Community efforts, community health: seven tips for creating successful health partnerships.

Recreation and park professionals recognize that public parks and programs are key community assets in promoting physical activity, yet our role as a central partner in preventative health care has only recently been acknowledged. We've had a difficult time convincing others of our central role in preventing obesity, diabetes, high blood pressure and chronic stress. However, these perceptions are now starting to change. A growing number of studies are documenting the link between park use and health.

Health organizations that had previously eschewed working with parks and recreation are now insisting on forming partnerships to create better access to park and recreation programs and facilities. However, successful partnerships between park and recreation agencies and health organizations don't occur by accident. These collaborations require persistence, mutual trust and a commitment to achieving program objectives. For these reasons, park and recreation professionals might be hesitant to take the plunge into a collaborative health partnership. Here are seven tips for helping your recreation organization develop successful partnerships with health care organizations:

1. INFANT HEALTH PARTNERSHIPS REQUIRE BABY STEPS

When establishing a new partnership with a health organization, don't try to accomplish too much too soon. It may take considerable time to learn about your other partners, and their resources and priorities. Consider kicking off your partnership with an easy-to-implement activity based on common goals. This could be as simple as asking your local hospital to provide a free health screening at a park event.

Another starter activity might be to provide health clinics with referral cards that include a map of local parks and trails. For example, in Lebanon Valley; Pa., local parks and recreation departments have offered referral cards to health practitioners. These practitioners are asked to refer this information to patients who might benefit from park and recreation activities. Once your partnership achieves critical mass with a small project, you'll then be in a better position to create more sophisticated and comprehensive partnership activities. For example, 10,000 Steps[R], a walking program co-sponsored by Three Rivers Park District, in Plymouth, Minn., and HealthPartners, provides participants with a pedometer, a planner and logbook, motivational cards and prize drawings to encourage walking 10,000 steps per day. The success of this program is now leading to other wellness classes and health events between these two partners.

2. LEARN THE LINGO OF THE HEALTH PROFESSION

In today's specialized society, it's crucial to learn the jargon used by your health partners. Know the definitions of morbidity and obesity; know what active living communities are, know the differences between physical activity and exercise, and, most important, know how these terms relate to existing parks and recreation services. Your understanding of this lingo will help you recognize when you and your health partner are discussing similar concepts. Mastery of health terms will also make your partners more comfortable in sharing their thoughts and perspectives with you, helping your partnership to gel more quickly.

3. INTEGRATE HEALTH BENEFITS INTO YOUR COMMUNICATIONS

Park and recreation organizations try to be many things to many different people. To some people, we represent champions of the environment, to others we may be advocates for youth crime prevention. If a park and recreation agency is committed to becoming a health partner, it may have to reposition its communications. Communications need to be consistent with promised health outcomes. It does us no good to say that we're in the health business, but then not explicitly communicate this message in our press releases, program guides and board meetings. In particular, we should write specific health benefits into our program objectives. If the health messages aren't included in your communications, other community health organizations will assume that you're not really in the health business.

4. USE SOLID EVIDENCE TO JUSTIFY THE LINK BETWEEN PARK USE AND HEALTH

A prerequisite in being recognized as a viable health partner is to establish a clear link between use of parks and recreation and improved health. Physically active recreation has significant health benefits for many different age groups and populations. However, just saying that our programs make visitors "feel better" or "help them relax" won't cut it with health professionals. You'll need to provide convincing data that links park use to improved health and fewer non-preventative doctor visits. There are a growing number of studies that document these relationships across a variety of park settings.

For example, a recent study funded by the National Recreation Foundation found that older adults who stayed longer at Cleveland Metroparks were also more likely to have lower blood pressures than those who visited for a shorter periods of time. As more of these health studies are completed, park and recreation professionals will be in a better position to justify their involvement in community health partnerships. See "Research Update" in the April 2003 issue of Parks & Recreation for more hard data on these types of studies.

5. YOU DON'T HAVE TO REINVENT THE HEALTH-PROMOTION WHEEL

Promoting physical activity and health isn't a new concept. Park and recreation advocates of the late 19th century were also concerned about providing activities to improve working conditions and community health. These concerns eventually spawned a number of public recreation programs and facilities. Before jumping ahead with a new health-promotion campaign, you may want to explore what has been done in the past. Were previous health-promotion programs successful? Why or why not? Understanding past practices will help refine current health-promotion programs.

6. CREATE PARTNERSHIPS THAT PROVIDE AN INCENTIVE FOR PHYSICAL ACTIVITY

In today's society, we've instituted disincentives for walking. One need only stroll through America's parking lots to experience this phenomenon. Choice spots, reserved for the "employee of the month" or the chief executive officer, are usually the closest to the building and require the least amount of walking. Communities that are genuinely interested in the health of their work force should establish partnerships that reward people for parking away from the building or walking or bicycling to work. For example, Bend, Ore., gives its employees $3 per day roundtrip for using non-motorized transit to work. Park agencies that have trail networks near places of employment might form a partnership with local businesses (and their health care providers) to promote a similar kind of incentive program.

7. IT'S ABOUT COLLABORATION, NOT COMPETITION

When it comes to today's pressing social concerns (health care, youth crime, urban sprawl), parks and recreation professionals have been on the outside looking in. Most of us know that our preventative services are extremely cost-effective compared to other social services. However, we should be cautious about pounding our chests and broadcasting our superiority compared to other disciplines. This kind of competitive positioning won't win over allies, nor will it foster an environment in which successful health partnerships can flourish. Perhaps a better way to be legitimately accepted by health organizations is to point out how recreation and parks maximize the effectiveness of existing services, without verbally threatening to eliminate their existence or reduce their budgets.

Partnerships among park and recreation agencies and health care providers are an attractive way to share resources and risks in promoting community health.

Taking these common-sense tips into consideration may allow your health partnership to grow fast and last longer. Park and recreation professionals who want to learn more about promoting health partnerships in their own community are also encouraged to review the special reports and publications offered by the Centers for Disease Control and Prevention (www.cdc.gov) and the Robert Wood Johnson Foundation (ww.rwj.org). By collaborating with other community health organizations, recreation and park professionals will be better equipped to promote and deliver health benefits to their citizens.

WHY WE MATTER

According to the Centers for Disease Control and Prevention, Americans are less healthy than ever. Half of Americans are overweight, and almost one-fourth are considered to be obese. Since 1991, obesity among the adult population has increased by 60 percent. The obesity epidemic is especially pronounced among America's youth. The percentage of overweight children has almost doubled in the last 20 years.

Physical inactivity is cited as the major culprit for America's obesity predicament. Recent research suggests that active living has been engineered and programmed out of our daily lifestyle. To reverse this trend, health organizations and community leaders are banding together to promote increased health through physical activity. These partnerships have the full support of national foundations and health organizations such as the Robert Wood Johnson Foundation, National Institutes of Health, American Heart Association and the Centers for Disease Control and Prevention.

Andrew Mowen, Ph.D. is an assistant professor within the School of Hotel, Restaurant and Recreation Management at The Pennsylvania State University, and was formerly the research and program evaluation manager at Cleveland Metroparks. He works closely with park and recreation professionals to develop innovative management strategies based on citizen needs and input. Mowan can be reached at 814-865-2102 or [e-mail].