Emerging research investigating strategies to increase physical activity (PA) in under resourced areas has found that interventions that use existing community resources are most effective (1–8). Play Streets are one example of an intervention that leverages community resources to promote PA. Play Streets have been implemented internationally to address resource access and safety inequities that impact youth PA (9). Play Streets are defined as the temporary closure of streets or other public spaces (e.g., schools, parks), that for a specified time period create a safe, low-cost space for children, adolescents, and/or their families to engage in active play (10–15). Play Streets are especially important for youth in rural communities without access to safe and/or well-maintained PA resources (13).
Play Streets have been implemented in various U.S. and international locations, despite a somewhat small body of research evaluating PA and community benefits. For example, over 650 Play Streets have been hosted in Chicago, IL since 2012 (9,10), and over 350 have been hosted in Seattle, WA since 2013 (9,12). Internationally, Play Streets have been implemented in many urban locations in England, Australia, Chile, and Belgium (14,16–18). In addition to popularity in urban spaces with varying income levels, Play Streets have been held in rural areas such as Oakland, MD, Warrenton, NC, Talihina, OK, and Cameron, TX (15,19). Despite recent successful Play Streets implementation, rural communities often disproportionately experience barriers to sustaining health promotion initiatives over time (20,21). While research has explored barriers to sustainability in urban locations (22), research is needed with rural community partners who have successfully implemented Play Streets to understand what implementation strategies they used or could use to ensure sustainability.
Existing research has established frameworks to ensure public health programs have the capacity to sustain activities over time (23–25). The Public Health Program Capacity for Sustainability Framework includes themes developed from an extensive literature review of community-level prevention programs related to tobacco use, PA, cardiovascular health, diabetes, and asthma (24). The nine major themes include (24):
• Funding Stability: making long-term plans based on a stable funding environment.
• Political Support: internal and external political environment which influences program funding, initiatives, and acceptance.
• Partnerships: connections between program and community.
• Organizational Capacity: resources needed to effectively manage the program and its activities.
• Program Adaptation: ability to adapt and improve to ensure effectiveness.
• Program Evaluation: monitoring of process and outcome data associated with program activities.
• Communications: strategic dissemination of program outcomes and activities with stakeholders, decision-makers, and the public.
• Public Health Impacts: program’s effect on the health attitudes, perceptions, and behaviors.
• Strategic Planning: processes that define program direction, goals, and strategies.
This qualitative study used the Public Health Program Capacity for Sustainability Framework to examine Play Streets implementation characteristics in four rural U.S. communities as they relate to sustainability from local partners’ perspectives.