How Leisure Agencies Can Address Preventive Public Health Factors?

Within the United States, park and recreation agencies (P&R) typically manage public leisure facilities, spaces, lands, and recreation programs. Public health (PH) evidence has increasingly pointed to local P&R agencies as a critical setting for promoting health. Addressing desired PH outcomes is a growing focus for P&R agencies. There are a variety of national programs and potential strategies available, but most agencies have limited resources and lack proven strategies on which to base their actions. However, the research base is growing. The global research question has shifted from asking IF leisure agencies can positively affect PH factors, to HOW they can best do so with limited resources. This study included a literature review along with iterative exploration through a threestage Delphi panel study with 17-leisure agency Key Informants in the U.S and Canada. Methods included identifying Informants through a waterfall selection process. Each had at least three years of senior administration experience in the field, representing agencies with interest in addressing and/or improving outcomes for at least one key health factor, and some designated assignment of resources towards addressing these issues. The study first explored which preventive PH factors appear to be most modifiable by leisure agencies. Results indicated that they are increased physical activity, improved nutrition, enhanced safety or perception of safety, increased social and parental engagement, improved transportation and access to locations (especially nature), and cessation or reduced over-consumption of tobacco and alcohol. However, research indicated that the priority of factors varies by community, and community-specific data on the health factors are not usually readily available to leisure agencies. The continuing challenge at the local level is determining the priority of the factors for agencies and their partners to address. The study explored methods, programs, strategies, and sample policies and documents utilized by agencies. Results indicated that it is critical to focus on: leadership to create a strong organizational culture of PH in P&R; allocation of staff and financial resources; cultural ethics of inclusion and equity; equitable access to assets and programs; collaboration; utilization of crime prevention and design strategies; increased health promotions; and centralized tracking of feasible measures. A community systems-thinking approach was suggested for identifying priorities and addressing the factors. Implications for research included need for additional validation and dissemination of research, evidence-based tools, and proven methods. Conceptual frameworks were refined to address management implications for a practice-focused systems approach, and to help address the gaps in knowledge transferal between leisure research and practice realms.