The ciclovía was held in Toppenish, Washington, which is located in a rural agricultural region in eastern Washington State. Based on the Rural-Urban Commuting Area Code (1–10), a standardized approach used to classify rural areas based on town size and commuting patterns to urban areas, Toppenish is classified as 4.2 (large rural community with a population of 10,000 to 49,999) [
19]. The Toppenish population is just over 10,000, where 74% of residents are Hispanic and 24% live below the federal poverty level [
20]. This study was approved by the Fred Hutchinson Cancer Research Center Institutional Review Boards, and informed consent was obtained from research participants.
We used a community-based participatory research approach to foster bidirectional learning with the community to create the content of the ciclovía, adapt the content to be feasible and acceptable for rural communities, and implement ciclovía, with a focus on sustainability through community adoption. In 2017 and 2018, the ciclovía was a research intervention, while in 2019, the ciclovía became a community-adopted program, supported and administered by the community, with the research team supporting the evaluation. The progression from research intervention to community adoption included four steps: 1) co-learning about the science of ciclovía, 2) learning the implementation process and navigating subsequent iterations, 3) creating tools to facilitate planning, implementation, and evaluation of ciclovía, and 4) developing transition steps from a research intervention to a community-adopted program.
Co-learning about the science of ciclovía
The CAB met quarterly to learn and review information about ciclovía as this was initially a new concept for our partnering community. The CAB included 35 community members. The members represented 22 local organizations including schools, community health centers, local health departments, community-based organizations, and community advocates. The CAB received $25 per meeting to compensate for their time and effort. Conversations in these sessions were about ciclovía’s origin from Bogota, Colombia, as a community-led social movement to claim the streets for physical activity; its passage to the US and subsequent adoption by communities with high socioeconomic status; and utility and adaptation of ciclovía to local context with the goal of sustainability. Because Together We STRIDE promoted healthy eating as well as physical activity, the community felt it was important to provide healthy food and beverage options at the event. The community provided healthy food through fruit donations from local farm owners, which included apples, bananas, and oranges. Water was provided as the healthy beverage, using reusable water bottles branded with the study logo for participants to use and take home. These two components helped create synergy with the project’s promotion of PA and healthy eating as interdependent attributes of a healthy, active lifestyle.
Learning the implementation process
A smaller steering committee of 10 CAB members was formed within the CAB with those who self-selected to be in the committee based on their availability and interest for more engagement. The steering committee led the planning and the implementation of the ciclovía. The 2017 planning meetings were focused on delineating roles and responsibilities for the community and researchers. The steering committee identified a venue for ciclovía, secured city permits to close streets, enlisted volunteers, and provided input throughout the planning and implementation process. The research team led the planning meetings, incorporated input from the steering committee, coordinated all the activities that would occur during ciclovía, tracked and updated the volunteer list, created the marketing and implementation tools, and led the evaluation of ciclovía.
The steering committee made several adaptations to ciclovía to fit the rural context in three specific ways. First, given that rural communities are more spread out than dense urban areas, the steering committee strategically selected an area with a park and adjacent streets proximal to the town center so that the event included multiple components conducive to PA (e.g., greenspace, crosswalks, and sidewalks connecting to local shops and businesses). Integrating these multiple components helped reinforce the idea that PA is accessible and feasible in the community. It also enabled the community to take advantage of the greenspace for event activities. Second, activity hubs for families (e.g., Zumba, yoga, aerobics) and children (e.g., walk the plank, hula hoops, jump rope) were placed in designated sections of the park and streets. This enabled us to show community members that this space was a community asset that could be shared for all kinds of PA and that the streets could be traveled via active transportation to get to places where people gather for physical and social activities. Third, bicycles and scooters donated by the community were raffled to families throughout the event to increase accessibility of bicycles to children and instill a connection between bicycles and wheels with the theme of ciclovía. To promote safe riding practices, the children who won the raffle were fitted with helmets, since wearing a helmet was not normalized in the community. The planning and implementation process were iterative, where lessons learned from previous years were discussed by the steering committee and consensus was reached to incorporate new elements to improve future ciclovías.
The steering committee and research team co-created multiple tools to plan and evaluate the ciclovías. Planning tools included standard operating procedures for planning and day-of-event implementation, planning timelines, planning checklists, event maps with locations of the activity stations, and a list of activity stations. Volunteers were assigned to each station. All volunteers were trained on their roles and given information on who to contact if questions arose during the ciclovía. All adolescent volunteers were supervised by adults.
For the 2017 ciclovía, we developed a logistics document to help organize event activities and track roles and responsibilities. The document included event logistics, such as event hours, lists of activity stations, and staff contact information. The document was updated after each ciclovía planning meeting to ensure that what was agreed upon in meetings was documented. We handed out individual copies to staff and volunteers at the ciclovía.
In planning the 2018 ciclovía, we adapted the logistics document into a Planning Checklist to improve usability (see Additional file
1 for Planning Checklist). We organized the checklist by activity and related components: equipment needed, main contact, status, and person(s) responsible for finalizing the activity. Like the logistic document, the checklist was updated after each ciclovía planning meeting to ensure the necessary components of each activity came together.
The evaluation tools included a participant’s survey, a participant count form, and data collection protocol. Data collectors were trained on their assigned tool before the event and received a refresher training on the day of the event to ensure accuracy and consistency.
Developing transition steps from a research intervention to a community-adopted program
In 2019, the community advisory board with CAB established transition steps from research intervention to community adoption through four major steps. First, to ensure that it was a community-led event, previous roles and responsibilities were revised and delineated for the community to lead the planning and implementation of the event. The research team provided assistance by scheduling planning meetings, co-managing the planning checklist, updating event flyers and banners, and overseeing the evaluation. Second, the community secured funding and resources through local connections to support the event. Funds were used to complement the donations from the community so that more bicycles, skateboards, and scooters were available through the raffle. A large helmet donation (of 150 helmets) was secured by the community to ensure that all children on wheels were fitted with helmets. Third, a planning guide was created by combining the resources created from previous ciclovías into a step-by-step guide. The manual describes the planning, implementation, and evaluation steps as well as supporting tools and resources to accomplish the plan (Ciclovía: Planning a Rural Open Streets Event; available at the weblink: Ciclovia Planning Manual.) The community used this manual and drew from their own experiences to plan and execute the ciclovía. Fourth, the steering committee reviewed the community stakeholders engaged in past ciclovías and reached out to other community members from their town and neighboring towns to promote awareness of ciclovía and its benefits.