Unity Care Implements Parkscriptions into their
Integrated Healthcare Centers in Bellingham and Ferndale

Recreation Northwest’s Parkscriptions Program launched in April 2019, partnering with doctors and other health care providers to prescribe time outdoors. Parkscriptions goal is to connect patients with positive outdoor experiences that result in healthier lifestyles and improved mental and physical health. One large group at Unity Care NW’s Integrated Community Healthcare Centers in Bellingham and Ferndale, WA have recently implemented the Parkscriptions Program as a vital part of their comprehensive approach to community health care.

Unity Care NW’s core mission is ‘healthcare for everyone’ so they accept most insurances and offer a discount program for the uninsured and the underinsured.

“We have one system and communication among medical staff, dental staff, behavioral health staff and a pharmacy all in one place. Our doctors, counselors, dentists and pharmacists are all integrated,” explains Unity Care NW Outreach and Enrollment Specialist, Megan Stephenson. “We have programs that support patients struggling with substance abuse, pain management, behavioral health and who need emotional support. Our support staff—such as case managers and community health workers—are also there to help as well as wrap-around supplementary programs to that.”

Although their programs have many moving parts, Unity Care NW found the Parkscriptions program relatively easy to implement.

“Even before Parkscriptions came along, our behavioral health clinicians had been recommending time and activities outside to help with depression and anxiety as a supplement to other supports like medication, therapy and diet,” recalls Stephenson. “I felt like it was a simple program element around a lot of concepts we were already familiar with. So we only had to figure out how to implement it as a program,” adds Stephenson. “We approached it more deliberately and found new ways to track participation, patient satisfaction and how it might affect their health.”

Unity Care NW found simple ways to implement Parkscriptions for many of their patients. Family Care Network were early champions of the program. They shared with us how they integrated the system, set up their recording and their electronic medical records. We didn’t have to start from scratch,” explains Moon. Because we use a holistic approach for all of our patients, any time a provider prescribes an antidepressant to someone, at the same time, we give a Parkscription, because they both have their benefit and can work together,” adds Stephenson. 

Their introduction to Parkscriptions includes walking the patient through the Parkscriptions online tool, WhatcomParkFinder.org. “The behavioral health team has a little more time to get into the website with the patient. Then they know how the website works, they can go use it on their own,” notes Stephenson.

They found that although their medical physicians might have a little less time during an appointment to connect patients with the website, their trained support staff—Case Managers and Community Health Workers—were able to work with patients on the Parkscription tools. 

“The Parkscriptions website is a tool that providers previously didn’t have,” adds Communications and Public Relations Associate, Jennifer Moon. “It is a resource that they and other staff can use to direct people to where they can best meet their particular need.”

Much More than a Website

Unity Care NW has also implemented Parkscriptions in other ways throughout their practice. 

“We started a free Parkscription program walking group. We meet once a week and offer a simple half hour walk. It is customized based on the mobility and needs of those that come,” explains Stephenson. “Those that have come have really enjoyed it. We’ve been able to talk about lots of different topics. I’ve walked with a family on a really beautiful nature walk along the creek behind the post office and down to Maritime Heritage Park. They asked about the plants along the trail and the city has already provided informational displays. The whole family learned a little bit and it was cool to see their curiosity about nature.”

“Those that have come out for the weekly walks have expressed interest and motivation in continuing to walk on their own,” adds Stephenson.

We also hand out a list of Parkscriptions Certified Programs to patients to let them know about other local activities they can do outside,” adds Stephenson. “We want them to have lots of choices in case one suggestion doesn’t work for them.”

“When the provider writes a Parkscription, we include the website address on the bottom of our visit summaries—the paperwork that goes home after a visit—as a recommendation and reminder,” adds Moon.

“We give out lots of Parkscriptions literature too depending on the needs of the patient,” Stephenson chimes in. “Working on prevention and interventions when someone has a chronic illness, there are things we can do to keep it from getting worse.”

Multiple Benefits of Parkscriptions

“Some think that health is something you can see or feel. But so much of our health is not necessarily visible. For example, being outside can help reduce inflammation, it helps with the chemical levels in your brain—things that you may not feel right now—but that is all happening even though you can’t see it on the outside,” explains Stephenson.

 “My favorite part of Parkscriptions is that just talking to someone about being outside as a healthy activity on its own is not enough. It’s hard for them to imagine how just being outside helps their health. We want to give people ideas about what to do—take a walk, do some stretching, kayaking, hiking and so on,” notes Stephenson. “That’s the part I really like, I’m not just suggesting a walk for the cardio, I’m also wanting to explain and encourage that just being outside and breathing in the fresh air and oxygen and having a quiet moment is super healthy for you. We’re all very busy. It gets left behind.” 

There are social aspects as well. “Just having a time and place to show up, if they are struggling to walk on their own, having a little accountability can help get people more into the habit. Social connection is a huge part of our physical and mental health,” says Stephenson. 

“If you don’t have that social connection it can impact your health in many ways. The research shows that social isolation among seniors can increase your risk of falls. That’s a mind blower to me,” adds Moon.

“Social isolation is linked to increases in hearing loss…,” notes Stephenson.  “Which can lead to cognitive issues, like increasing your risk for dementia…,” adds Moon.

“That then feeds back into social isolation. If you can’t hear well, you might isolate yourself and it leads to a vicious cycle,” Stephenson says.

That’s where we focus. What are the things you can do now to help ourselves in the future, things that can help you avoid that cycle later? It can have an impact on you and your family and community.”

Learning to Self-Parkscribe

Although some patients may take their provider’s advice more seriously than hearing about it on their own or from a Community Health Worker, many are able to use the web tools at home on their own.

“The beauty of the Parkscription is that it doesn’t have to come from a provider, you can self-Parkscribe,” notes Stephenson. “We…explain that, from your own house, you can plug in your address and find a local greenspace or park, a place to walk to, as a goal, and then back, or to find a park you want to try and then drive there and walk around.”

More About Unity Care

“Unity Care NW is a federally qualified health center that was born out of the Interfaith Coalition. It became its own nonprofit in about 2008,” explains Stephenson. Parkscriptions pairs nicely with Unity Care NW’s other programs including their vegetable prescription program, Whatcom Veggie Rx, that combines a grocery voucher with support from a dietician and nutrition classes. This program is especially valuable to those managing diabetes. “Used in conjunction with Parkscriptions, we want to help move that population in a healthy direction that also improves their health outcomes as well,” notes Moon. 

Unity Care NW also partners with the YMCA on their Diabetes Prevention Program that includes a support group that emphasizes tools to change your lifestyle to prevent the development of Type 2 diabetes. “We’re encouraging them to get outside too and talking about the Parkscription tools available to get them there,” notes Stephenson. “We let the person lead the conversation and we’re trained to find those moments when they are ready for help and then we are there. We help them get a bus pass or a ride. We listen and then help get them there.”