Reducing childhood obesity through coordinated care: Development of a park prescription program

Abstract

Major hindrances to controlling the current childhood obesity epidemic include access to prevention and/or treatment programs that are affordable, provide minimal barriers for participation, and are available to the general public. Moreover, successful childhood obesity prevention efforts will require coordinated partnerships in multiple sectors such as government, health care, school/afterschool, and the community but very few documented sustainable programs currently exist. Effective, community-based health and wellness programs with a focus on maintaining healthy weight via physical activity and healthy eating have the potential to be a powerful referral resource for pediatricians and other healthcare professionals who have young patients who are overweight/obese. The Miami Dade County Department of Parks, Recreation and Open Spaces in partnership with the University of Miami UHealth Systems have created a "Park Prescription Program (Parks Rx 4Health(TM))" that formally coordinates pediatricians, families, parents, caregivers, and child/adolescents to provide daily obesity-prevention activities. This Parks Rx 4Health(TM) program that we describe here allows UHealth pediatricians to seamlessly refer their overweight and obese patients to Fit2Play(TM), an evidence-based, park-based afterschool health and wellness program. Measurable outcomes that include body mass index, blood pressure, fitness, and nutrition knowledge are being collected at baseline and at 3-and 6-mo after referral to document patient progress. Results are then shared with the referring physician so they can follow up with the patient if necessary. Identifying successful models that integrate primary care, public health, and community-based efforts is important to accelerating progress in preventing childhood obesity. Effective, community-based health and wellness programs with a focus on physical activity and nutrition education could be a powerful referral resource for pediatricians who have obese patients.

Health professionals' views and experiences of discussing weight with children and their families: A systematic review of qualitative research

“…Making use of interventions such as social prescribing (referring patients to activities or programmes available within the community to improve their health and wellbeing; Bickerdike et al, 2017; Messiah et al, 2016).…”

The Association of Knowledge, Attitudes and Access with Park Use before and after a Park-Prescription Intervention for Low-Income Families in the U.S.

“…One approach currently gaining popularity is "park prescriptions", defined here as programs where clinicians prescribe or recommend park visits to encourage healthy, active living. In practice, these programs range from providers printing out maps of local parks [5], to partnerships with existing park programs [6], to health care providers leading park outings with patients [7].…”

The Effects of Park-Based Interventions on Health-Related Outcomes Among Youth: A Systematic Review

“…3 Yet, evidence suggests that youth, defined by the World Health Organization as children and adolescents 0–19 years, 4 , 5 are not meeting international physical activity guidelines, thereby contributing to poor health outcomes in childhood and later on in life. 1 , 6 - 8 Globally 80% of adolescents aged 11 to 17 do not meet the physical activity recommendations of at least 60 minutes per day of moderate-to-vigorous-intensity physical activity (MVPA), 9 and international studies of children from 3–6 years have found 21.2–35.6% of children do not engage in daily MVPA. 10 , 11 A recent evidence summary of physical activity studies for children and adolescents 5–17 years found that of the 21 systematic reviews evaluated, each review was geared towards interventions that impacted physical activity, yet there were limited reviews that examined the association between physical health and mental health for youth.…”