Needs and assets mapping in low-income communities: A case study of using multiple methods and technology to promote physical activity in Latino families

1
Needs and assets mapping in low-income
communities A case study of using multiple
methods and technology to promote physical
activity in Latino families Suzanna M. Martinez,
MS, Karen J. Coleman, Ph.D., Jeanette Candelaria,
Jennifer L. Terpstra, MPH, Barbara Ainsworth,
Ph.D., Kevin Patrick, MD, MS, and John Elder,
Ph.D.
ABSTRACT The San Diego Prevention
Research Center (SDPRC) is a community-academic
partnership between the Center for Disease
Control and Prevention (CDC), San Ysidro Health
Center (SYHC), San Diego State University (SDSU),
and the University of California, San Diego
(UCSD). The primary mission of the SDPRC is to
promote physical activity in the U.S./Mexico
border community of San Ysidro, CA. As part of
this mission an extensive Needs and Assets
Mapping project was done using Geographical
Information Systems (GIS), behavioral
observation, key informant interviews, and
surveys. This represents a unique approach to
developing physical activity interventions for
underserved communities with a combination of
community- and technology-driven approaches.
Input from environmental, community, and
individual levels will be used to develop a
tailored program to promote lifetime physical
activity for Latino families. This approach can
be used nationwide to conduct research on
ethnically- and regionally-tailored physical
activity promotion as a means for preventing
chronic disease. INTRODUCTION In
2003, nearly 39 of Americans did not meet the
physical activity recommendation and 15 were
inactive (CDC). Lack of physical activity is a
risk factor for chronic disease, obesity and
overweight. Poor diet and physical inactivity
account for 400,000 deaths in the U.S. An
estimated 64 of Americans are classified as
overweight or obese (CDC). More than 61 million
Americans suffer from CVD and 17 million
Americans have diabetes. Three quarters of the
U.S. health care budget is used to treat chronic
diseases, many related to physical inactivity and
poor nutrition. These statistics make physical
activity promotion a challenge and a major public
health priority. The CDC is promoting
community collaboration and partnerships to
prevent chronic disease in socioeconomically
disadvantaged neighborhoods. Researchers are
investigating and evaluating new strategies to
promote community-wide physical activity (PA). In
addition to community-based participatory
research (CBPR), technological strategies are
being incorporated into research for health
promotion. Geographical Information Systems (GIS)
are one of these new technological advancements,
most commonly used to map communities for
factors related to barriers and facilitators of
PA. This project is the first to date that
combines GIS technology with needs and assets
mapping from CBPR to fully explore a communitys
full potential to enact PA interventions.

METHODS Participants Individuals
identified as key members in San Ysidro, CA
participated in key informant interviews (KII).
A total of 18 KII were conducted with persons
from San Ysidro agencies. In addition, 50
intercept interviews were conducted with
individuals who came to inquire about the SDPRC
at a community health fair in San Ysidro, CA.
Procedure The KII were conducted by
trained interviewers whose purpose was to guide
the interviews and to assess past and existing
health programs. Perceptions of physical
activity, perceived needs and barriers to
physical activity in the community, and
recommendations for physical activity
interventions to promote health behavior were
addressed. In addition, the interviews served to
identify potential collaboration between agencies
within the community, as well as parks,
recreation centers, and sports leagues and any
type of physical activity clubs present in the
community. Interviews were recorded and
transcribed for analysis. The 50 brief
intercept interviews administered at the
community health fair aims were to identify
current places for physical activity and
potential places that one might go to if it were
more convenient. The San Diego Nutrition
Network (SDNN) provides a free GIS map viewer
(www.cnngis.org) that maps many health-related
locations and uses a variety of commonly
available databases (i.e. US Census). The SDNN
GIS database also includes crime statistics,
disease rates, health clinic activities, walking
and biking trails, park and school locations, WIC
vendors, bus and trolley routes. All data
collected was used to build maps of the San
Ysidro community environments. A visual
representation of both maps are depicted in
Figures 1 and 2.
RESULTS The community of San Ysidro is
located in San Diego County and lies just North
of the U.S./Mexico border. In 2004, there were a
total of 28,440 people living in San Ysidro, with
almost 91 being Latino. The median age was 24.8
and the median household income was 28,611. Of
those living in San Ysidro, 34 had less than a
9th grade education, 53 were living in group
quarters, and 28 were living below the federal
poverty level. The crime statistics for 2005 were
lower than in 2003 with the highest rates being
vehicle theft (871) and property theft (376). In
2004, reports showed six rapes, 22 armed
robberies, 47 street arm robberies, and 70
assaults. Community members and leaders
told us that walking, dancing, volleyball, bike
riding, and community gardening were the most
likely to be accepted as interventions by the San
Ysidro community. Some of the barriers to
promoting PA are only three bike paths in San
Ysidro which are difficult to access, only run
North and South, and lead to dead space. There is
only one pool in the community, also somewhat
inaccessible, and none of the public schools in
the area have a certified Physical Education (PE)
instructors, offer PE more than once or twice per
week, or had success with promoting walk/bike to
school initiatives. There were few walking paths
within the community and only one track at the
high school which was not open to the community.
There are several assets identified by
both GIS and community agency leaders including
community members willing to promote a PA
intervention for the community, and schools
willing to provide their facilities for community
PA. There is a large land reserve with walking
paths, however, it is not within walking distance
of the community and thus is never used. Two
sites have been identified for possible community
gardening, one of which was used in previous
years. On the intercept survey, 42 of 50 adults
indicated that they engaged in PA at one
recreation center and 7/12 parks in San Ysidro.
Figure 2. GIS map of San Ysidro with WIC vendors,
restaurants, food stamp locations, schools,
fitness centers, healthcare facilities, and ratio
of Food Stamp recipients to lt 130 federal
poverty level-2005

• GIS Community Assets/Barriers Summary
• 12 Parks
• 2 Fitness Gyms
• 2 Community Gardens Sites (potential)
• 4 Health Agencies
• 3 Regional Community Programs
• 1 School Health Center
• 29 Public Schools (13 Healthy Start Schools)
• 5 Private Schools
• 8 Public Schools with 2005 FITNESSGRAM
  Results
• 18 WIC vendors and 1 WIC Clinic
• 14 Food Stamp Certified Vendors
• 10 General Grocers
• 3 Trolley Stations
• 3 Bus Routes
• 15 Seated Restaurants
• 16 Fast Food Restaurants, Pizza Vendors, and
  Delis
• 1 Ice Cream Truck

Figure 1 GIS map of San Ysidro, CA with bus and
trolley stops, and parks.