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Strengthen the Evidence for Maternal and Child Health Programs

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Evidence Tools
MCHbest. Physical Activity.

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Strategy. Green Space and Parks

Approach. Create new parks and green space or rehabilitate empty or underutilized public areas to promote physical activity

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Overview. Where children live and what they have available in regard to areas and opportunities for physical activity are important considerations for communities who want to promote physical activity. There are differences in people's capacity to engage in different types of physical activity according to different factors, for example.[1] Improving availability to green space and parks through renovations or rehabilitation of underutilized or abandoned spaces can be a way to improve availability to areas of physical activity and reduce obstacles to physical activity. Studies with positive outcomes included increasing the number of parks, length of sidewalks, and amount of green space, as well as introducing community-organized play days in available public spaces.[2,3]

Evidence. Emerging Evidence. Strategies based on emerging evidence show promise but have not undergone extensive testing. While these approaches demonstrate potential, their effectiveness remains unconfirmed. Prioritize rigorous monitoring to ensure they achieve desired outcomes for all MCH populations.

Access the peer-reviewed evidence through the MCH Digital Library or related evidence source.

Potential Data Sources. Data to support this strategy can be accessed through:

  • Project planning documents and funding records
  • Community engagement and input records
  • Maintenance and usage logs for park amenities

Outcome Components. This strategy has shown to have impact on the following outcomes (Read more about these categories):

  • Environmental Health. This strategy improves the impact of physical, chemical, and biological factors in the environment on health.
  • Health and Health Behaviors/Behavior Change. This strategy improves individuals' physical and mental health and their adoption of healthy behaviors (e.g., healthy eating, physical activity).

Detailed Outcomes. For specific outcomes related to each study supporting this strategy, access the peer-reviewed evidence and read the Intervention Results for each study.

Intervention Type. Policy Development and Enforcement (Read more about intervention types and levels as defined by the Public Health Intervention Wheel).

Intervention Level. Community-Focused

Examples from the Field. Access descriptions of ESMs that use this strategy or aligned components.

Sample ESMs. Here are sample ESMs to use as models for your own measures using the RBA framework (see The Role of Title V in Adapting Strategies).

Quadrant 1:
Measuring Quantity of Effort (“What/how much did we do?”)

  • Number of community assessments conducted to identify areas lacking green space access. (Assesses data-driven planning)
  • Number of community engagement sessions held to gather input on green space design. (Measures comprehensive planning process)

Quadrant 2:
Measuring Quality of Effort (“How well did we do it?”)

  • Percent of green space projects that incorporate universal design principles for usability. (Measures design standards)
  • Percent of green space plans that include community relevant features and activities. (Evaluates responsiveness)

Quadrant 3:
Measuring Quantity of Effect (“Is anyone better off?”)

  • Number of local policies updated to support green space preservation and development. (Shows policy-level changes)
  • Number of community programs initiated to activate new for rehabilitated green spaces. (Assesses programming to support usage)
  • Number of additional hours of outdoor physical activity reported by residents near new for improved green spaces. (Quantifies behavior change)
  • Number of new walking for biking routes created to connect residential areas to green spaces. (Assesses improvements in active transportation)

Quadrant 4:
Measuring Quality of Effect (“How are they better off?”)

  • Percent of green space resources allocated to neighborhoods with highest obesity rates. (Measures resource distribution)
  • Percent of park features designed based on input from various community groups. (Assesses comprehensive decision-making)
  • Percent increase in physical activity levels among residents near new for improved green spaces, disaggregated by key characteristics. (Directly evaluates behavior change across subgroups)
  • Percent reduction in gaps in park access between different neighborhoods. (Measures improvements in environmental access)

Note. When looking at your ESMs, SPMs, or other strategies:

  1. Move from measuring quantity to quality.
  2. Move from measuring effort to effect.
  3. Quadrant 1 strategies should be used sparingly, when no other data exists.
  4. The most effective measurement combines strategies in all levels, with most in Quadrants 2 and 4.

Learn More. Read how to create stronger ESMs and how to measure ESM impact more meaningfully through Results-Based Accountability.

References

1 Centers for Disease Control & Prevention. (2022, July 26). Physical Activity Facts. https://www.cdc.gov/healthyschools/physicalactivity/facts.htm

2 Heath GW, Bilderback J. Grow healthy together: Effects of policy and environmental interventions on physical activity among urban children and youth. Journal of Physical Activity and Health. 2019 Feb 1;16(2):172-176.

3 Meyer MRU, Hamilton CNB, Prochnow T, McClendon ME, Arnold KT, Wilkins E, Benavidez G, Williams TD, Abildso CG, Porter KMP. (2019).Come together, play, be active: physical activity engagement of school-age children at Play Streets in four diverse rural communities in the US. Preventive Medicine. 2019 Oct;129:105869.

This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U02MC31613, MCH Advanced Education Policy, $3.5 M. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.