02-1: Prescribe Outside Presentation — original pdf
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Prescribe Outside Implementing a Parks Rx Program in a Pediatric Residency Marybeth Wootan Holst, MD & Samuel Williams, DO MBA Project Overview Objective Launch a Nature Prescription Program at Community Care Pflugerville that integrates pediatric resident nature education with practical tools to introduce nature prescriptions into clinical care. Target Population (Ages 4-18): Elevated BMI (>85th percentile) Excessive daily screen time Behavioral or mental health concerns Stressful social situations Clinical Goals Resident Training: Comprehensive education on the therapeutic value of nature and efficient clinical delivery. Goal: Nature prescriptions discussed and documented in at least 50% of applicable visits. Community Scaling: Strengthening local healthcare and community partnerships. Metric Success: Validation through provider surveys and objective chart review. Partnership: Austin PARD Provided Materials Patient Integration • • • • Clinically-designed posters & brochures QR code on each prescription for families to Professional Prescription Pads Interactive Provider Training Kits Localized Travis County Park Maps connect with Austin PARD resources and provide feedback to parks department. www.austintexas.gov/pardrx Project Materials (Sponsored by Austin PARD) Measuring Outcomes Chart Reviews - Baseline chart review (Aug-Nov 2024) - Mid-point chart review (Sept-Dec 2025) - Final chart review (Jan-Apr 2026) Resident and Staff Surveys - Survey conducted before and after resident training Survey Results: Confidence and Frequency Survey Results: Perceived Effectiveness/Importance Survey Results: Resident Knowledge Check Universal Benefit Beyond Exercise - Even healthy children significantly benefit - Activity-based prescriptions are not the from nature prescriptions only way nature provides benefits Key Insights & Lessons Learned EMR Tools Partnership Time Barriers Simple, accessible Strategic relationship with Efficient workflow remains documentation tools are crucial Austin PARD very rewarding. the #1 challenge for busy for sustained clinical success. pediatric providers. Next Steps Program Sustainability: Future residents, outpatient clinic subcommittee PDSA Cycles: - Patient focus groups - Patient outcomes/barriers Expansion: - Consider partnership with Pflugerville Parks & Recreation Dept - ParksRx America Dissemination: Texas Children in Nature Network Summit (2026), TPS/Dell Med Research Day (2027) Questions? References 1. Petrunoff N, Yao J, Sia A, Ng A, Ramiah A, Wong M, Han J, Tai BC, Uijtdewilligen L, Müller-Riemenschneider F. Activity in nature mediates a park prescription intervention's effects on physical activity, park use and quality of life: a mixed-methods process evaluation. BMC Public Health. 2021 Jan 22;21(1):204. doi: 10.1186/s12889-021-10177-1. PMID: 33482787; PMCID: PMC7825241. 2. Razani N, Kohn MA, Wells NM, Thompson D, Hamilton Flores H, Rutherford GW. Design and evaluation of a park prescription program for stress reduction and health promotion in low-income families: The Stay Healthy in Nature Everyday (SHINE) study protocol. Contemp Clin Trials. 2016 Nov;51:8-14. doi: 10.1016/j.cct.2016.09.007. Epub 2016 Sep 29. PMID: 27693759. 3. Razani N, Niknam K, Wells NM, Thompson D, Hills NK, Kennedy G, Gilgoff R, Rutherford GW. Clinic and park partnerships for childhood resilience: A prospective study of park prescriptions. Health Place. 2019 May;57:179-185. doi: 10.1016/j.healthplace.2019.04.008. Epub 2019 May 3. PMID: 31060017. 4. Razani N, Long D, Hessler D, Rutherford GW, Gottlieb LM. Screening for Park Access during a Primary Care Social Determinants Screen. Int J Environ Res Public Health. 2020 Apr 17;17(8):2777. doi: 10.3390/ijerph17082777. PMID: 32316482; PMCID: PMC7216015. 5. Razani N, Hills NK, Thompson D, Rutherford GW. The Association of Knowledge, Attitudes and Access with Park Use before and after a Park-Prescription Intervention for Low-Income Families in the U.S. Int J Environ Res Public Health. 2020 Jan 21;17(3):701. doi: 10.3390/ijerph17030701. PMID: 31973173; PMCID: PMC7037040. 6. Cronin-de-Chavez A, Islam S, McEachan RRC. Not a level playing field: A qualitative study exploring structural, community and individual determinants of greenspace use amongst low-income multi-ethnic families. Health Place. 2019 Mar;56:118-126. doi: 10.1016/j.healthplace.2019.01.018. Epub 2019 Feb 5. PMID: 30735881. 7. Messiah SE, Jiang S, Kardys J, Hansen E, Nardi M, Forster L. Reducing childhood obesity through coordinated care: Development of a park prescription program. World J Clin Pediatr. 2016 Aug 8;5(3):234-43. doi: 10.5409/wjcp.v5.i3.234. PMID: 27610338; PMCID: PMC4978615. “Research” Texas Children in Nature Network. www.texaschildreninnature.org/resources/research 8.