Page - 389 - in Biodiversity and Health in the Face of Climate Change

389 but the green space was similar in size, with similar characteristics, and served a similar population to the intervention site. Four studies that involved major park improvements coupled with promotion programmes showed a significantly positive post-intervention effect for: increasing usage (Tester and Baker 2009; Ward Thompson et  al 2013; King et  al 2015; Slater et  al 2016); physical activity (Tester and Baker 2009; King et  al 2015; Slater et  al 2016); quality of life (Ward Thompson et  al. 2013); and perception of safety (Ward Thompson et  al. 2013). Tester and Baker (2009) evaluated the effects of major improvements to playing fields of two public parks as well as physical activity pro- grammes, and training and skills development for park and recreation programme staff. Results showed that playing field improvements, with and without family and youth involvement initiatives, significantly increased visitation and overall physical activity (four- to ninefold increase) compared to the control group. Ward Thompson et  al. (2013) investigated the impact of regeneration of deprived areas in Glasgow, UK.  Green spaces were upgraded through clearing rubbish and signs of vandalism; construction of improved footpaths, installation of signage and entrance gateways; and publicity and organization of group activities to encourage opportunities for use. Quality of life (p  =  0.002), perceptions of safety (p  <  0.05) and usage (p  <  0.001) significantly improved among local residents compared with the control site. King et  al. (2015) demonstrated significant improvements in park usage (p  =  0.004) and physical activity of users (p  =  0.007) after the transformation of 2 acres of undevel- oped green space into a recreational park (including footpaths, playing fields, benches and basketball courts) and a community garden in an area of transitional housing for the homeless and refugees. Slater et  al. (2016) showed significant improvements in park usage and physical activity levels of users over time (up to 12  months) in 39 intervention parks that undertook major improvements including replacement of old playground equip- ment and ground surfacing, coupled with extensive community engagement activi- ties to encourage and promote park usage, compared with control sites. Three studies showed significant intervention effects for minor park improve- ments including significant increases in walking (NSW Health 2002), park usage and physical activity of users (Cohen et  al. 2013; Cranney et  al. 2016). An interven- tion in Sydney (NSW Health 2002) involved park modifications (e.g. signage, greening, improved paths and a new playground), park promotion use via advertise- ments, walking maps and the establishment of walking groups. A large randomised controlled trial (RCT) by Cohen et  al. (2013) involved 51 parks allocated to one of three management trials. Park Directors received training from marketing consul- tants regarding outreach, customer service and promotion events. Each park received $4000 to spend on park programmes, which included signage (e.g. banners, walking path signs), promotional incentives (e.g. water bottles, park-branded key chains, individually targeted e-mails), and outreach activities (e.g. hiring community engagement officers, buying activity materials). Cranney et  al. (2016) investigated the effects of the provision of an outdoor gym in Sydney alongside hosting exercise sessions and targeted marketing and promotional strategies to engage older adults. 17 Environmental, Health and  Equity Effects of  Urban Green Space Interventions