Mental health clients' receptiveness to and recommendations for integrating physical activity discussions into therapy: a mixed methods study.

OBJECTIVE: The mental health benefits of physical activity are well-established. Integrating physical activity counseling into therapy would expand the reach of this evidence-based treatment for mental illness. This mixed methods study examined mental health clients' receptiveness and recommendations for effectively discussing physical activity in therapy. METHODS: A diverse sample of U.S. adults in therapy (N = 478) completed a survey that included the open-ended question: What specific recommendations would you have for your therapist to effectively discuss physical activity with you? We conducted a qualitative content analysis to identify their most common recommendations. RESULTS: Most participants indicated they would be comfortable discussing physical activity with their therapist. The content analysis resulted in 26 unique categories; most common recommendations included: provide information about what to do (n = 81), discuss physical activity benefits (n = 63), be understanding and nonjudgmental (n = 49), provide accountability (n = 41), and consider physical/mental health conditions (n = 35). Overarching themes emphasized making mental health central to discussions, tailoring discussions to each client, and reframing physical activity as a feasible, enjoyable activity. CONCLUSIONS: Mental health clients are open to discussing physical activity during therapy if it is approached in a supportive, understanding, and personalized way. Clients' recommendations can inform future professional development for therapists.

Promoting Strength Training Among Baby Boomers: Message Framing Effects on Motivation and Behavior.

BACKGROUND: Regular participation in strength training significantly enhances older adults' physical and functional health, yet only 14% of adults over age 50 report engaging in strength training at least twice per week. Exercise messages about why and how older adults should engage in strength training could influence their perceptions of and participation in the behavior. This study was designed to promote strength training among adults aged 50-70 and to determine whether the message frame accompanying a brief workout would have an impact on participants' motivation, self-efficacy, and/or physical activity behavior. METHODS: Participants (N = 308) were randomly assigned to one of four message conditions: Easy Intrinsic, Hard Intrinsic, Easy Extrinsic, or Hard Extrinsic. Immediately after completing baseline measures of motivation and physical activity, participants received the recommended strength training workout and corresponding motivational message. They completed follow-up measures of motivation and physical activity 2 weeks later. RESULTS: Controlled regulation was higher at follow-up among participants exposed to an extrinsic message relative to an intrinsic message (F(3,208) = 3.08, p = .03). Strength training (Z = - 5.95, p < .001) and moderate physical activity (Z = - 3.23, p = .001) increased among participants not engaging in regular strength training at baseline. CONCLUSIONS: These results suggest message framing may have a short-term impact on Baby Boomers' physical activity motivation, such that emphasizing extrinsic goals (i.e., weight loss and appearance) may contribute to controlled motivation. However, repeated measurements are needed to determine the longer-term maintenance and influence of these effects.

Advancing Uterine Cancer Survivorship Among African American Women.

BACKGROUND: Few studies have examined health behavior interventions for African American women who are uterine cancer survivors. Black-white differences in uterine cancer survival suggest that there are unmet needs among these survivors. METHODS: This article identifies opportunities to address disparities in uterine corpus cancer survival and quality of life, and thereby to increase uterine cancer survivorship among African American women. RESULTS: For cancer survivors, common side effects, lasting for long periods after cancer treatment, include fatigue, loss of strength, lymphedema, and difficulty sleeping. A variety of interventions have been evaluated to address physical and mental health concerns, including exercise and dietary interventions. Considerable information exists about the effectiveness of such interventions for alleviating distress and improving quality of life among cancer survivors, but few studies have focused specifically on African American women with a uterine corpus cancer diagnosis. Research-tested culturally tailored lifestyle interventions are lacking. CONCLUSIONS: There is a need for a better understanding of uterine cancer survivorship among African American women. Additional evaluations of interventions for improving the quality of life and survival of African American uterine cancer survivors are needed.

"We actually care and we want to make the parks better": A qualitative study of youth experiences and perceptions after conducting park audits.

This study explored youths' experiences and perceptions about community engagement as a result of participating in a community-based data collection project using paper and mobile technology park environmental audit tools. In July 2014, youth (ages 11-18, n=50) were recruited to participate in nine focus groups after auditing two parks each using paper, electronic, or both versions of the Community Park Audit Tool in Greenville County, SC. The focus groups explored the youths' experiences participating in the project, changes as a result of participation, suggested uses of park audit data collected, and who should use the tools. Four themes emerged related to youths' project participation experiences: two positive (fun and new experiences) and two negative (uncomfortable/unsafe and travel issues). Changes described as a result of participating in the project fell into four themes: increased awareness, motivation for further action, physical activity benefits, and no change. Additionally, youth had numerous suggestions for utilizing the data collected that were coded into six themes: maintenance & aesthetics, feature/amenity addition, online park information, park rating/review system, fundraising, and organizing community projects. Finally, six themes emerged regarding who the youth felt could use the tools: frequent park visitors, community groups/organizations, parks and recreation professionals, adults, youth, and everyone. This study revealed a wealth of information about youth experiences conducting park audits for community health promotion. Understanding youth attitudes and preferences can help advance youth empowerment and civic engagement efforts to promote individual and community health.

An Initiative to Facilitate Park Usage, Discovery, and Physical Activity Among Children and Adolescents in Greenville County, South Carolina, 2014.

INTRODUCTION: Parks are important settings for increasing population-level physical activity (PA). The objective of this study was to evaluate Park Hop, an incentivized scavenger-hunt-style intervention designed to influence park usage, discovery, park-based PA, and perceptions of parks among children and adolescents in Greenville County, South Carolina. METHODS: We used 2 data collection methods: matched preintervention and postintervention parent-completed surveys and in-park observations during 4 days near the midpoint of the intervention. We used paired-samples t tests and logistic regression to analyze changes in park visitation, perceptions, and PA. RESULTS: Children and adolescents visited an average of 12.1 (of 19) Park Hop parks, and discovered an average of 4.6 venues. In a subset of participants, from preintervention to postintervention, the mean number of park visits increased from 5.0 visits to 6.1 visits, the proportion of time engaged in PA during the most recent park visit increased from 77% to 87%, and parents reported more positive perceptions of the quality of park amenities. We observed more children and adolescents (n = 586) in the 2 intervention parks than in the 2 matched control parks (n = 305). However, the likelihood of children and adolescents engaging in moderate-to-vigorous PA was significantly greater in the control parks (74.3%) than in Park Hop parks (64.2%). CONCLUSION: Park Hop facilitated community-collaboration between park agencies and positively influenced park usage, park discovery, time engaged in PA during park visits, and perceptions of parks. This low-cost, replicable, and scalable model can be implemented across communities to facilitate youth and family-focused PA through parks.

ParkIndex: Development of a standardized metric of park access for research and planning.

OBJECTIVE: A lack of comprehensive and standardized metrics for measuring park exposure limits park-related research and health promotion efforts. This study aimed to develop and demonstrate an empirically-derived and spatially-represented index of park access (ParkIndex) that would allow researchers, planners, and citizens to evaluate the potential for park use for a given area. METHODS: Data used for developing ParkIndex were collected in 2010 in Kansas City, Missouri (KCMO). Adult study participants (n=891) reported whether they used a park within the past month, and all parks in KCMO were mapped and audited using ArcGIS 9.3 and the Community Park Audit Tool. Four park summary variables - distance to nearest park, and the number of parks, amount of park space, and average park quality index within 1mile were analyzed in relation to park use using logistic regression. Coefficients for significant park summary variables were used to create a raster surface (ParkIndex) representing the probability of park use for all 100m×100m cells in KCMO. RESULTS: Two park summary variables were positively associated with park use - the number of parks and the average park quality index within 1 mile. The ParkIndex probability of park use across all cells in KCMO ranged from 17 to 77 out of 100. CONCLUSION: ParkIndex represents a standardized metric of park access that combines elements of both park availability and quality, which was developed empirically and can be represented spatially. This tool has both practical and conceptual significance for researchers and professionals in diverse disciplines.

Are park proximity and park features related to park use and park-based physical activity among adults? Variations by multiple socio-demographic characteristics.

BACKGROUND: Parks are valuable resources for physical activity (PA) given their widespread availability and low cost to maintain and use. Both proximity to parks and the availability of particular features are important correlates of PA. However, few studies have explored multiple measures of proximity simultaneously or the specific facilities associated with park use and park-based PA among adults, let alone differences across socio-demographic characteristics. The purpose of this study was to examine associations between park proximity and park facilities and adults' park use and park-based PA, while also exploring differences by gender, age, race, and income. METHODS: Data on monthly park use and weekly amount of PA undertaken in parks were collected via a mail survey of adults from randomly-selected households (n = 893) in Kansas City, Missouri (KCMO) in 2010-2011. Three measures of park proximity were calculated within 1 mile of participating households: distance to the closest park, number of parks, and total park area. All parks in KCMO were audited using the Community Park Audit Tool to determine the availability of 14 park facilities within 1 mile of each participant (e.g., trail, playground, tennis court). Multilevel logistic regression was used to examine the relationship between each of park use and park-based PA and 1) three measures of park proximity, and 2) the availability of 14 park facilities within 1 mile of participants. Separate analyses were conducted by gender, age, race, and income, while controlling for all socio-demographic characteristics and BMI. RESULTS: Across all sub-samples, distance to the closest park was not significantly related to either park use or park-based PA. However, numerous significant associations were found for the relationship of number of parks and amount of park space within 1 mile with both outcomes. As well, diverse facilities were associated with park use and park-based PA. For both park proximity and facilities, the significant relationships varied widely across gender, age, race, and income groups. CONCLUSIONS: Both park proximity and park facilities are related to park use and park-based PA. Understanding how such associations vary across demographic groups is important in planning for activity-friendly parks that are responsive to the needs of neighborhood residents.

Perceptions of neighborhood park quality: associations with physical activity and body mass index.

BACKGROUND: Parks are important resources for physical activity (PA), yet few studies have examined how perceptions of park characteristics relate to PA and health. PURPOSE: This study investigated associations between perceptions of neighborhood park quality and overall moderate-to-vigorous PA (MVPA), park-based PA, and body mass index (BMI). METHODS: Data were collected via questionnaire from 893 households in Kansas City, Missouri. RESULTS: The newly developed neighborhood park quality scale demonstrated good test-retest and internal reliability. Residents' perceptions of neighborhood park quality were related to PA and health outcomes. Perceiving parks as a benefit was positively related to overall MVPA and park-based PA and negatively related to BMI. Perceptions of well-used parks were positively related to BMI, while perceived cleanliness was negatively related to park-based PA. CONCLUSIONS: Better measuring and understanding how perceptions of local parks are associated with PA and health can improve appreciation of how parks facilitate active living.

Exploring the distribution of park availability, features, and quality across Kansas City, Missouri by income and race/ethnicity: an environmental justice investigation.

BACKGROUND: Parks are key community assets for physical activity, but some evidence suggests these resources are not equitably distributed. PURPOSE: This study examined disparities by income and race/ethnicity in the availability, features, and quality of parks across Kansas City, Missouri. METHODS: All parks and census tracts (CTs) were mapped using geographical information systems, and park features and quality were determined via audits. Multivariate analyses of covariance analyzed differences in park availability, features, and quality across low-, medium-, and high-income and race/ethnicity CT tertiles. RESULTS: Low-income CTs contained significantly more parks, but also had fewer parks with playgrounds and more quality concerns per park. High minority CTs had more parks with basketball courts, but fewer parks with trails. Medium-income CTs contained more aesthetic features per park. CONCLUSIONS: Future research should examine policies that contribute to and that might rectify disparities in park features and quality, especially in low-income and high minority areas.

Demographic variations in observed energy expenditure across park activity areas.

OBJECTIVE: Parks are important physical activity (PA) settings, but few studies have examined PA differences between park areas according to multiple user demographic characteristics. This study explored variations in adult/senior and child/teen PA intensity across park settings by gender, age, and race/ethnicity. METHODS: In July-August 2009, the System for Observing Play and Recreation in Communities (SOPARC) was used in four parks in Kansas City, Missouri to record park users' PA behavior within specific park areas. A total of 8855 observations were recorded. ANCOVAs compared mean energy expenditure (EE) for various demographic groups across the five most-used park target areas for adults/seniors and children/teens. RESULTS: Among adults/seniors, all sub-samples exhibited higher EE on paved trails (0.086-0.093 kcal/kg/min) and tennis courts (0.086-0.089 kcal/kg/min), than in open spaces, playgrounds, or picnic shelters. Among children/teens, the child, White, and all child/teen sub-samples showed greater EE on playgrounds (0.088-0.089 kcal/kg/min) than in picnic shelters. CONCLUSION: Park planning and design efforts should consider environmental and programming initiatives to increase intergenerational PA levels within park areas such as playgrounds, open spaces, and picnic shelters.

Differences in youth and adult physical activity in park settings by sex and race/ethnicity.

We examined differences by sex and race/ethnicity in the observed moderate- to vigorous-intensity physical activity (MVPA) of youth and adults in diverse areas of 4 parks in Kansas City, Missouri, in 2009. Male youth were more active on playgrounds and pools or splashpads than female youth. White youth were less active than nonwhite youth in open spaces and on paved trails. Male adults were more active in open spaces than female adults, and white adults were more active on paved trails than nonwhite adults. Understanding variations in MVPA between user groups can inform park design efforts to foster increased activity among all visitors.

The Effect of Outdoor and Indoor Group Exercise Classes on Psychological Stress in College Students: A Pilot Study with Randomization.

Emerging evidence suggests that outdoor group exercise may reduce stress more than indoor group exercise because the outdoor environment provides unique mental health benefits. Stress leads to illnesses and diseases, but exercise mitigates harmful impacts. This study explored differences in perceived stress and outdoor physical activity participation among college students in an indoor or outdoor group exercise class. Data were collected pre-, mid- (after four sessions), and post-intervention (after eight sessions). Seventeen participants indicated an interest in the study, but 13 signed up. Participants completed a four-week group exercise intervention that met twice weekly in outdoor and indoor conditions. Mixed ANOVAs with Tukey post hoc tests determined between-group differences in perceived stress and outdoor physical activity levels. Partial eta-squared (η2p) estimated effect sizes. Significant differences in perceived stress scores existed across time for the whole sample [f(2, 12) = 48.359, p < 0.001, η2p = 0.890] and for the interaction between time and condition [f(2, 12) = 10.051, p = 0.003, η2p = 0.626]. Post hoc analysis revealed that the outdoor group's perceived stress (p < 0.001) was reduced more than the indoor group post-intervention (p = 0.028).

Neighborhood park access and park characteristics are associated with weight status in youth.

This study investigated park access and park quality in the context of childhood obesity. Participants were 20,638 children ages 6-17y from a large primary care health system. Analyses tested associations of park access and park characteristics with children's weight status, and sociodemographic interactions. Both park access and the quality of nearest park were associated with a lower odds of having obesity. Park quality interacted with age, sex, and income. Findings suggest park access is important for supporting a healthy weight in children. Park quality may be most important among 12-14-year-olds, girls, and higher income groups.

Youth physical activity and the COVID-19 pandemic: A systematic review.

The purpose of the systematic review was to identify, evaluate, and synthesize evidence from available published literature examining the impact of the coronavirus disease 2019 (COVID-19) pandemic on youth physical activity (PA). A systematic review of the literature was conducted for years 2020-2021. Published articles were searched in eight databases. Inclusion criteria included: availability of full-text, written in English language, and reported quantitative or qualitative results of original or secondary data on PA and COVID-19 related factors among youth (ages 5-17 years). A standard quality assessment tool assessed risk of bias and quality of included articles. The search retrieved 2,899 articles with 51 articles ultimately meeting inclusion criteria. The majority of articles (65 %) investigated change in PA from before to during the pandemic. Most evidence indicated an overall decrease in youth PA levels during the pandemic with differences observed among sub-populations (e.g., age, sex or gender), type, and location. Findings suggest pandemic-related closures hindered PA participation due to a high reliance on school- and sport-based PA. Programmatic strategies (e.g., activity breaks, active curriculum, free online activities/lessons) should include aligning intervention measures and geared towards evolving and ongoing PA promotion based on the latest findings.

Effects of the COVID-19 Pandemic on Physical Activity Behavior across Domains and Settings.

COVID-19 restrictions and alterations to daily living (e.g. working from home, caregiving responsibilities) necessitated changes in physical activity (PA) behavior. The purpose of this study was to understand how PA within specific domains and behavior settings changed during the COVID-19 pandemic, as well as the extent to which PA increased or decreased as a function of participants' gender, work location (i.e., home vs. jobsite) and caregiving responsibilities. An e-survey, conducted April-June 2020, examined changes in PA across domains and settings in a national sample of 805 adults. Respondents reported domain-specific increases in household and recreational PA, but decreases in active transportation, occupational PA, and public transportation use. Weekly minutes of PA changed significantly across all behavior settings, with reported increases in home-based, neighborhood, parks/trails, and total PA, and decreases in PA through recreational sports and fitness facilities. Total weekly PA minutes increased by 10.6%. Those with caregiving responsibilities reported increases in household PA and PA frequency, whereas those without caregiving responsibilities were more likely to report increases in sitting. Those working from home reported a larger increase in neighborhood PA. Those working at a jobsite with caregiving responsibilities reported less weekly PA, while those working from home with caregiving responsibilities reported greater weekly PA. The overall increase in weekly PA minutes and ability to adapt to different domains/settings was encouraging. Future interventions should capitalize on domain- and setting-specific changes, while considering work location and caregiving responsibilities to develop innovative PA promotion strategies.

A Scoping Review of the Health Benefits of Nature-Based Physical Activity.

The health benefits of physical activity and spending time in nature are well established. However, youths and adults in the United States are not participating in sufficient levels of physical activity and are not spending much time outdoors. Recently, the need for equitable access to nature for all populations has been receiving more public health attention, though a specific focus on nature-based physical activity has been limited. The purpose of this scoping review is to operationalize the health benefits of nature-based physical activity in order to provide guidance for collaborations to program administrators, advocates, and researchers. Peer-reviewed literature is found in PubMed, Medline, Web of Science, and Google Scholar as well as in published reviews of the literature. The literature is divided into three categories of: 1) amount and location of nature-based components and physical activity; 2) added health benefits of exposure to nature-based components and physical activity; and 3) nature-based components and physical activity effect on non-white, marginalized, and vulnerable populations. This review supports and encourages multiple strategies to increase nature-based physical activity as this provides even greater benefit to health and wellness than exposure to nature or physical activity alone. Although many of the physical and mental health benefits of nature and physical activity are well established, additional research is needed to better understand the relationship between exposure to nature and nature-based physical activity, which will require greater investment and support from funding agencies.

Prescribing Physical Activity in Parks and Nature: Health Care Provider Insights on Park Prescription Programs.

BACKGROUND: Health care providers (HCPs) promoting physical activity (PA) through programs such as Park Prescriptions (ParkRx) are gaining momentum. However, it is difficult to realize provider PA practices and program interest, and differences in program success exist by provider type (eg, primary vs secondary). This study explored HCPs' (1) PA counseling practices, (2) knowledge/interest in ParkRx, (3) barriers and resources needed to implement PA counseling and ParkRx programs, and (4) differences in primary versus secondary HCPs. METHODS: An e-survey administered in Spring/Summer 2018 to HCPs in 3 states examined study objectives. RESULTS: Respondents (n = 278) were mostly primary (58.3%) HCPs. The majority asked about patient PA habits and offered PA counseling (mean = 5.0, SD = 1.5; mean = 4.8, SD = 1.5), but few provided written prescriptions (mean = 2.5, SD = 1.6). Providers were satisfied with their PA counseling knowledge (mean = 3.8, SD = 1.0) but not with prescribing practices (mean = 3.2, SD = 1.1). Secondary HCPs placed higher importance (P = .012) and provided significantly more written PA prescriptions (P = .005). Time was a common barrier to prescribing PA (mean = 3.4, SD = 1.2), though more so for primary HCPs (P = .000). Although few HCPs knew about ParkRx programs, 81.6% expressed interest. Access to park information and community partnerships was an important resource for program implementation. CONCLUSIONS: HCPs underutilize PA prescriptions. Despite little awareness, HCPs were interested in ParkRx programs.

The Electronic Community Park Audit Tool (eCPAT): Exploring the Use of Mobile Technology for Youth Empowerment and Advocacy for Healthy Community Policy, Systems, and Environmental Change.

Empowering and engaging youth in advocacy and participatory action research (PAR) for healthy community environments is an emerging approach to reducing the childhood obesity epidemic. Technology is a promising strategy for engaging youth in such efforts. The Community Park Audit Tool (CPAT) is user-friendly tool for evaluating the ability of parks to promote youth physical activity. Recently an electronic version of the tool (eCPAT) was developed and validated. The purpose of this study was to explore the use of eCPAT mobile technology on youth empowerment and advocacy. This study examined tool usability, youths' technology access, use, and readiness for PAR efforts, effectiveness of mobile technology on youth empowerment and advocacy, interaction effects between tool format and regular technology use, and tool format preferences. Youth ages 11-18 years were recruited and randomized into one of three study conditions: Control (no audit), paper (CPAT), and mobile technology (eCPAT). Intervention youth completed two park audits using assigned format. A subsample of youth in the Control group completed both CPAT and eCPAT audits for comparison. Independent samples t-tests and MANCOVAs explored differences in post-project levels of tool usability and empowerment and advocacy scores between groups. Multivariate linear regression analysis explored the interaction between Control, Paper, or eCPAT group membership and mean technology use in predicting empowerment and advocacy. Youth (n = 124) completed pre and post surveys. The majority of youth had access to technology (smartphone 77.4%, tablet/iPad 67.7%). Youth used mobile technology at least once a day to use apps (M = 7.8, SD = 3.2), browse the web (M = 6.3, SD = 3.3), and search for information (M = 6.3, SD = 3.5). Youth were also ready and willing to use technology for PAR (M = 3.42-3.59). No main or interaction effects were found for post-project levels of youth empowerment or advocacy. However, the eCPAT tool had high usability scores, was better liked, and was preferred by youth over paper-pencil methods. Mobile technologies are ubiquitous and a preferred strategy among youth for engagement in community change. Future studies should explore mobile technology as a potential strategy for engaging youth in ongoing PAR efforts to achieve successful engagement and advocacy in community healthy environmental change.

Development of the Physical activity and Your Nutrition for Cancer (PYNC) smartphone app for preventing breast cancer in women.

BACKGROUND: In the U.S., breast cancer accounts for more cancer deaths in women than any site other than lung cancer. Based upon attributable risks, about 30-35% of breast cancers could potentially be prevented by addressing obesity, physical inactivity, increased alcohol consumption, and carcinogenic exposures such as hormone replacement therapy (HRT). We need methods of reducing women's risks of this disease that are attractive and easy to use, widely accessible to diverse women, and able to be easily amended to account for new research. METHODS: The overall objective of this 12-month project is to develop and test a smartphone app to provide women with information about how they can reduce their risk of breast cancer through healthy behaviors such as physical activity, weight management, restricting caloric intake, consuming a healthy diet and proper nutrition, engaging in regular physical activity, and avoiding carcinogenic exposures such as HRT and alcohol. The specific aims are: (I) to develop a smartphone app for breast cancer prevention using a behavioral framework; (II) to ensure interconnectivity with commercially available products (Fitbit device for monitoring physical activity and the LoseIt! smartphone app for monitoring and tracking diet and nutrition); and (III) to ensure that the mHealth intervention is suitable for women with varying levels of health literacy and eHealth literacy. RESULTS: The app, referred to as Physical activity and Your Nutrition for Cancer (PYNC), is being coded on an iOS platform. Users will be able to access the breast cancer prevention app using their smartphone or tablet. The app's design will ensure interconnectivity with commercially available products for monitoring and tracking physical activity, caloric intake, diet and nutrition. Using the app, it will be feasible for users to connect and sync their Fitbit and LoseIt! accounts so that information collected about physical activity, caloric intake, diet, and nutrition can be conveniently assessed from one portal. The Fitbit device and app provides reminders and allows users to set physical activity goals. Users will be able to access health education information about breast cancer risk-reduction with attractive graphics and visual displays. CONCLUSIONS: Future directions will include testing the efficacy of the mHealth intervention in increasing physical activity, improving diet and nutrition, and weight management through a randomized controlled trial, and widespread dissemination and implementation research.

Exploring Attitudes, Perceived Norms, and Personal Agency: Insights Into Theory-Based Messages to Encourage Park-Based Physical Activity in Low-Income Urban Neighborhoods.

BACKGROUND: Public parks hold promise for promoting population-level PA, but studies show a significant portion of park use is sedentary. Past research has documented the effectiveness of message-based strategies for influencing diverse behaviors in park settings and for increasing PA in nonpark contexts. Therefore, to inform message-based interventions (eg, point-ofdecision prompts) to increase park-based PA, the purpose of this study was to elicit insights about key attitudes, perceived norms, and personal agency that affect park use and park-based PA in low-income urban neighborhoods. METHODS: This study used 6 focus groups with youth and adults (n = 41) from low-income urban areas in Kansas City, MO, to examine perceptions of key attitudinal outcomes and motivations, perceived norms, key referents, and personal agency facilitators and constraints that affect park use and park-based PA. RESULTS: Participant attitudes reflected the importance of parks for mental and physical health, with social interaction and solitude cited as key motivations. Of 10 themes regarding perceived norms, influential others reflected participants' ethnic makeup but little consensus emerged among groups. Social and safety themes were cited as both facilitators and constraints, along with park offerings and setting. CONCLUSIONS: Information about attitudes, perceived norms, and personal agency can increase understanding of theoretically derived factors that influence park-based PA and help park and health professionals create communication strategies to promote PA.