In previous findings from the 2000 to 2001 baseline assessment, neighborhoods with lower playground quality scores also tended to have fewer playgrounds in proportion to youth population (9
), suggesting that playgrounds in these neighborhoods may experience more wear and require more frequent maintenance. Between 2000 to 2001 and 2007, PAB staff met with Boston residents and with the Boston mayor's office and the Parks Department to share a complete list of observed playground quality scores, and released a report summarizing key findings (12
). The results of our follow-up assessment suggest that the Parks Department renovation schedule has equitably addressed playgrounds according to need and that the quality of playgrounds studied improved between 2000 to 2001 and 2007. In this study, we observed lower playground quality at baseline among city playgrounds in a disadvantaged area compared with other city areas. Our finding that before baseline playground assessment, playgrounds in the disadvantaged area were renovated at a rate similar to that of other city areas, suggests that differences in baseline playground quality across areas may be due to differences in use and maintenance rather than construction. We found that among parks that had not been renovated before baseline, those identified as in need of renovation based on low playground quality scores were renovated at a significantly higher rate than those with higher quality scores. Furthermore, accounting for baseline quality, playgrounds were replaced according to need in both disadvantaged and other city areas after the initial playground assessment.
Results from the follow-up observational assessment corroborate findings regarding playground renovations. Many of the playground quality items that improved between the baseline and follow-up assessments were related to playground equipment construction, suggesting that newer installations are meeting more stringent safety standards. The playground quality items that continued to have low compliance were largely related to maintenance issues, such as upkeep of safety surfacing and attention to broken or missing equipment.
Findings regarding bicycle and pedestrian access offer a starting point for further dialogue and collaboration to provide and improve local bicycle and pedestrian access to these playgrounds and parks, which are destinations for children and adults alike. Overall, pedestrian access appeared better than bicycle access around the parks assessed. Road lighting and sidewalks, basic infrastructure associated with reductions in pedestrian injuries (10
), were found surrounding nearly all parks. However, other features that can increase pedestrian safety, such as traffic calming measures (22
), could be improved. Cheaper and simpler strategies, such as installing pedestrian-related signage to identify pedestrian crossings for drivers, are feasible first steps toward improving the infrastructure. The addition of bicycle racks in and around parks will make cycling to these destinations more attractive. In 2007, the Boston Mayor's Office began several citywide initiatives promoting bicycling and has added 1,500 bicycle parking spaces and 33 miles of bicycle lanes throughout Boston neighborhoods since our assessment (23
Several limitations to this study should be noted. The study was conducted in 1 city by using an observational design without a comparison community. Therefore, we cannot account for natural history, particularly with respect to the overall economic climate and the lifespan of playgrounds. We did not know the age of each playground at baseline, which would likely influence observed playground quality and renovation scheduling, because we lacked detailed capital budget data before FY 1996. Analyses of playground renovations after baseline were limited by small sample size and produced wide confidence intervals; point estimates should be interpreted with caution. The measure used to determine playground renovation rates was not assessed for reliability or validity. We lacked detailed project descriptions and did not confirm project construction dates through discussion with city officials or through direct observation, except among the subsample of parks observed. We also did not examine other funding sources for playground renovations, which could vary by park location. Future studies could compare playground renovation history across communities, validate the method for identifying playground renovations by using city Parks Department capital budgets, and investigate other sources of park renovation funding.
For observational assessments, results are representative only of playgrounds in the disadvantaged area that had low observed playground quality at baseline. Because of resource limitations, we were not able to observe playground quality or bicycle and pedestrian access citywide or make comparisons by city area or baseline quality with sufficient power. A comprehensive assessment of all Boston playgrounds is needed to describe citywide changes in playground quality. In the playground quality instrument used, items contribute equally to the playground score, so the same score for 2 different parks or for the same park at baseline and follow-up may not reflect equivalent injury hazard. At follow-up, 1 researcher (J.L.B.) completed all playground quality assessments, whereas at baseline 5 researchers (including C.H. and A.L.C.) assessed quality. However, 1 researcher (A.L.C.) assessed 64% of parks at baseline, and the instrument demonstrated good interrater reliability (r
= 0.77) (9
). The bicycle and pedestrian access instrument was not tested for reliability or validity. Also, bicycle and pedestrian access scores do not account for parent or child perceptions of the environment, potentially significant factors affecting decisions about active transportation (5
). Future studies could assess validity of the bicycle and pedestrian access instrument and investigate transportation infrastructure on a larger scale and across a larger geographic area.
One of many ways to promote physical activity and health among children and youths is through provision of accessible, quality recreational infrastructure, including playgrounds. In this study, data from Parks Department capital budgets indicate an equitable rate of playground renovation across city areas according to need, as observed and communicated through the PAB community-based research project.