Am J Prev Med. 2013;45:590–7. doi: 10.1016/j.amepre.2013.06.015. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Cohen DA, Sehgal A, Williamson S, Sturm R, McKenzie TL, Lara R, Lurie N. Park Use and Physical Activity in a Sample of Public Parks in the City of Los Angeles. RAND; Santa Monica: 2006. [Google Scholar]
  4. De las Nueces D, Hacker K, DiGirolamo A, Hicks LS. A systematic review of community-based participatory research to enhance clinical trials in racial and ethnic minority groups. Health Serv Res. 2012;47:1363–86. doi: 10.1111/j.1475-6773.2012.01386.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Godbey GC, Caldwell LL, Floyd M, Payne LL. Contributions of leisure studies and recreation and park management research to the active living agenda. Am J Prev Med. 2005;28:150–58. doi: 10.1016/j.amepre.2004.10.027. [DOI] [PubMed] [Google Scholar]
  6. Godbey GC, Graefe A, James SW. The benefits of local recreation and park services: A nationwide study of the perceptions of the American public. National Recreation and Park Association; Ashburn, VA: 1992. [Google Scholar]
  7. Hawe P, Shiell A, Riley T. Complex interventions: How “out of control” can a randomised controlled trial be? BMJ. 2004;328:1561–3. doi: 10.1136/bmj.328.7455.1561. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Katz DL, Murimi M, Gonzalez A, Njike V, Green LW. From controlled trial to community adoption: The multisite translational community trial. Am J Public Health. 2011;101:e17–27. doi: 10.2105/AJPH.2010.300104. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Marsh T, Derose KP, Cohen DA. Exploring park director roles in promoting community physical activity. J Phys Act Health. 2012;9:731–8. doi: 10.1123/jpah.9.5.731. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. McKenzie TL, Cohen DA, Sehgal A, Williamson S, Golinelli D. System for Observing Play and Recreation in Communities (SOPARC): Reliability and feasibility measures. J Phys Act Health. 2006;3:S208–S22. doi: 10.1123/jpah.3.s1.s208. [DOI] [PubMed] [Google Scholar]
  11. Minkler M. Using participatory action research to build healthy communities. Public Health Rep. 2000;115:191–97. doi: 10.1093/phr/115.2.191. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Minkler M. Linking science and policy through community-based participatory research to study and address health disparities. Am J Public Health. 2010;100:S81–S87. doi: 10.2105/AJPH.2009.165720. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Pazoki R, Nabipour I, Seyednezami N, Imami SR. Effects of a community-based healthy heart program on increasing healthy women’s physical activity: A randomized controlled trial guided by community-based participatory research (CBPR) BMC Public Health. 2007;7:216. doi: 10.1186/1471-2458-7-216. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Ryan GW, Bernard HR. Data management and analysis methods. In: Denzin NK, Lincoln YS, editors. Handbook of qualitative research. Sage Publications; Thousand Oaks: 2000. pp. 769–802. [Google Scholar]
  15. Ryan GW, Bernard HR. Techniques to identify themes. Field Methods. 2003;15:85–109. [Google Scholar]
  16. Suminski RR, Petosa RL, Jones L, Hall L, Poston CW. Neighborhoods on the move: A community-based participatory research approach to promoting physical activity. Prog Community Health Partnersh. 2009;3:19–29. doi: 10.1353/cpr.0.0051. [DOI] [PubMed] [Google Scholar]
  17. Tester J, Baker R. Making the playfields even: Evaluating the impact of an environmental intervention on park use and physical activity. Prev Med. 2009;48:316–20. doi: 10.1016/j.ypmed.2009.01.010. [DOI] [PubMed] [Google Scholar]
  18. Tinsley HEA, Tinsley DJ, Croskeys CE. Park usage, social milieu, and psychosocial benefits of park use reported by older urban park users from four ethnic groups. Leisure Sci. 2002;24:199–218. [Google Scholar]
  19. Trickett EJ. Community-based participatory research as worldview or instrumental strategy: Is it lost in translation(al) research? Am J Public Health. 2011;101:1353–55. doi: 10.2105/AJPH.2011.300124. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Trickett EJ. Trickett Responds: Letter. Am J Public Health. 2012;102:582. [Google Scholar]
  21. Trickett EJ, Beehler S, Deutsch C, Green LW, Hawe P, McLeroy K, Miller RL, Rapkin BD, Schensul JJ, et al. Advancing the science of community-level interventions. Am J Public Health. 2011;101:1410–19. doi: 10.2105/AJPH.2010.300113. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. Troiano RP, Berrigan D, Dodd KW, Masse LC, Tilert T, McDowell M. Physical activity in the United States measured by accelerometer. Med Sci Sports Exerc. 2008;40:181–8. doi: 10.1249/mss.0b013e31815a51b3. [DOI] [PubMed] [Google Scholar]
  23. U.S. Department of Health and Human Services. Physical activity and health: a report of the Surgeon General. Author; Atlanta, GA: 1996. [Google Scholar]
  24. Veitch J, Ball K, Crawford D, Abbott GR, Salmon J. Park improvements and park activity: A natural experiment. Am J Prev Med. 2012;42:616–19. doi: 10.1016/j.amepre.2012.02.015. [DOI] [PubMed] [Google Scholar]
  25. Viswanathan M, Ammerman A, Eng E, Gartlehner G, Lohr KN, Griffith D, Rhodes S, Samuel-Hodge C, Maty S, et al. Community-based participatory research: Assessing the evidence. RTI International-University of North Carolina; Research Triangle Park, NC: 2004. [PMC free article] [PubMed] [Google Scholar]

RESOURCES