Abstract 18923: Associations of Park Access With Physical Activity Levels During 1 Month Period After Acute Coronary Syndrome

Abstract

Introduction: Physical activity (PA) is an important predictor of recovery after an acute coronary syndrome (ACS) event, and research has demonstrated the importance of neighborhood walkability on PA. Walkability is shaped by land use, density, and the development of parks and pedestrian spaces, which may be particularly important in urban areas. However, it is unclear whether discrete components of walkability, such as park access, independently impact PA levels in ACS survivors. The purpose of this study was to investigate how residential park proximity and percentage of park land use impact PA levels during the month following a suspected ACS event. Methods: This sample included patients (n=374, 49% female, 63 ± 11.9 y) who presented to the emergency department for suspected ACS. PA data (sedentary behavior [SB], light intensity [LPA], moderate-vigorous intensity [MVPA]) were collected using a wrist worn GENEActiv accelerometer for 30 days post-discharge. Park access was assessed using Geographic Information System and operationalized to include count of parks and percentage of land use covered by parks within a 1km radius area around each geocoded home address. Multiple linear regressions were conducted to determine the relationship between park access factors (count and land use), PA levels, and SB. Results: Models adjusted for demographics, comorbidities, and disease severity indicators (Grace risk score, length of hospitalization) found a statistically significant positive association between park land use and MVPA (B [95% CI]= 44.25 [4.55-83.94], p-value=0.029). Additionally, there was a statistically significant positive association between park count and SB (B [95% CI]= 1.97 [0.42-3.53], p-value=0.013). Conclusions: We found that residential park land use was positively associated with MVPA in the first month following suspected ACS. Additionally, there was a positive association between park count and SB. These findings suggest that greater park access in neighborhoods may play a significant role in activity levels during ACS recovery. Future research is needed to understand which aspects of urban park design/environment should be modified to enhance physical activity and reduce sedentary behavior in ACS survivors.