Background:
Overweight and obesity among Canadian children have grown at a significant rate in the last two decades. Declines in average daily energy expenditure are one likely underlying cause. The magnitude of the obesity problem favors interventions at a population level. Schools offer a good setting in which to incorporate physical activity into the lives of children using both curricular and non-curricular approaches. In Alberta, Canada in 2005 the Daily Physical Activity Initiative (DPAI) was introduced which mandated 30 minutes of physical activity for students in grades 1 through 9. In many places worldwide walk-to-school (WTS) programs such as the Walking School Bus have been promoted for some 20 years as means of increasing activity associated with the school day. Despite the existence of some very popular WTS programs and the perception of a crowded school curriculum, DPAI was chosen as the policy option to increase activity physical activity among school-aged children.
Objective:
The purpose of this study is to examine why decision-makers in Alberta have chosen not to adopt an active transportation program as a policy option for increasing levels of physical activity in school-aged children. As a comparison this research will look at why the option of DPAI has recently been adopted. Understanding what makes one policy option favorable over another will be valuable for health promoters seeking policy change to enhance the health of populations.
Methods:
A conceptual framework was created to examine the policy community, policy networks, and the public policy processes impacting physical activity in schools. Information from publicly available sources was gathered about the organizations influencing policy that affects physical activity opportunities for children in schools. Using the policy process as described by Howlett and Ramesh (1995) and Kingdon (1995), this research reviewed existing literature on public policy relating to physical activity in schools, reviewed key policy documents and interviewed key individuals within education to identify the facilitators and barriers to efforts to effectively increase levels of physical activity in school-aged children, towards addressing childhood obesity. Using a non-probability sampling technique, 20 individuals from key stakeholder organizations were selected and interviewed. Interviewees included two ministers of the crown who have held portfolios for education and health, current government managers, a school board trustee, school administrators, health professionals who interact with the school system and representatives of non-governmental organizations related to physical activity.
Results:
DPAI has been chosen by policy makers as the policy option to combat childhood obesity because it has several characteristics that made it viable. Benefits of implementing DPAI were shown to accrue to both the health and education of the students through research conducted over a period of 20 years. This factor gained the support of teachers who are a critical link in the implementation of the program. Because schools were previously equipped to provide activity programs, the funding required for DPAI was minimal making it politically popular. Another key political factor was that a physician was named minister of education and he bridged the gap between health and education.
Conversely, walk-to-school initiatives lack some supports needed to make them viable policy options as well as being incongruent on some terms with the beliefs held by the community at this time. Obesity and health are secondary concerns of educators and no research directly states that walking to school improves learning. Because some children live outside of the school neighbourhood and travel by car, WTS is not a universally feasible solution to inactivity. Ambiguity exists regarding who is responsible for transporting children to school - parents or schools? A critical shortcoming of WTS initiatives is that they are promoted by non-profits that are politically week and lack a well-placed policy entrepreneur to champion the option.
Conclusions:
Many societal beliefs are barriers blocking the uptake of walk-to-school initiatives. Institutions’ propensity for incremental rather than wholesale change favours the DPAI because it fits into the existing structures of education delivery. Interests supporting walk-to-school initiatives are relatively weak. These are challenges that proponents of walking initiatives need to address and that professionals seeking change in other areas can learn from. Health promoters are more likely to have their favoured intervention adopted if they use proper measurements and evaluations to show that benefits will accrue to key stakeholders. Feasibility of the solution should be tested and refined by circulating it throughout the concerned community for input and feedback. It is useful to identify and recruit a policy champion to maneuver the solution through the political stream and open policy windows.
Support:
Dr. Jean C. Nelson Memorial Foundation, The Heart and Stroke Foundation of Canada, and the Canadian Institutes for Health Research – Institute of Nutrition, Metabolism and Diabetes.
