Playgrounds for Health Equity: A Mixed Methods Study in Urban Central Texas.

Active outdoor play is a critical source of physical activity for children, and playgrounds constitute a key setting. However, research examining equity in access to playgrounds through a public health lens is limited in the United States (U.S.). This study in Austin, Texas, aimed to (1) assess geographic equity in public playground availability and (2) understand the organizational landscape and key actors' perspectives on barriers and opportunities for improvement. All metropolitan area public-access playgrounds were geocoded, and census tracts were categorized by playground count, median household income, percent of the population under ten and predominant race/ethnicity. Multinomial regression models examined the associations between neighborhood sociodemographic characteristics and playground availability. An organizational landscape analysis identified key organizations of relevance for playground access equity. Semi-structured interviews were conducted with representatives of key organizations, and inductive coding was used to identify themes. Results indicated greater availability of playgrounds in higher-income and predominantly non-white neighborhoods independent of the number of children a neighborhood had. Thirty-five key organizations across four partially overlapping focus domains (government, construction/architecture, community engagement, advocacy) were identified. Key informant interviews revealed six main themes (equity, community-based work, community mobility, playground environment, organizational scope, and advancing playground initiatives). Policy efforts in Austin should address socioeconomic disparities in playground availability and strengthen cross-sectoral collaboration.