title: Improving park space access for the Healthy Kids, Healthy Communities partnership in Denver, Colorado.
abstract: BACKGROUND
  In 2010, Denver Public Health at Denver Health was awarded a Robert Wood Johnson Foundation Healthy Kids, Healthy Communities (HKHC) grant that supported policy, system, and environmental changes to expand healthy food access through gardens and large-chain grocery stores and expand environments that are safe for all children to play, walk, and bike. Systems-thinking approaches enhanced the Denver partnership's work to identify and address the multiple and complex factors affecting the environment changes implemented to increase active living and healthy eating. Continued application of the systems-thinking approach in Denver will sustain outcomes for obesity prevention efforts beyond the grant project cycle, specifically in park space redevelopment.
  
  
  METHODS
  Key members of the Denver HKHC coalition were invited to participate in a half-day group model-building workshop to create behavior-over-time graphs and a causal loop diagram. These activities were intended to build on the Denver HKHC partnership's work by identifying factors that affect or are affected by policy, system, and environmental changes that influence active living, healthy eating or childhood obesity.
  
  
  RESULTS
  Environments (ie, park space, farms, gardens) developed or renovated should consider identifying and addressing a range of factors that may influence access and utilization of active living and healthy eating.
  
  
  CONCLUSIONS
  Denver's partnership found the experience highly valuable for identifying the policy, system, and environment change pathways that lead to increases in active living and healthy food access. In addition, it highlighted the need to identify and address the multiple and complex change pathways to ensure the outcomes of environment change, especially with park space, implemented in Denver achieve increased access to active living and healthy eating.
authors.affiliation: Denver Public Health at Denver Health, Denver, Colorado.
authors.forename: Jennifer Wieczorek
authors.initials: JW
authors.lastname: Moreland
mesh_terms: D000383:Agriculture / Q000379:methods / Q000592:standards*; D003120:Colorado; D000072001:Diet, Healthy / Q000523:psychology; D004779:Environment Design / Q000592:standards*; D015444:Exercise / Q000523:psychology; D015438:Health Behavior; D006291:Health Policy; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D000068316:Parks, Recreational / Q000592:standards*; D011634:Public Health / Q000379:methods / Q000592:standards