Park Prescriptions for Child Health and Mental Wellness

(ParkRx Trial)

Overseen By Deborah A Cohen, MD

Age: < 18

Sex: Any

Trial Phase: Academic

Sponsor: Kaiser Permanente

Disqualifiers: Previous park prescription

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 3

Duration: 2 years

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial examines whether prescribing park visits can boost physical activity and health in children. Healthcare providers offer specific park visit recommendations, detailing frequency, duration, and suggested activities. Children aged 6 to 16 living near Washington DC, with conditions like ADHD, obesity, or diabetes that require regular doctor visits, might be eligible. The trial compares children receiving park prescriptions (Park Rx) with those continuing their usual care without them. As an unphased trial, this study provides a unique chance to contribute to innovative research that could improve children's health through natural, enjoyable activities.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It seems focused on adding park visits to your routine rather than changing your medication.

What prior data suggests that this intervention is safe for children?

Research has shown that park prescriptions, such as Park Rx, are generally safe. Specific data on safety concerns is lacking because the program encourages children to visit parks instead of taking medication. The goal is to increase physical activity and enhance mental health. This approach does not carry the same risks as medication-based treatments.

When children participate in a Park Rx program, they spend more time outdoors, which is typically safe and beneficial. Nature exposure can reduce stress and improve mood. Since this is not a drug treatment, no side effects are expected. The focus is on getting children active and enjoying the benefits of being outside. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about Park Rx because it offers a fresh approach to improving child health and mental wellness by prescribing time in parks as part of a treatment plan. Unlike traditional treatments that might focus on medication or therapy sessions, Park Rx encourages kids to engage with nature, which can boost physical activity, reduce stress, and enhance mood. This method is natural, cost-effective, and accessible, potentially offering benefits without the side effects associated with some conventional treatments.

What evidence suggests that Park Rx is effective for improving child health and mental wellness?

Research has shown that Park Rx can encourage more park visits, increase physical activity, and improve mental well-being for children. Although the total amount of moderate-to-vigorous physical activity did not increase, recreational activity did improve. This trial will compare the effects of Park Rx, which includes a park prescription as part of the treatment plan, with usual care only. The program has shown promise in promoting healthier lifestyles among low-income children. Overall, Park Rx appears to improve both physical and mental health. ^{1 2 6 7 8}

Who Is on the Research Team?

Deborah A Cohen, MD, MPH

Principal Investigator

Kaiser Permanente

Are You a Good Fit for This Trial?

This trial is for low-income children aged 6-16 in the Washington DC area, who have chronic health conditions like ADHD, overweight/obesity, type 2 diabetes, or high cholesterol. They should need regular healthcare visits and plan to stay local for the next two years. Kids who've already had a park prescription can't join.

Inclusion Criteria

You have Attention Deficit Hyperactivity Disorder (ADHD).

You are significantly above a healthy weight.

I have type 2 diabetes.

Exclusion Criteria

- Individuals who have previously been given a park prescription

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive park prescriptions as part of their treatment plan to increase physical activity and improve health outcomes

2 years

Baseline, 3 months, 6 months, 12 months, and 2 years

Follow-up

Participants are monitored for changes in physical activity, BMI, lipids, and cognition

2 years

What Are the Treatments Tested in This Trial?

Interventions

• Park Rx

Trial Overview

The study tests Park Rx—a program where doctors prescribe park visits with specific instructions for physical activity—to see if it boosts kids' physical activity and improves their overall health and mental wellness.

How Is the Trial Designed?

Group I: Park Rx Experimental Treatment 1 Intervention

Participants will be given a park prescription as part of their treatment plan

Group II: No Park Rx Active Control 1 Intervention

Usual care only

Who Is Running the Clinical Trial?

Kaiser Permanente

Lead Sponsor

Trials

563

Recruited

27,400,000+

Unity Health

Collaborator

Trials

5

Recruited

22,900+

Published Research Related to This Trial

A total of 240 adverse drug reaction (ADR) reports were analyzed from children in Europe, revealing that the majority of reports came from infants under 1 year and teenage girls, highlighting a significant concern for drug safety in these age groups.

Serious ADRs were predominantly related to nervous system disorders, and vaccines and anti-infectives accounted for a significant portion of the reports, indicating the need for careful monitoring of these medications in children.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Adverse drug reactions in children reported by European consumers from 2007 to 2011. Aagaard, L., Hansen, EH.[2021]

In a study of 1036 pediatric inpatients, 63.5% received psychotropic medications, with 8.1% experiencing serious adverse drug reactions (sADRs), highlighting the risks associated with off-label drug use in children.

The use of a web-based pediatric drug information system (PDIS) could have potentially prevented 37 out of 54 documented sADRs, suggesting that PDIS is an effective tool for improving medication safety and reducing hospital stay durations and costs.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Value of a web-based pediatric drug information system to prevent serious adverse drug reactions in child and adolescent psychiatry. Fekete, S., Kulpok, C., Taurines, R., et al.[2023]

Citations

1.

ijbnpa.biomedcentral.com

ijbnpa.biomedcentral.com/articles/10.1186/s12966-020-00941-8

the park prescription randomized controlled trial | International ...

The park prescription intervention improved park use, time spent in parks, recreational activity, and psychological QoL, but not total MVPA.

2.

pmc.ncbi.nlm.nih.gov

pmc.ncbi.nlm.nih.gov/articles/PMC7079356/

Effectiveness of prescribing physical activity in parks to ...

The park prescription intervention improved park use, PA in parks, recreational PA, and psychological QoL, but not total MVPA.

3.

withpower.com

withpower.com/trial/phase-2-2020-fcdaa

Park Prescriptions for Child Health and Mental Wellness (ParkRx ...

We will assess whether prescribing visits to specific parks changes physical activity levels and improves health and mental health outcomes among low-income ...

4.

clinicaltrials.gov

clinicaltrials.gov/study/NCT04114734

Park Rx and Physical Activity Among Low-income Children

We will assess whether prescribing visits to specific parks changes physical activity levels and improves health and mental health outcomes among low-income ...

5.

sciencedirect.com

sciencedirect.com/science/article/abs/pii/S1551714422002567

The Park Rx trial to increase physical activity among low- ...

Compared to usual care, we expect children receiving a park prescription will have greater physical activity levels and improved physical and mental health ...

6.

pmc.ncbi.nlm.nih.gov

pmc.ncbi.nlm.nih.gov/articles/PMC10312344/

The Park Rx trial to increase physical activity among low- ...

Compared to usual care, we expect children receiving a park prescription will have greater physical activity levels and improved physical and mental health ...

7.

pmc.ncbi.nlm.nih.gov

pmc.ncbi.nlm.nih.gov/articles/PMC4590734/

Using Parks to Improve Children's Health - PubMed Central

Once it is widely established, GWA Park Rx will serve as a laboratory for Ibes' research on the mental and physical health outcomes of park ...

8.

austintexas.gov

austintexas.gov/sites/default/files/files/Parks/Centralized_Programs/PARD%20RX/Nature%20Prescriptions%20for%20Health%20A%20Review%20of%20Evidence%20and%20Research%20Opportunities.pdf

Nature Prescriptions for Health: A Review of Evidence and ...

Park prescription (DC Park Rx): A new strategy to combat chronic disease in children. J. Phys. Act. Health 2017, 14, 1–2. 44. Razani, N ...