Applying Systems Thinking Approaches to Address Preventive Health Factors through Public Parks and Recreation Agencies




Delphi method, physical activity, nutrition, management, community planning


Within the United States parks and recreation agencies (P&R) manage public facilities, spaces, lands, and recreation programs. Public health (PH) evidence has increasingly pointed to local public P&R agencies as critical for promoting preventive health. Programs and strategies are available, but most P&R agencies have limited resources and lack local knowledge on which to base actions. However, the research base is growing. The global research question has shifted from asking IF P&R agencies can positively affect PH factors, to HOW they can best do so with limited resources.

This research adapted a systems theory approach to how local public P&R agencies are addressing health factors. Methods included a literature review along with iterative exploration through a three-stage Delphi panel study with 17 P&R agency Expert Panelists in the U.S and Canada. Panelists were identified through a waterfall selection process. Each had at least three years of senior administration experience with interest in addressing PH factors.

The study explored which preventive factors appear to be most modifiable by P&R. Results indicated increased physical activity, improved nutrition, enhanced safety or perception of safety, increased social and parental engagement, improved transportation and access to locations (especially nature), and cessation or reduced overconsumption of tobacco and alcohol. However, the priority of factors varies by community, and the continuing challenge is determining the priority of the factors for agencies and their partners to address. Community-specific data are not typically readily available to P&R agencies. Programs, strategies, internal methods, policies, and documents utilized by agencies were collected. Thirty-one related national initiatives (programs) were identified and ranked by the panelists.

Key common strategies for P&R were identified. Results indicated a need to focus strategies on leadership and adequate funding to create a strong organizational culture of systematic assessment for addressing PH through allocation of P&R staff and financial resources. Systems thinking analysis and strategies can improve outcomes for cultural ethics of inclusion and equity, equitable access to assets and programs, collaboration with other partners, utilization of crime prevention and environmental design strategies, increased health promotions and education, and centralized tracking and evaluation of feasible measures.

Implications for research include needs for additional validation and dissemination of research, evidence-based tools, and proven methods. There continues to be a strong need to help address gaps in knowledge transfer between research and practice realms. Management implications suggest methods for practice to enhance systems-thinking approaches for better preventive health outcomes through P&R in communities.

Author Biography

Teresa L Penbrooke, GP RED GreenPlay

Dr. Teresa Penbrooke’s career has included over 30 years of private and non-profit business management, teaching, and research, including years as a parks and recreation agency administrator and program coordinator for three different public agencies in Colorado. Teresa now authors books and articles, teaches for universities, state, and national associations, conducts research, and consults. Areas of focus are quality of life systems planning and management, leadership, access to nature, modifying preventive community health, operations, strategic planning, and community engagement. She is the Director of the Healthy Communities Research Group and Faculty for GP RED, a national non-profit that provides Research, Education, and Development for health, recreation, and land management agencies. Teresa is also the CEO and Founder of GreenPlay, LLC, a leading national private parks, recreation, tourism, and open space consulting firm, which has completed community engagement and planning for over 500 communities since 1999. Teresa has a BS in Kinesiology, a Masters in Organizational Management, and her PhD is in Parks, Recreation, and Tourism Management from North Carolina State University. She loves combining her natural intellectual curiosity, love of the outdoors and healthy lifestyles, entrepreneurial spirit, and public sector heart to help communities thrive. More information can be found at or