Abstract TU203: Leveraging Parks for Physical Activity Promotion and Cardiovascular Health among African American Children: Feasibility, Acceptability, and Preliminary Efficacy of the NatureUplift Pilot Randomized Trial

Introduction: Children remain underrepresented in cardiovascular health (CVH) research, and few studies have tested community-engaged interventions to promote CVH early in life. We conducted a park-based pilot trial and evaluated its feasibility, acceptability, and preliminary efficacy on children’s moderate- to vigorous-intensity physical activity (MVPA) (primary outcome). Methods: NatureUplift was a 12-week, two-arm pilot randomized trial conducted among African American parent-child (aged 8-12 yrs) dyads (N=13) during summer 2024, co-designed with community partners at Three Rivers Park District (Plymouth, MN) and delivered by culturally representative liaisons. The NatureUplift group (n=6) received weekly light-intensity nature-based activities (e.g., outdoor yoga, forest bathing). The NatureUplift+Active group (n=7) completed the same activities plus moderate- to vigorous-intensity hiking. Make-up sessions were offered as needed. Feasibility outcomes included recruitment, retention, and session attendance. Acceptability was assessed via Likert-scale surveys in week 12. Accelerometers measured MVPA at baseline, week 4, and week 12. Within-group changes and between-group differences were estimated using linear mixed models adjusted for child sex, with treatment-by-time interaction. Given the pilot design, interpretation focused on 95% CIs. ClinicalTrials.gov: NCT06445556. Results: Recruitment occurred April-May 2024, with 81% of eligible families enrolled. Ninety-two percent completed the 12-week intervention and follow-up assessments. Average session attendance was 74% ( NatureUplift ) and 67% ( NatureUplift+Active ). All families completed make-up sessions. In both arms, most children (83%-100%) “agreed” or “strongly agreed” that they liked participating in the study, enjoyed having a culturally representative program leader, felt the program activities were interesting, and would recommend participation. From baseline to week 12, MVPA declined in NatureUplift (-33 min/day, 95% CI -53, -13) but exhibited an attenuated decline in NatureUplift+Active (-13 min/day, 95% CI -19, 19). Wide confidence intervals indicated no precise evidence of treatment-by-time interaction. Conclusions: This pilot trial was feasible and highly acceptable, with the hiking component potentially supporting the maintenance of MVPA over time. Our community-engaged and culturally affirming approach lays the groundwork for a future full-scale efficacy trial leveraging parks to advance CVH equity.