Participatory design of a comprehensive playground intervention manual for obesity mitigation in Phoenix, AZ

In the past three decades alone, the United States has witnessed a dramatic rise in the prevalence of obesity and overweight in adults and children. Efforts towards obesity mitigation and prevention have produced promising recommendations and researchers and practitioners alike acknowledge that real solutions must match the complexity of the problem. Comprehensive approaches that target environmental, economic, socio-cultural, and knowledge-based factors that influence diet and physical activity are highly recommended. However, the literature yields little in the way of what such comprehensive obesity interventions actually entail and how they ought to be developed. In particular, there are knowledge gaps in how various stakeholder groups can bridge institutional barriers to collaborate in ways that maximize resources, build upon synergies, and avoid duplication of efforts; and how specific recommendations are actually implemented. This thesis aims to contribute to an emerging body of literature that fills this gap by presenting a practical case study on how to create a playground obesity intervention in the Gateway District of Phoenix, Arizona, in collaboration with researchers, health professionals, neighborhood residents, and city officials. The objectives were two-fold: 1. To outline concrete steps that will allow an organization to create a playground linked with healthy kids education program that aims to increase physical activity, perceptions of safety, and community cohesion; 2. To outline how diverse stakeholders can collaborate effectively to create such a cohesive, complex obesity intervention. A detailed, actionable intervention manual was drafted through semi-structured interviews, literature review, a survey, a stakeholder workshop, and an extended peer-review. The manual describes the sequence of actions necessary for creating an innovative playground that reinforces learning, encourages creative play, and increases physical activity. The sequence of actions was linked with existing local assets, stakeholder roles and responsibilities, costs, and potential barriers. This manual, as well as the process itself, can serve as a transferable model for helping organizations come together to build the capacity required in order to tackle complex health challenges.