Abstract
Background and Purpose. The American Heart Association recommends community-based research on shared use of physical activity (PA) spaces. Pasadena, a community in southeast Houston, Texas with lower socioeconomic status and racial/ethnic diversity, was the setting for our study. Efforts to increase access to PA in Pasadena include building the evidence on PA resources. The purpose of this research was to utilize survey data in a community setting to inform and target efforts around sharing PA spaces. Method. An online survey was administered to K-12 school (n = 25) and park (n = 30) administrators, church leaders (n = 10), community organizations (n = 2), a health care center, and a local business. Results. Park facilities in Pasadena shared by agreement with two high schools and three baseball/softball leagues were ballfields, tennis courts, and jogging paths. No park facilities were shared with faith-based organizations. Four parks communicated daily, and five schools communicated with parks quarterly about providing opportunities for PA. Key facilitators to sharing facilities were building relationships and collaboration, service to the community, and improving health. Key barriers were cost, maintenance, staffing, and prioritizing use with limited time, facilities, and resources. Conclusions. This study is the first of its kind to address shared use at the community level and suggests opportunities to improve communication and partnerships between parks, schools, and churches. This research will inform ongoing efforts to promote access by identifying barriers and motivators among stakeholder groups to help facilitate shared use agreements.
Keywords
Introduction
Increasing access to physical activity opportunities is associated with positive changes in youth physical activity behavior and many additional individual, social, economic, and environmental benefits for communities (Kahn et al., 2002; Kanters, Bocarro, Filardo, et al., 2014; Roemmich et al., 2006). Increasing access to physical activity can be described as changes to local environments that create new opportunities for physical activity or reduce the cost of existing opportunities (Briss et al., 2000). However, communities of color and lower income areas often have fewer locations and limited access to places that can be used for physical activity (Powell, Slater, Chaloupka, & Harper, 2006; Wolch, Byrne, & Newell, 2014). Also, many communities have limited opportunities to provide physical activity programing because existing facilities do not share their recreational space, and/or may restrict availability to the general public (Carlton et al., 2017; Evenson, & McGinn, 2004; Evenson, Wen, Lee, Heinrich, & Eyler, 2010). Finding opportunities for physical activity is even more challenging for ethnic minority communities, especially among those whose primary language is not English.
Background
One solution to this challenge is through the shared use of existing community spaces to provide opportunities for physical activity. Shared use refers to situations where schools or other entities open up their facilities during nonschool or nonbusiness hours for community use. Sharing physical activity spaces is an American Heart Association recommended strategy to increase physical activity in the community setting (Young et al., 2014). Benefits of shared use include increased physical activity levels for the community, shared schools or facilities as a resource for the public, and increased levels of physical activity leading to potential improvement in children’s academic performance (Farley et al., 2007; Young et al., 2014). A survey of four geographic regions in the United States found that of all types of shared facilities, outdoor public facilities were more likely to be available to the community than indoor facilities (Evenson & McGinn, 2004). Nationally, challenges to opening facilities to the community include liability, insurance, safety, cost, staffing, and maintenance (Spengler, 2012). For low socioeconomic status communities and in communities of color, facilities are less likely to offer shared use than in higher income communities (Cox et al., 2011; Hardison-Moody et al., 2017; Kanters, Bocarro, Moore, Floyd, & Carlton, 2014).
Another form of shared use, called shared-use agreement, is the provision of access through a formal contract between the facility and another entity including municipalities, nonprofits, or faith-based groups (Young et al., 2014). Shared-use agreements encourage physical activity by formalizing collaborations with organizations that offer organized, supervised activities, such as a sports league utilizing a community park (Spengler, 2012). Key issues to be addressed in implementing shared-use agreements are facility costs, staffing and maintenance, misuse, and liability concerns (Jones & Wendel, 2015; Spengler, Ko, & Connaughton, 2012). With these challenges in mind, the American Heart Association recommends community-based research on shared use to further investigate the process, outcomes, and the networks connecting partners in the community setting (Young et al., 2014). Earlier national studies found a lack of progress in the shared-use landscape with insufficient community-level assessment (Evenson et al., 2010; Evenson & McGinn, 2004; Spengler, 2012; Spengler, Connaughton, & Carroll, 2011). Current shared-use efforts, such as those through ChangeLab Solutions, have increased over the last decade, specifically with regard to the community-level setting and health equity.
The Study on Environmental and Individual Deter-minants tested the social ecological framework and demonstrated access to facilities is a crucial step in creating a supportive environment for physical activity behavior (Giles-Corti & Donovan, 2002). Not only is access to a supportive physical environment important, strategies and programming are needed to influence individual and social environmental factors supporting community-level physical activity (Carlton et al., 2017; Giles-Corti & Donovan, 2002). The purpose of this study was to determine facilitators and barriers, and other key issues, relevant to sharing facilities with the public for the purposes of active recreation, sport, and other forms of physical activity in urban, low-income and ethnic minority communities. This study fills a gap in the literature on the topic of shared use by investigating shared use at the micro-level and within the community context in an urban setting with a low-income and ethnic minority population. This is particularly important because of the limited access to physical activity opportunities for ethnic minority communities and communities whose language is not primarily English. Additionally, important research to practice links are shared.
Method
Partners
The research team attended a town hall hosted by the Clinton Health Matters Initiative (CHMI) in Houston, Texas. The purpose of the meeting was to solicit community input and perspective in providing context to the current state of shared use and existing physical activity networks and spaces within Houston. Also, at the meeting, the author team focused efforts on a smaller portion of the Houston area, Pasadena, to account for this project’s scope and community’s need. After refining project goals, the team collaborated with community partners, CHMI, Healthy Living Matters (HLM), and the Harris County Public Health, via e-mail and by phone over the next several months.
Within the Houston area, CHMI is designed to increase youth access to sports, especially for low-income and ethnically diverse youth. One of CHMI’s stakeholders, HLM—Pasadena, is a community coalition that has more than 80 organization members that includes MD Anderson, Catholic Health Initiatives St. Luke’s Health, the City of Pasadena’s Health Department, Parks and Recreation, School District, and faith-based organizations. HLM has similar goals to CHMI, with a focus on the reduction of childhood obesity through policy efforts and increased visibility. The policy actions most relevant to our project goes by the name “PLAY” (not an acronym), which aims to promote safe, adequate, and appropriate physical activity for all children in Harris County.
Collaborative efforts among the research team and community partners, included the creation of a facility list for all locations having the potential to support active recreation, sport, and other forms of physical activity, identification of facility administrators for each of the facilities on the list, and input on survey design and delivery. After the facility list was vetted, surveys were distributed to facility administrators. From their respective entities, community partners sent reminder e-mails, and encouraged survey participation during data collection.
Setting
The priority area for this study was the city of Pasadena, which borders the city of Houston, Texas. Pasadena has approximately 36% of residents living below the federal poverty level, 57% primarily Hispanic/Latino, 26% of people aged 25 and older with less than a high school degree, 77% of children are overweight or obese, and 77% of overall residents getting less than the recommended levels of physical activity (Harris County Public Health & Environmental Services, 2014). The author team spearheaded a recent effort to increase access to physical activity in Pasadena, including the documentation of physical activity resources. Specifically, CHMI has identified access to physical activity as a priority area to reduce preventable health outcome recurrences and has worked within the Houston area to develop an Access to Sports Coalition. HLM—Pasadena is a CHMI community coalition in support of implementing shared-use agreements and/or developing community-school partnerships.
While there is an escalation in efforts to increase access to physical activity, sport, and play in the Houston/Pasadena area such as through the efforts of CHMI and HLM, there is a lack of data surrounding existing physical activity resources to support advocacy efforts and policy implementation. After discussions with community partners, three priority zip codes within the northern portion of Pasadena (77506, 77502, and 77503) were set as the priority area. This area has higher rates of childhood obesity, families living below the poverty line, greater ethnic diversity, and is consistently used as a priority area for community led initiatives (Harris County Public Health & Environmental Services, 2014). Only facilities within the geographic region of the three priority zip codes were included in this study.
Procedures
In August 2016, community partners created and vetted a list of all facilities with the potential for active recreation, sport, and other forms of physical activity within three priority zip codes (77506, 77502, and 77503) in Pasadena. The list included all schools within the Pasadena Independent School District, Pasadena Parks and Recreation park facilities, faith-based organizations, two community organizations, a local business, and a community health center. A self-report online survey was developed using Qualtrics, and administered to facility administrators at K-12 schools (n = 25) and parks (n = 30), church leaders (n = 10), community organizations (n = 2), a health care center, and a local business in October and November 2016. Facility administrators were the principals of the schools, the head of the Pasadena Parks and Recreation Department, lead pastors at each of the churches, and the directors of the other facilities. Some facility administrators, including the parks administrator, were responsible for more than one facility within the priority zip codes, and were asked to respond once to the survey. Surveying facility-level administrators has been used in prior studies to understand key barriers to shared use (Spengler, Connaughton, & Maddock, 2011).
Survey items derived from a previously validated questionnaire investigating perceptions of liability risk (Spengler et al., 2012). A Delphi panel of experts reviewed the original questionnaire in 2009, was more recently vetted and updated by a separate panel of experts in 2016 and received institutional review board approval. Updates to the original survey, was the addition of potential opportunities to increase access to physical activity (facilitators). Survey items included demographics of the facility-level administrator, description of the types of physical activity programs offered, communication with other organizations in the Northern Pasadena area, partnership with these organizations, level of sharing of their respective facilities with other entities within and outside of the priority zip codes, and the facilitators and barriers to shared use of each individual facility. Recruitment included an e-mail to facility administrators containing the survey link, a 1-week follow-up call, and consecutive e-mails and calls for second and third contact attempts. Survey results were collected and analyzed in Qualtrics. Descriptive statistics were gathered and analyzed in Microsoft Excel. Additionally, some results were linked to a geospatial map of the facilities and shared with community partners for input before finalizing the map (described further in another paper by the author team).
Results
A total of 25 facility administrators responded to the survey to account for 53 of the 68 facilities (78%), and a response rate of 64% for facility administrators. Within each sector, responses accounted for all the 30 parks, 13 of the 25 schools, 6 of the 9 churches, and all the other 4 organizations. Common types of physical activity programs offered at the facilities included team and individual sports and practices (in parks), physical education classes, recess, and free play (in schools), and other activities such as youth group and ladies exercise classes (in churches), and boot camps (in other organizations).
With regard to communication between organizations such as schools, churches, and parks about physical activity opportunities, 14% reported contact monthly, 29% quarterly, 29% yearly, and 29% never communicated at all. Specifically, four parks communicated daily, and five schools communicated with parks quarterly about providing opportunities for physical activity. In response to describing current relationships with other organizations, one facility administrator responded that they collaborate (work side-by-side and actively pursue opportunities to work together) with at least one other organization in the priority zip codes, two responded with coordination (work side-by-side as separate organizations to achieve common program goals), two with cooperation (share information and work together when any opportunities arise), two with communication only (share information only when it’s advantageous), and the other responses were not linked or integrated with another organization regarding physical activity opportunities.
For shared use of space, 33% of amenities such as fields, courts, and so forth, were shared through a formal shared use agreement with other entities for the purpose of providing opportunities for physical activity (see Figure 1). When looking at the aggregate, all sectors shared some of their space, with ball fields, playgrounds, and gymnasiums reported as the most commonly shared amenities. Only parks reported that they had formal shared-use agreements (contracts) governing the shared use of the following amenities: ballfields, tennis courts, and jogging paths. These agreements were with two high schools and three baseball/softball leagues. No park facilities were shared with faith-based organizations by formal agreement.
Type of Facility Amenities Shared With Others
The survey asked facility administrators to discuss facilitators and barriers when sharing their facility with the public or other entities by responding to two separate Likert-type scales. Each scale had several preselected items listed regarding shared use with response options ranging from not at all important to extremely important. Table 1 displays facilitators and barriers with relation to the type of facility sector. Overall, the key facilitators to sharing facilities were building relationships and collaboration, service to the community, and improving health. For schools, churches and others, building relationships with families was the most important facilitator while public service was most important for parks. Overall, the most common barriers reported were cost, maintenance, staffing, and prioritizing use with limited time, facilities and resources. The sectors differed in the most important barrier with parks reporting priority of use issues, schools reporting liability concerns, churches reporting staffing, and others indicating cost as the most important barrier. Once all survey data were collected and studied, results were shared with community stakeholders through a formal presentation with time for feedback regarding dissemination efforts and recommendations for future use.
Self-Report of Facility Administrators Facilitators and Barriers to Shared Use
Discussion
Survey responses yielded several existing physical activity programs were offered across the organizations, demonstrating there are some opportunities to be active within the priority zip codes. Communication and partnership findings revealed, infrequent communication patterns, with at most a few organizations communicating monthly or less frequently, and only one organization reporting collaboration with another entity. Growth in communication and coordination of physical activity programs and facilities may help mobilize residents to participate in more opportunities. In particular, communication must improve where opportunities for partnerships exist between organizations within walking distance. Consistent with the efforts around the Centers for Disease Control and Prevention’s (CDC) Comprehensive School Physical Activity Program, strong coordination between all organizations in the priority zip codes can help youth participate in and reach national guidelines for physical activity (CDC, 2013).
Across sectors, respondents reported facilitators to shared use showing a willingness and interest in sharing facility space with the community. Aligned with many of the benefits of shared use, respondents stated they would be encouraged to share their facility to meet the health needs of the community and to build better relationships with families. Shared-use promotion efforts can use these motivating factors as communication tools to solicit buy-in regarding informal or formal sharing of facilities. With regard to barriers to shared use, this study mirrors national efforts in the types of challenges faced by facility administrators including staffing, liability, and cost. As an example, results of this study support findings from national studies where liability was found to be an important and primary barrier to shared use for schools (Spengler, Connaughton, & Maddock, 2011). Adding to the knowledge gained from the findings from national studies, this community assessment reveals sector-level differences in the barriers faced by facilities within the priority zip codes. Attention to the sector differences will be crucial in creating a coordinated and connected network of partners and addressing gaps in access and programming as can be indicated on a community asset map.
Utilizing formal shared-use agreements may help address the barriers surrounding liability, misuse of facilities, insurance, and maintenance concerns expressed by facility administrators (Chace & Vilvens, 2015). For example, a sport organization may enter into an agreement with a school, stating they will take care of the field, or might take on the risk of liability, in exchange for use of the school facilities. These types of formal agreements set guidelines for use and help address and relieve concerns among parties of the agreement (Young et al., 2014).
Written policies on shared use, though important, are not effective without communication and implementation. A Pasadena Independent School District policy, for example, states that it allows community relations and nonschool use of facilities (Pasadena ISD 101917). Though the policy exists, it is possible that not all the schools are aware of the policy, and for those that are aware, they may not know how to implement the policy for the purposes of shared use. Also, community partners and organizations interested in physical activity promotion may not be aware that schools in Pasadena have the ability to enter into a shared-use agreement. Such partners might include professional sports teams interested in offering camps and after school programs, as well as the Young Men’s Christian Association (YMCA), which was recently forced to close its location within the priority zip codes. Additionally, past efforts involving shared-use agreements have primarily targeted schools, with fewer efforts targeting churches and other community agencies and organizations. To promote shared use for these particular facilities in the priority zip codes, additional education and awareness efforts must be carried out by community partners.
To help schools who may also be concerned about cost, the Joint Use Cost Calculator, developed by 21st Century School Fund and University of California–Berkeley’s Center for Cities and Schools, allows schools to determine the cost of ownership of all of its facilities and grounds and enables schools to develop a fee structure for community use (Filardo, Vincent, Allen, & Franklin, 2010). While developing a fee structure is only a part of the process to enter into a shared-use agreement, it will allow community organizations to negotiate utilization of school facility space. Similarly, these formulas and processes can be utilized for churches and other organizations who express cost as one of their main barriers to shared use.
Unique to this study as compared with national studies conducted on shared use is the investigation of faith-based organizations and their respective facilities in a small-underserved Hispanic/Latino community. In the past 10 years, physical activity interventions in faith-based organizations have increased and have been successful at improving health (Hardison-Moody et al., 2017; Lancaster, Carter-Edwards, Grilo, Shen, & Schoenthaler, 2014; Tristão Parra, Porfírio, Arredondo, & Atallah, 2018). The CDC has suggested faith-based organizations as settings to promote physical activity, and the National Physical Activity Plan dedicates a section to faith-based settings (CDC, 2011). Interestingly, during recruitment, several respondents from faith-based organizations mentioned the confusion or lack of fit for participating in this study due to their affiliation as a church. When probed using the survey questions regarding level of physical activity programming and facility space available for physical activity, many of these organizations were not only equipped with amenities that could be used for the purposes of physical activity but also offered physical activity programming and were interested in being a part of the shared-use network. These facilities hold great potential for serving the physical activity needs of people in the community and within the priority zip codes.
The study had several limitations, including a small community-level sample size, limiting the ability to generalize to other settings. Second, we were not able to secure participation from all the churches, with speculation, and confirmation from one respondent that churches may have opted out due to feeling of lack of fit or relevance to the study. Another limitation was that there were a few organizations that were not included on our list that study participants reported in the survey. These were two Spanish-language churches and the City of Pasadena who was a stakeholder in the study but was not considered a participant despite the city offering programs and having some facility space. While this community is predominantly Hispanic/Latino, awareness of access to physical activity programs or facilities with service offered in Spanish was very low, if not absent from the discussions with community partners. Improving community awareness of available physical activity programs is essential in providing equitable access to residents in Northern Pasadena.
Conclusions
This research will inform ongoing efforts to promote access to physical activity through the identification of facilitators and barriers to shared use within Pasadena. For example, a presentation of these study findings was shared with CHMI and HLM, and results were posted in quarterly newsletters. Both community-level partners utilized findings to spark a series of programs aimed at increasing access to physical activity through the Access to Sports Coalition. One outcome was the creation of a new playground/play space in an identified place of need. Within the priority zip codes, understanding the reasons for not opening or sharing space can be used as a starting point in negotiating use and developing contractual arrangements for sharing space. Efforts to include facilities identified in this study have been initiated by CHMI and HLM. Also, promotional efforts can be enhanced by understanding the motivating factors behind sharing physical activity spaces with the public. For instance, the district-level policy on shared use was emphasized in the presentation and newsletter. This policy clarifies liability protections for schools and discussing it with school-level representatives may encourage schools to engage in shared use agreements with external organizations.
This study is one of the first to address shared use at the local level in an urban low-income and ethnic minority community (Omura et al., 2017), and can serve as a blueprint, in conjunction with asset mapping, to guide future efforts around promoting and increasing access to physical activity spaces within communities of this type. Specifically, an increase in efforts to form connections between community, faith-based organizations, and schools, to address physical activity at multiple levels of the social ecological framework. As an example, future work should consider forming a task force or coalition representative of all partners in the community, including the school-level administrators, leaders of community programs, the director of parks and recreation, and the pastors and/or outreach directors of faith-based organizations. For low-income and ethnic minority communities, it is also crucial to include individuals and organizations working to promote shared use who understand the culture and native languages of the residents. Communicating the importance and the specific roles of community partners in the effort to increase access to physical activity is critical to fostering a supportive physical environment.
