The Park Prescription Study: Development of a community-based physical activity intervention for a multi-ethnic Asian population

Abstract

This mixed-methods study aims to inform the development of a ‘Park Prescription’ intervention, including face-to-face counseling on physical activity and park use and providing weekly structured exercise sessions in the park to promote physical activity. Participants aged 40–65 years were recruited from regional health screening events in Singapore where they completed a questionnaire (N = 97) and consented to focus group (FG) participation (N = 16). The questionnaire assessed current park use, and the type, duration, and intensity of park-based activities that would be of interest. FGs explored the barriers and facilitators of physical activity (in parks). Short interviews (N = 16) with ‘doers’, i.e., people already engaging in park-based physical activity, identified motivational factors and ways to overcome common barriers. Participants acknowledged the health benefits of parks and valued them because of their pleasant landscapes, greenery and facilities. However, few participants engaged in physical activity at the parks, because they were too busy or too tired. Participants mostly indicated doing informal activities, such as walking, cycling or playing traditional Asian games when using the parks for exercise. A variety of low-to-moderate intensity park-based activities such as walking, cycling or aerobics were of interest to participants who expressed the willingness to engage in structured exercise sessions on weekday evenings or weekend mornings. Strategies to increase physical activity in parks included: encourage planning, create social support, identify alternatives for bad weather, improve proximity/accessibility to parks and park safety. The effectiveness of the Park Prescription intervention in promoting physical activity, park use, as well as physical and mental well-being will be tested in a one-year Randomized Controlled Trial.

Effectiveness of prescribing physical activity in parks to improve health and wellbeing - the park prescription randomized controlled trial

“…At the time of the study, health screenings took place across the entire city and participants for the present RCT were recruited from screenings conducted by a large hospital with a catchment population in the northern part of Singapore. Health screenings, together with the recruitment process to our study, had been previously described in detail [32,33]. Briefly, screening events followed a systematic approach at common community outdoor open spaces or community centers, followed by separate sessions during which residents picked-up their health report.…”

“…Due to its greenery and easy access to parks and green spaces it is also referred to 'a city in a garden' [30,31]. However, research has shown that 63% of Singaporeans visit parks and green spaces only twice per month or even less and few reported to engage in active sports in parks [32]. The Singapore context creates an opportunity to explore the application of the novel and increasingly popular approach of Park Prescription to the general population.…”

“…The Park Prescription Trial was conceptualized to address the research evidence gaps and evaluate a carefully developed park prescription intervention (PPI), implemented in the context of community health screenings free to middle-aged adult Singaporeans [32,33]. The objectives of the trial were a) to determine the effectiveness of PPI on PA related behaviours (including the primary outcome, accelerometer-measured moderate-to-vigorous PA), time spent in parks and PA in parks, as well as mental well-being and physical health outcomes, and b) to understand the mechanisms of impact of the PPI through a comprehensive process evaluation using qualitative and quantitative methods.…”

Activity in Nature Mediates a Park Prescription Intervention’s Effects on Physical Activity, Park Use and Quality of Life: A Mixed-Methods Process Evaluation

“…themes being repeated to a point where no new themes emerge) may not have been achieved. However, for most of the research questions it was only appropriate to engage these participants, they provided valuable insights and some of these were consistent with FGD feedback from the formative research that was conducted to develop the intervention (30).…”

“…They discussed being motivated by the intervention to do this in their own time. The formative research conducted to develop the PPI also found, that the target population of the intervention appeared to have a preference for shorter and less intense exercise (30). A population survey of 1,332 adults (response rate 46%) selected randomly from an Australian electoral role, which included questions on participants' preferences for structured versus unstructured PA found that 53% reported enjoyment of unstructured PA and 31% reported high enjoyment of structured PA.…”