The objective of this study was to assess if built environment changes to two suburban parks that involved extensive community engagement and physical activity programming increased park use and physical activity. This study employed a natural experiment evaluation design where community engagement informed the redesign of two neighborhood parks. Community engagement in the redesign of the parks was tracked as was the diversity of the partners on the steering committee and participation by community members in the process. Before and after park improvements, data were collected using the System for Observing Play and Recreation in Communities (SOPARC) instrument to measure change in use and activity level in each park. Park use increased at both parks, but physical activity levels did not significantly improve. The number of park visitors observed increased by 53% and 50%, respectively. Both parks had increased usage during evening hours when the family programming was the greatest. This study has several implications for policy and practice. First, this study suggests that community engagement can play a role in redesigning a park and likely leads to increased awareness and use of neighborhood parks. Second, while park use increased, simply adding new features to a park may not immediately increase physical activity. Additional efforts need to be made to activate the park and increase physical activity. Third, practitioners should not discount the value of building park awareness that increases park use as it may be a first step to increasing physical activity.

Context: Only 58% of eligible Coloradans are enrolled in the Supplemental Nutrition Assistance Program (SNAP). In recent years, more community-based organizations (CBOs) and health care clinics are incorporating screening for social needs into their workflows. Program: Seven Colorado-based CBOs and 3 clinics received funding (2016-2018) to screen for food insecurity (FI) and provide SNAP application assistance to their clients and patients. Implementation: Funded agencies were required to implement strategies focused on particular populations or settings based on Food Research and Action Center recommendations. Evaluation: A 5-part care cascade from screening to SNAP enrollment was conceptualized to guide the evaluation. Funded CBOs and clinics were asked to submit de-identified individual-level data to the evaluation team (number and characteristics of individuals screened, screening results, interest in receiving assistance, submitted application, enrolled in SNAP). The purpose of the evaluation was to assess the proportion of individuals CBOs and clinics screen for FI and assist with completing a SNAP application and describe the characteristics of individuals who are not interested in receiving assistance to complete a SNAP application and the characteristics of individuals who enroll in SNAP. Results: Thirty-five percent of individuals who reported FI participated in the care cascade and enrolled in SNAP. CBOs assisted a greater proportion of food-insecure individuals (55%) than clinics (22%) (P < .001). Males, adults 40 years or older, rural residents, and African Americans were more likely to be interested in receiving assistance, and adults 40 years or older, rural residents, and American Indians/Alaska Natives were more likely to enroll in SNAP. Discussion: CBOs were more successful in assisting individuals along the care cascade than clinics. Certain subpopulations are more likely to be interested in receiving assistance and enrolling in SNAP. These findings can be used by public health practitioners to plan interventions to increase enrollment in SNAP.

The two leading causes of death in the U.S. are heart disease and cancer.¹ x 1 National Center for Health Statistics. Health, United States, 2016: With Chartbook on Long-term Trends in Health. NCHS, Hyattsville, MD; 2017 Google Scholar See all References Both of these diseases have modifiable risk factors, including diet, physical activity, and tobacco use.² x 2 Youon, P.W., Bastian, B., Anderson, R.N., Collins, J.L., and Jaffe, H.W. Potentially preventable deaths from the five leading causes of death—United States, 2008–2010. MMWR Morb Mortal Wkly Rep. 2014; 63: 369–374 PubMed | Google Scholar See all References The National Academy of Medicine and The Guide to Community Preventive Services (The Community Guide) recommend policy and environment strategies that local governments can take to increase healthy behaviors and improve health outcomes.³ x 3 Transportation Research Board, National Academy of Medicine, National Research Council. Local Government Actions to Prevent Childhood Obesity. National Academies Press;, Washington, DC; 2009 DOI: https://doi.org/10.17226/12674 Google Scholar See all References ^{, 4} x 4 Truman, B.I., Smith-Akin, C.K., Hinman, A.R. et al. Developing the Guide to Community Preventive Services—overview and rationale. Am J Prev Med. 2000; 18: 18–26 DOI: https://doi.org/10.1016/S0749-3797(99)00124-5 Abstract | Full Text | Full Text PDF | PubMed | Google Scholar See all References In 2008, to help local governments adopt policy and environmental strategies to improve population health, Kaiser Permanente worked with Public Health Advocates to establish the Healthy Eating/Active Living (HEAL) Cities and Towns Campaign in California. The Campaign provides local government agencies with the information, tools, and personalized assistance they need to implement the policy and environment strategies recommended by the National Academy of Medicine and Community Guide. Cities and towns that join the Campaign do so first by signing a resolution to express intent to work with the Campaign. Subsequently, cities work to formally adopt or implement programs, practices, policies, and environmental changes to support HEAL.

Healthcare systems such as Kaiser Permanente are increasingly focusing on patients’ social health. However, there is limited evidence to guide social health integration strategy. The purpose of this study was to identify social health research opportunities using a stakeholder-driven process. A modified Concept Mapping approach was implemented from June 2021 to February 2022. Stakeholders (n=746) received the prompt, “One thing I wish we knew more about to advance my work addressing social health...” An inductive content analysis approach was used to assign topics and synthesize and refine research-focused statements into research questions. Questions were then rated on impact and priority by researcher stakeholders (n=16). Mean impact and priority scores and an overall combined score were calculated. Question rankings were generated using the combined score. Brainstorming produced 148 research-focused statements. A final list of 59 research questions was generated for rating. Question topics were (1) Data, Measures, and Metrics; (2) Intervention Approach and Impact; (3) Technology; (4) Role of Healthcare Systems; (5) Community-Based Organizations; (6) Equity; (7) Funding; and (8) Social Health Integration. On a scale from 1 (low) to 10 (high), the mean impact score was 6.12 (range=4.14–7.79), and the mean priority score was 5.61 (range=3.07–8.64). Twenty-four statements were rated as both high impact (>6.12) and high priority (>5.61). The broad range of topics with high impact and priority scores reveals how nascent the evidence base is, with fundamental research on the nature of social risk and health system involvement still needed.