National Recreation and Park Association

Purpose and ObjectivesEffective community-based programs to manage arthritis exist, but many adults with arthritis are unaware that these programs are available in their communities. An electronic health record (EHR) referral intervention was designed to strengthen health care and community-based partnerships and increase participation in these arthritis programs. The intervention was developed in response to a national effort that aimed to enhance the health, wellness, and quality of life for people with arthritis by increasing the awareness and availability of, and participation in arthritis-appropriate evidence-based interventions.Intervention ApproachThe National Recreation and Park Association recruited 4 park and recreation agencies and their health care partners to implement an EHR-based retrospective and point-of-care referral intervention. Eligible for referral were adults aged 45 or older with an arthritis condition who were seen by a physician within the past 18 months, and were living within the park and recreation service area. After health care organizations identified eligible adults, they either mailed communication packages describing the availability and benefits of the intervention and conducted phone calls to encourage arthritis-appropriate intervention participation or counseled and referred patients during an office visit.Evaluation MethodsThe pilot was assessed by using semi-structured interviews with key intervention staff members and the Consolidated Framework for Implementation Research.ResultsOur approach resulted in referrals for 3,660 people, 1,063 (29%) of whom participated in an intervention. Analysis of key informant interviews also highlighted the specific contextual factors, facilitators, and barriers that influenced the adaptation and overall implementation of the referral intervention.Implications for Public HealthOur pilot demonstrates that successful coordination between health care organizations and community-based organizations can promote awareness of and participation in community-based programs. An understanding of the contextual factors and lessons learned can be used to inform processes that can lead to more effective and sustainable health care and community-based partnerships.

The NFMA held its annual Industry Roundtable at its 2012 conference. Representatives from the GFOA, ICI, MSRB, and NABL engaged in a lively discussion that addressed threats to municipal bond tax exemption, underwriter-led consents, and the increased regulatory treatment of the municipal bond market as a result of Dodd-Frank.

A collaborative framework that influences the promotion of policy related to physical activity should include parks and recreation as well as public health practitioners and researchers. As governments at all levels become increasingly focused on the impact of public resources, park and recreation agencies are challenged to document and demonstrate the impact of leisure services. Public policy associated with parks and recreation is driven by public interest and is often debated in the absence of relevant research to demonstrate the determinants and correlates of parks and recreation to address prevailing social conditions. This paper describes current policy and funding issues faced by public parks and recreation professionals responding to increasing physically active leisure across the lifespan of Americans. We also discuss how a collaborative framework approach can be used to inform public policy designed to increase the physical activity of the American public.

On the international level there exists a fabric of functional societies concerned with recreation. Over the years the machinery for recreation co- operation and exchange developed piecemeal. Now the international recreation program is taking form as a comprehensive movement. The challenge still out- runs the achievement.