November 2014 - Parks & Recreation - 18

Community Center

Research Update: Evidence-Based
Programs and Practice
Resources, equity and why parks and recreation should move in this direction
By Mary J. Christoph, MPH, and Laura L. Payne, Ph.D.

hat parks and recreation help facilitate healthy, active lifestyles and physical activity is particularly important given that more than two-thirds of
adults in the U.S. are overweight or obese, a risk factor for many chronic
diseases. Since the 1990s, there has been a shift from chronic disease treatment
to prevention and wellness, and a focus on developing and implementing more
evidence-based practices (EBPs). Evidence-based practices are well-researched
programs that have been tested broadly and demonstrate effectiveness in a variety of populations; often, programs are focused around health promotion/disease prevention. Some early examples from the 1990s include NRPA's Hearts
'N Parks program and CATCH (Coordinated Approach to Child Health),
while current examples of EBPs include the Arthritis Foundation's Walk with
Ease program and the Stanford Chronic Disease Self-Management program.
Although EBPs are becoming more widespread, there are still significant disparities regarding organizations' knowledge and capacity to adopt EBPs.
Geographic Hurdles
Rural areas are particularly constrained by lack of human and monetary resources. According to 2013
U.S. Census data, almost 20 percent
of this country's population lives in
rural areas, which have higher poverty, all-cause mortality, obesity-related chronic diseases - 39.6 percent

16 Parks & Recreation

of rural versus 33.4 percent of urban
residents - inactivity and poorer access to healthy food.
While the Centers for Disease
Control and Prevention (CDC) has
emphasized the adoption of evidence-based health and wellness
programs, many rural communities
lack the knowledge, organizational

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capacity, funding and partnerships
to implement them. Even though
fewer rural residents are insured and
they are more likely to smoke or be
inactive than urban or suburban residents, relatively few rural counties
are included in funding initiatives to
target these risk factors and improve
wellness and prevention in their communities. Thus, it is important to
understand what is currently being
done in rural communities to prevent
chronic disease, assess program effectiveness and develop strategies that
lead to improved capacity to make
community-level changes in health
behavior and health outcomes.
Case Study of a Rural Community
The authors evaluated a recreation-based wellness program in a
rural Midwestern town - South
Town's (pseudonym) population is
13,000 and is 85.4 percent Caucasian
and 10.2 percent African-American.
The median household income is
$31,905, compared to $47,367 for the
state, and 14.6 percent of residents
live below the poverty line, while 18
percent are uninsured. In 2009, a local
hospital partnered with a recreation
center and a faith-based organization
to create a wellness center providing
community-based programs to address chronic disease management.
The resulting adult wellness program
promotes weight loss through physical activity and nutrition education.
More than 300 participants had
completed the six-week program by

November 2014 - Parks & Recreation

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