Journal of Healthy Eating and Active Living

Playgrounds for Health Equity: A Mixed Methods Study in Urban Central Texas

2025-12-05T08:34:29+00:00

Active outdoor play is a critical source of physical activity for children, and playgrounds constitute a key setting. However, research examining equity in access to playgrounds through a public health lens is limited in the United States (U.S.). This study in Austin, Texas, aimed to (1) assess geographic equity in public playground availability and (2) understand the organizational landscape and key actors' perspectives on barriers and opportunities for improvement. All metropolitan area public-access playgrounds were geocoded, and census tracts were categorized by playground count, median household income, percent of the population under ten and predominant race/ethnicity. Multinomial regression models examined the associations between neighborhood sociodemographic characteristics and playground availability. An organizational landscape analysis identified key organizations of relevance for playground access equity. Semi-structured interviews were conducted with representatives of key organizations, and inductive coding was used to identify themes. Results indicated greater availability of playgrounds in higher-income and predominantly non-white neighborhoods independent of the number of children a neighborhood had. Thirty-five key organizations across four partially overlapping focus domains (government, construction/architecture, community engagement, advocacy) were identified. Key informant interviews revealed six main themes (equity, community-based work, community mobility, playground environment, organizational scope, and advancing playground initiatives). Policy efforts in Austin should address socioeconomic disparities in playground availability and strengthen cross-sectoral collaboration.

Qualitative Assessment of Facilitators of and Barriers to Physical Activity Policy, Systems, and Environment Change in Rural West Virginia

2025-07-29T18:04:48+00:00

Policy, systems, and environment (PSE) change interventions are an evidence-based approach to take in rural areas of the US to improve physical activity (PA) rates. However, there is a need to understand the unique factors that affect such interventions in rural areas. This study used a descriptive, qualitative design to capture the perspectives of 25 key informants across eight participating counties as part of federally funded project. After purposive recruiting of participants via community-based coalition meetings and snowball sampling, trained researchers conducted semi-structured interviews via Zoom. Multiple team members developed a hierarchical coding structure of facilitators and barriers of PSE change including interpersonal, environmental, systems, or policy-related factors. Systems factors, when conceptualized using a resources-based model of public health capacity, were more often mentioned as facilitating or presenting a barrier to PSE change than were interpersonal, policy, or environmental factors. Specifically, the existence (or absence) of organizations and their financial and operational priorities were critical determinants of PA PSE change. The findings from this qualitative descriptive study can be used by rural practitioners to identify key facilitators of community-based PA PSE change to focus on based on the size and scope of the environmental change and may offer guidance for researchers doing similar work.

The Association between walkability and diverse health metrics: moderating role of social vulnerability

2025-12-05T08:33:45+00:00

Little research has considered associations between walkability and multiple health outcomes and the moderating effect of social determinants of health. This study examined relationships between walkability and diverse health issues (depression, poor mental health, poor physical health, mobility disability, obesity) and no leisure-time physical activity and whether these relationships were moderated by social vulnerability. Then, we assessed whether these moderated effects varied between urbanicity. For 1089 census tracts in South Carolina, we compiled EPA National Walkability Index, 6 health metrics from the CDC-PLACES dataset, and the CDC Social Vulnerability Index. Multilevel regression models were employed to account for the nested structure of the data, with census tracts (level 1) nested within counties (level 2). Overall, tract walkability was significantly negatively associated with poor mental health, poor physical health, obesity, and no leisure-time physical activity. The interaction between National Walkability Index and Social Vulnerability Index suggested that the relationship between health metrics and walkability varied depending on the level of social vulnerability in the community. In addition, tract rural or urban classification significantly affected the relationship between walkability and some health metrics. This study’s findings provide valuable insights for equitable urban planning and strategies to address walkability and public health issues.

Programs to Partnerships

2025-07-29T18:01:05+00:00

Chronic diseases remain a pressing issue in Texas, where high rates of obesity, diabetes, and cardiovascular conditions challenge public health. The Texas A&M AgriLife Extension Service addresses health by translating research into practice at the community level through educational programming and resources created by Extension Specialists and delivered by Extension Agents. HealthTalk Express is a simple, pre-prepared program addressing chronic conditions and encouraging active living and healthy eating. The program delivers short, science-based health presentations designed to inform and inspire behavior change. Since its relaunch in 2023, HealthTalk Express includes 12 modules and has reached over 2,000 adults across 43 counties, offering presentations on topics like stress reduction, heart disease, diabetes prevention, and cancer screening. Evaluation data show significant improvements in participant knowledge (+1.1 on a 5-point scale) and strong intention to adopt healthier behaviors (average score = 4.3 on a 5-point scale). Innovative evaluation methods using the AgriLife Extension Howdy Health platform allow for streamlined data collection and real-time reporting. In addition to improving health, the program fosters strategic partnerships by connecting Extension Agents to local organizations like senior centers, schools, and worksites. Agents report that providing one-shot and short series programs like HealthTalk Express provides a gateway to future programming. Also, its design enables delivery by trained Master Wellness Volunteers, expanding reach and freeing up Agents to engage in broader community-based solutions, like coalition-building. With continued development, HealthTalk Express stands as a promising and scalable model for chronic disease prevention and partnership development within the Cooperative Extension system.

Assessing the Impact of Sharrows on Bicyclist Behavior

2025-12-05T08:33:06+00:00

Bicycle infrastructure preferences vary by user experience and comfort, but evidence suggests both cyclists and drivers perceive separated bike lanes as safer than shared lane markings (sharrows). Little is known about sharrows impact in real-world settings, as no observational studies have evaluated their before and after installation impact. Santa Ana, California, incorporated sharrows into its active transportation plan to increase and encourage safe riding in a downtown commercial corridor where separated bike lanes were not feasible. Researchers conducted a natural experiment using a pre-post study design, collecting baseline data in 2015 before installation, and follow-up data in 2016 and 2017. A total of 54 hours of direct bicycle observation was conducted across two target areas over three years (2015 – 2017). A modest increase in bicycling was observed from 2015 to 2016, but was not sustained into 2017. Sidewalk and wrong-way riding increased slightly over time, while participation by female riders and older adults (65+) declined post-intervention. Sharrows offer a low-cost, scalable approach for promoting road sharing and guiding cyclists toward safer positioning, particularly in resource-constrained urban areas. This study’s real-world evaluation underscores the importance of tailoring active transportation infrastructure to meet safety and accessibility needs for all. Findings suggest sharrows are effective when paired with complementary strategies, such as targeted education, driver awareness efforts, or enhanced infrastructure, to better serve diverse populations and promote long-term engagement in bicycling. Further research can build on these insights by integrating user-centered evaluation methods and emerging data technologies.