Use of a public park for physical activity in the Caribbean: evidence from a mixed methods study in Jamaica.

BACKGROUND: Small island Caribbean countries such as Jamaica are now facing an epidemic of obesity and decreased physical activity (PA) levels. Public parks have been shown to be important resources for PA that also provide psychological and social benefits associated with increased PA. There are no studies that document PA in parks in the Caribbean. METHODS: This study utilized a mixed method approach by using the System for Observing Play and Recreation in Communities (SOPARC) to obtain baseline data on park usage patterns in Emancipation Park, a large urban public park in Jamaica. In addition, in-depth interviews were conducted to gain additional insights on the park's use for PA. RESULTS: The park was used mostly by females, in the evenings and by persons 18-64 years old. Females had significantly lower mean energy expenditure (EE) than males (0.078 versus 0.080 kcal/kg/min, p < 0.05). In-depth interviews revealed that safety, a central location within a business district, aesthetic appeal, a walking track and individual health benefits were key reasons for persons engaging in PA at the park. CONCLUSIONS: This is the first study to describe the usage of a public park for PA in Jamaica. The study elicited aspects of park use for PA in a major urban park in Jamaica from different vantage points by using direct systematic observation augmented with a qualitative approach. It revealed important differential park use for PA by sex, age group and EE levels, and provided insights into factors that motivate and hinder park usage for PA. This can be used by policymakers in Jamaica to inform PA interventions to reduce obesity, provide baseline data for comparisons with other parks in developing countries and to advocate for well-designed public parks.

Agency, lapse in condom use and relationship intimacy among female sex workers in Jamaica.

This paper explores barriers to consistent condom use among female sex workers in Jamaica in a qualitative study using grounded theory. Multiple perspectives were sought through 44 in-depth interviews conducted with female sex workers, clients, the partners of sex workers and facilitators of sex work. Poverty and lack of education or skills, severely limited support systems as well as childhood abuse served to push the majority of participants into sex work and created vulnerability to HIV and other STIs. Despite these constraints, women found ways to exercise agency, ensure condom use, adopt protective measures and gain economic advantage in various aspects of the Jamaican sex trade. Perceived relationship intimacy between sex workers and their clients and/or their main partners emerged as the main factor contributing to reduced risk perception and inconsistent condom use. Relationship intimacy, with associated trust and affirmation of self, is the most important factor influencing sexual decision-making with respect to lapse in condom use among female sex workers in Jamaica. Study findings provide important insights that can enhance individual psychosocial, interpersonal and community-based interventions as well as inform environmental, structural and policy interventions to reduce risk and vulnerability among female sex workers.