Schuylkill Center for Environmental Education
Featuring a tot lot with a dinosaur slide, climbing equipment for older kids, wide pavements with room for bikes and scooters, and an open, grassy field, Clark Park, in the middle of a busy West Philadelphia neighborhood, is just what the doctor ordered.
Walking around the nine-acre park, Chris Renjilian, a physician at Children’s Hospital of Philadelphia (CHOP), points out the varied opportunities for young people in the area to get outside and get active – a prescription, he says, for healthier living.
“What we have known forever intuitively – that being physically active and being outdoors is good for you – now has a lot of research behind it to prove it,” Renjilian says. “It’s an easy idea to sell, we now just need to make it happen.”
In partnership with the Schuylkill Center for Environmental Education, the City of Philadelphia’s Parks and Recreation Commission and the United States Forest Service, Renjilian and his CHOP colleagues are about to do just that. With support from The Barra Foundation, Nature Rx will launch this spring at four of the hospital’s clinics around the city. Doctors will begin prescribing outdoor recreation to thousands of young patients and their families, using newly created tools, resources and incentives designed to make getting outside easy and fun.
“The simple idea,” says Gail Farmer, former director of education at the project’s lead sponsor, the Schuylkill Center, “is to put resources in the hands of physicians and also patients, parents and caregivers so they are motivated about outdoor play and see it as accessible, easy and safe.”
Studies show that children spend only one percent of their free time outdoors, and an average of seven and a half hours a day in front of screens. The rise of such a sedentary lifestyle among young people, health experts say, has contributed heavily to the country’s increasing rates of obesity, diabetes, hypertension, asthma and depression.
“Childhood has retreated indoors,” says Farmer. “With Nature Rx, we want to help turn that around.”
Key to the effort is training and empowering doctors, who have limited time to cover a lot of ground during patient visits, to optimize how they counsel patients on outdoor play. With Nature Rx, clinicians will be prompted through an online system — called the Electronic Health Record (EHR), which they already use to guide them through appointment protocols — to talk about the medical and therapeutic benefits of spending time outdoors. Loaded into the EHR will also be a fully searchable database of all of Philadelphia’s parks, trails and other green spaces, allowing doctors, patients and their families to create a personalized plan to get outside. In each patient’s end-of-visit paperwork will be a printout on the parks that meet their needs, and a written “prescription” outlining goals for visits and activities.
As a follow-up to the doctor visits, Nature Rx will dispatch so-called Nature Navigators to work one-on-one with families to bring down barriers, such as time constraints or safety concerns, some may face in trying to meet their prescribed goals. Incentives, like an online rewards system, are also in the works to encourage families to stick to their activity plans.
For the idea to grow beyond the first four sites, the program’s evaluation needs to demonstrate value to time-crunched clinicians. Built into the program will be studies of the impact of its intervention model on the behavior of doctors and patients and on measures of health and wellness.
Along with promoting health and wellness, Nature Rx is expected to produce other benefits, such as introducing families to their local parks, which in turn is likely to increase community engagement and neighborhood involvement. And connecting young people to nature, organizers say, may help grow a future generation interested in preserving outdoor public spaces.
The Nature Rx website and database will also be valuable resources for any city resident looking for ways to get outside. Based on a comprehensive, first-of-its-kind audit of Philadelphia’s outdoor assets, the database will include visitor information about each location, such as distance to public transportation, access to restrooms and whether it is stroller-friendly. It will also allow users to filter searches according to dozens of criteria, including what types of playground equipment and activities, like swimming or ice skating, are offered on site. Additional available information will include visitor comments and a live data feed displaying upcoming park events and programs. For Clark Park that will likely mean information will be posted about the farmers’ market held there once or twice a week, depending on the season.
Renjilian used to live near the park, so he is familiar with the goings on there, but he can’t wait to learn about other green spaces around the city and to share the Nature Rx database with his patients. He says that not knowing where to direct interested patients has been a challenge to helping them follow through on his recommendations to get active.
“I’ve always encouraged them to do physical activity, but I wouldn’t know specifics about their neighborhoods and interests,” he says. “Now we’ll all have this great resource, which means we can talk about getting kids and families outside, and do it in a way that is specific, local, customized and achievable.”