{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T10:20:21Z","timestamp":1760955621953,"version":"build-2065373602"},"reference-count":30,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2016,4,8]],"date-time":"2016-04-08T00:00:00Z","timestamp":1460073600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Introduction: Childhood obesity affects ~20% of children in the United States. Environmental influences, such as parks, are linked with increased physical activity (PA). Objective: To examine whether changes in Body Mass Index (BMI) z-score were associated with construction of a new park. Methods: A quasi-experimental design was used to determine whether living in proximity of a park was associated with a reduction in BMI z-score. Children were selected from health clinics within an 11 mile radius of the park. A repeated-measure ANOVA was employed for analysis of the relationship between exposure (new park) and BMI z-score. Results: Participants were 1443 (median age 10.3 range (2\u201317.9 years), BMI: z-score 0.84 \u00b1 1.09) African American (77.4%) adolescents. Change in BMI z-score was not statistically different for children living at different distances from the park after controlling for age, gender, race, ethnicity, or payer type (p = 0.4482). We did observe a small 0.03 increase in BMI z-score from pre- to post-park (p = 0.0007). There was a significant positive association between child\u2019s baseline age and BMI z-score (p &lt; 0.001). Conclusions: This study found proximity to a park was not associated with reductions in BMI z-score. Additional efforts to understand the complex relationship between park proximity, access, and PA are warranted.<\/jats:p>","DOI":"10.3390\/ijerph13040411","type":"journal-article","created":{"date-parts":[[2016,4,8]],"date-time":"2016-04-08T21:02:38Z","timestamp":1460149358000},"page":"411","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Urban Park Development and Pediatric Obesity Rates: A Quasi-Experiment Using Electronic Health Record Data"],"prefix":"10.3390","volume":"13","author":[{"given":"TaShauna","family":"Goldsby","sequence":"first","affiliation":[{"name":"Office of Energetics, University of Alabama at Birmingham, Birmingham, AL 35294, USA"},{"name":"Nutrition Obesity Research Center, University of Alabama at Birmingham, Birmingham, AL 35294, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brandon","family":"George","sequence":"additional","affiliation":[{"name":"Office of Energetics, University of Alabama at Birmingham, Birmingham, AL 35294, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valerie","family":"Yeager","sequence":"additional","affiliation":[{"name":"Department of Global Health Management and Policy, Tulane University, New Orleans, LA 70112, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bisakha","family":"Sen","sequence":"additional","affiliation":[{"name":"Department of Health Care Organization and Policy, University of Alabama at Birmingham, Birmingham, AL 35294, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alva","family":"Ferdinand","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Management, Texas A&amp;M Health Science Center, College Station, TX 77843, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Devon","family":"Sims","sequence":"additional","affiliation":[{"name":"Scientific Technologies Corporation, Scottsdale, AZ 85258, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bryn","family":"Manzella","sequence":"additional","affiliation":[{"name":"Jefferson County Department of Health, Birmingham, AL 35233, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Asheley","family":"Cockrell Skinner","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine, The Duke Clinical Research Institute, Duke University, Durham, NC 27705, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3566-9399","authenticated-orcid":false,"given":"David","family":"Allison","sequence":"additional","affiliation":[{"name":"Office of Energetics, University of Alabama at Birmingham, Birmingham, AL 35294, USA"},{"name":"Nutrition Obesity Research Center, University of Alabama at Birmingham, Birmingham, AL 35294, USA"},{"name":"Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL 35294, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nir","family":"Menachemi","sequence":"additional","affiliation":[{"name":"Department Health Policy and Management, Indiana University, Indianapolis, IN 46202, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2016,4,8]]},"reference":[{"key":"ref_1","unstructured":"Centers for Disease Control and Prevention Childhood Obesity Facts: Prevalence of Childhood Obesity in the United States, 2011\u20132012, Available online: http:\/\/www.cdc.gov\/healthyschools\/obesity\/facts.htm."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"S18","DOI":"10.1038\/sj.ijo.0800880","article-title":"Role of physical activity in the prevention of obesity in children","volume":"23","author":"Goran","year":"1999","journal-title":"Int. J. Obes. Relat. Metab. Disord."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1493","DOI":"10.1097\/00005768-199911000-00001","article-title":"Physical activity in the prevention and treatment of obesity and its comorbidities: Evidence report of independent panel to assess the role of physical activity in the treatment of obesity and its comorbidities","volume":"31","author":"Grundy","year":"1999","journal-title":"Med. Sci. Sports Exerc."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1146\/annurev.publhealth.22.1.337","article-title":"Preventing obesity in children and adolescents","volume":"22","author":"Dietz","year":"2001","journal-title":"Annu. Rev. Public Health"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1016\/j.healthplace.2007.08.004","article-title":"The sociodemographics of land use planning: Relationships to physical activity, accessibility, and equity","volume":"14","author":"Aytur","year":"2008","journal-title":"Health Place"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1016\/S0749-3797(02)00472-5","article-title":"Exploring the effect of the environment on physical activity: A study examining walking to work","volume":"23","author":"Craig","year":"2002","journal-title":"Am. J. Prev. Med."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1016\/j.amepre.2008.05.028","article-title":"Walkability and body mass index density, design, and new diversity measures","volume":"35","author":"Smith","year":"2008","journal-title":"Am. J. Prev. Med."},{"key":"ref_8","first-page":"A100","article-title":"Children\u2019s active commuting to school: Current knowledge and future directions","volume":"5","author":"Davison","year":"2008","journal-title":"Prev. Chronic Dis."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"83","DOI":"10.4278\/0890-1171-18.1.83","article-title":"Environmental correlates of physical activity in a sample of Belgian adults","volume":"18","author":"Sallis","year":"2003","journal-title":"Am. J. Health Promot."},{"key":"ref_10","first-page":"E57","article-title":"Effect of changes to the neighborhood built environment on physical activity in a low-income African American neighborhood","volume":"9","author":"Gustat","year":"2012","journal-title":"Prev. Chronic Dis."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1542\/peds.2005-0058","article-title":"Inequality in the built environment underlies key health disparities in physical activity and obesity","volume":"117","author":"Nelson","year":"2006","journal-title":"Pediatrics"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"935","DOI":"10.1001\/archpediatrics.2010.167","article-title":"The effect of perceived and structural neighborhood conditions on adolescents\u2019 physical activity and sedentary behaviors","volume":"164","author":"Kim","year":"2010","journal-title":"Arch. Pediatr. Adolesc. Med."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1007\/s10708-009-9303-8","article-title":"Got green? Addressing environmental justice in park provision","volume":"75","author":"Sister","year":"2010","journal-title":"GeoJournal"},{"key":"ref_14","unstructured":"Institue of Medicine (2012). Accelerating Progress in Obesity Prevention: Solving the Weight of the Nation, National Academy of Sciences."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"486","DOI":"10.2105\/AJPH.2006.085837","article-title":"Association of the built environment with physical activity and obesity in older persons","volume":"97","author":"Berke","year":"2007","journal-title":"Am. J. Public Health"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1016\/j.ypmed.2010.07.013","article-title":"Where can they play? Outdoor spaces and physical activity among adolescents in U.S. urbanized areas","volume":"51","author":"Casanova","year":"2010","journal-title":"Prev. Med."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"139","DOI":"10.4278\/0890-1171-20.2.139","article-title":"How do perceptions of local neighborhood relate to adolescents\u2019 walking and cycling?","volume":"20","author":"Carver","year":"2005","journal-title":"Am. J. Health Promot."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Cook, T.D. (2015). Quasi-Experimental Design, Wiley Encyclopedia of Management, John Wiley & Sons, Ltd.","DOI":"10.1002\/9781118785317.weom110227"},{"key":"ref_19","unstructured":"Wooldridge, J.M. (2013). Introductory Econometrics: A Modern Approach, South-Western College Pub."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"2391","DOI":"10.1377\/hlthaff.2011.0212","article-title":"Quasi-experimental studies suggest that lowering air pollution levels benefits infants\u2019 and children\u2019s health","volume":"30","author":"Currie","year":"2011","journal-title":"Health Aff."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1097\/01.PHH.0000346006.59275.1e","article-title":"Quasi-experimental evaluation without regression analysis","volume":"15","author":"Rohrer","year":"2009","journal-title":"J. Public Health Manag. Pract."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"E84","DOI":"10.5888\/pcd10.120132","article-title":"Use of practice-based research network data to measure neighborhood smoking prevalence","volume":"10","author":"Linder","year":"2013","journal-title":"Prev. Chronic Dis."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1177\/003335491212700316","article-title":"Using GIS for administrative decision-making in a local public health setting","volume":"127","author":"Taylor","year":"2012","journal-title":"Public Health Rep."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"826","DOI":"10.1016\/S0140-6736(11)60812-X","article-title":"Quantification of the effect of energy imbalance on bodyweight","volume":"378","author":"Hall","year":"2011","journal-title":"Lancet"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1000","DOI":"10.3945\/ajcn.115.115576","article-title":"Validity of the WHO cutoffs for biologically implausible values of weight, height, and BMI in children and adolescents in NHANES from 1999 through 2012","volume":"102","author":"Freedman","year":"2015","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"590","DOI":"10.1038\/sj.ijo.0803300","article-title":"Body mass index in children and adolescents: Considerations for population-based applications","volume":"30","author":"Must","year":"2006","journal-title":"Int. J. Obes."},{"key":"ref_27","unstructured":"Centers for Disease Control and Prevention About Child & Teen BMI, Available online: http:\/\/www.cdc.gov\/healthyweight\/assessing\/bmi\/childrens_bmi\/about_childrens_bmi.html."},{"key":"ref_28","first-page":"109841","article-title":"Does playground improvement increase physical activity among children? A quasi-experimental study of a natural experiment","volume":"2013","author":"Phongsavan","year":"2013","journal-title":"J. Environ. Public Health"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1016\/j.ypmed.2010.02.002","article-title":"Using accelerometers and GPS units to identify the proportion of daily physical activity located in parks with playgrounds in New Zealand children","volume":"50","author":"Quigg","year":"2010","journal-title":"Prev. Med."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"246","DOI":"10.1177\/0013916515614368","article-title":"If you build it will they come? Does involving community groups in playground renovations affect park utilization and physical activity?","volume":"48","author":"Slater","year":"2016","journal-title":"Environ. Behav."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/13\/4\/411\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T19:21:59Z","timestamp":1760210519000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/13\/4\/411"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,4,8]]},"references-count":30,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2016,4]]}},"alternative-id":["ijerph13040411"],"URL":"https:\/\/doi.org\/10.3390\/ijerph13040411","relation":{},"ISSN":["1660-4601"],"issn-type":[{"type":"electronic","value":"1660-4601"}],"subject":[],"published":{"date-parts":[[2016,4,8]]}}}