Park Rx and Physical Activity Among Low-income Children

Study Overview
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Brief Summary
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This study is a randomized controlled trial to evaluate ParkRx, a clinic-based counseling intervention in which health care providers prescribe park visits at a specific frequency, duration, and includes instructions for physical activity in the parks. We will assess whether prescribing visits to specific parks changes physical activity levels and improves health and mental health outcomes among low-income pediatric patients.

Detailed Description
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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.

Official Title
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Park Rx, Physical Activity and Other Health Benefits Among Low-income Children

Conditions
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Physical Activity, Mental Health Wellness 1

Intervention / Treatment
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* Behavioral: Park Rx


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: ages >6 and <16 with one or more diagnoses of chronic conditions that usually require two or more routine health care provider visits per year. ADHD, or Overweight or obesity, or hypertriglyceridemia or hypercholesterolemia, or pre-diabetes or Type 2 diabetes. AND Likely to live in the Washington DC area in the next 2 years. Exclusion Criteria: - Individuals who have previously been given a park prescription

Ages Eligible for Study
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Minimum Age: 6 Years
Maximum Age: 16 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Participants will be assigned to get Park Rx or to receive care as usual.
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Park Rx<br>Participants will be given a park prescription as part of their treatment plan | Behavioral: Park Rx<br>* Participants will be advised to visit a specific park at a specific frequency and duration<br>|
| No Intervention: No Park Rx<br>Usual care only | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in Physical Activity | Accelerometer measured | Baseline, 3 months, 6 months 12 months and 2 years | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in Cognition | We will use the NIH toolbox A)The Flanker Inhibitory Control Test; B) Dimensional Change Card Sort Test C) List Sorting Working Memory Test | Baseline, 3 months, 6 months 12 months and 2 years |