Beyond subsidies: An inclusive approach to address financial barriers and inform policy action on access to municipal physical activity infrastructure among young families with low income.

IntroductionFamilies with low income face barriers to children's physical activity (PA) engagement. Municipalities can address financial barriers (in addition to physical and social ones) to PA participation by providing free or low-cost access to municipally-operated indoor and outdoor recreation spaces, and recreation programming.PurposeWe aimed to develop a set of strategic actions municipal governments can adopt to optimize access and use of municipal recreation spaces among preschool-aged children from families with low income.MethodsThrough a triangulation process and deductive-inductive analyses to develop recommendations for municipal action, we combined: data from a Photovoice study in Strathcona County, Canada, that engaged families with children aged 3-5 years who received subsidies to use municipal recreation infrastructure to understand their perceptions on factors impacting their use; public health action-oriented Framework and Guidebook on financial wellbeing; evidence from a targeted critical literature review; and an intersectionality approach (Gender-based Analysis Plus).FindingsTwenty-one themes emerged from the Photovoice data and included, for instance, lack of and inconvenient public transit and poor playground design. Findings suggest that investing in physical infrastructure is not enough to promote participation, as other factors (e.g., flexible program scheduling) implicate recreation space use. We developed 34 recommendations for municipal actions (e.g., offering in-person registration for people with limited access to the internet) organized into eight of the Framework's entry points.ConclusionsOur paper offers an actionable approach for municipalities to centre their efforts to promote use of recreation spaces equitably and meet specific needs of families with low income.