Active Living Research

The Robert Wood Johnson Foundation requested this utilization-focused evaluation of its Active Living Research (ALR) program. This evaluation reports on the trajectory of influence of past and future ALR outcomes on field-building and policy contributions as well as on possible users of completed and disseminated ALR products. In 2006 and 2007, key-informant interviews were conducted with 136 representatives of first-line potential users of ALR research products, including state physical activity and nutrition program coordinators, policymakers, scientists, and funders. Literature reviews, bibliometric analyses, and document reviews served to describe the context for ALR’s work and the ways it could enhance its utility for field building and policymaking. The contributions of ALR to the emerging transdisciplinary field included leadership in the development of measurement tools, epidemiologic studies, implementation research, the translation of research to practice, and the communication of learned lessons to diverse audiences. ALR’s contributions to policy discussions were found across a spectrum of policy-development phases that included describing the problem, raising awareness of alter- native strategies for increasing physical activity, convening nontraditional partners, and evaluating policy implementation. Policy-relevant research can make contributions to policymakers’ thinking but almost never causes a change by itself. Five years after the original authorization of ALR, there is ample evidence of its recognition as a resource by key players, its field-building influence, and its contributions to policy discussions. All these bear promise for a broader contribution to obesity prevention. Recommendations for increasing ALR’s impact on policy and practice are offered. 

In 2000, the Robert Wood Johnson Foundation (RWJF) expanded its efforts to improve healthy lifestyles by targeting increased physical activity in daily life. RWJF staff selected environmental and policy change as the primary approach to this health behavior issue, building on their decade-long work on tobacco control. RWJF staff posited that progress on policy and practice in this nascent field would require both the development of an evidence base and capacity among researchers to produce needed knowledge and the development and testing of policies and interventions, with support for successful policies and interventions coming from professionals and policymakers. Conse- From Gutman Research Associates (Gutman, Morley), Cranbury, New Jersey; Barker Bi-Coastal Health Consultants, Inc. (Barker), Calabasas, California; and the School of Public Health, Columbia University (Samples-Smart), New York, New York Address correspondence and reprint requests to: Marjorie A. Gutman, PhD, Gutman Research Associates, 42 North Main Street, Cranbury NJ 08512. E-mail: magutman1@aol.com. An evaluation was undertaken of the initial 6 years of the Active Living Research (ALR) program. Conducted in 2006 and analyzed in 2007, the evaluation was designed to assess productivity and progress on all three program goals and to inform consideration of program re-authorization. The evaluation was a retrospective, in-depth, descriptive study utilizing multiple methods, both qualitative and quantitative. Qualitative data were derived mainly from 88 interviews with key informants. Quantitative data were derived primarily from a web-based survey of grantee investigators. Examples of key indicators of ALR’s progress in addressing its goals were (1) in building a knowledge base: 40% of grantee investigators reported producing at least one scientific publication based on their ALR study, averaging two papers per principal investigator who had published; (2) in growing a transdisciplinary field: investigators funded in the first five rounds of grants reported representing more than 20 disciplines; and (3) in contributing to policy change: ten examples were reported of contribution to specific policy changes. In addition, more than one-third (37%) of principal investigators had leveraged additional funds, averaging $275,000 per ALR grant, suggesting that ALR also had made progress in growing financial resources for the field. Overall, ALR made strides during 6 years in addressing its mission to develop a transdisciplinary field of research on environmental and policy factors that promote physical activity. The evaluation provided insight into useful approaches and strategies for building a nascent research field and suggested how to enhance the contribution of research to policy.

Changes in policies and built environments are advocated as part of efforts to increase physical activity, but in 2001 the knowledge base to inform these changes was limited. The Robert Wood Johnson Foundation addressed this deficit by initiating Active Living Research (ALR). The mission of ALR was to stimulate and support research that could guide the improvement of environments, policies, and practices to promote active living. The program’s goals were to (1) build the evidence base about environmental and policy factors related to physical activity, (2) build the capacity of researchers in multiple fields to collaborate, and (3) inform and facilitate policy change. To build the evidence base, 121 grants were supported with $12.5 million. Efforts were made to support new investigators, fund investigators from numerous disciplines, and increase the demographic diversity of researchers. Activities to build capacity to conduct collaborative research included annual conferences, journal supplements, seminars for multiple disciplines, and the posting of environmental measures. Coor- dination with Active Living Leadership was a primary means of communicating research to policymakers. Other activities to facilitate the application of research included research summaries written for nonresearchers, collaborations with Active Living by Design, several components of the website (www.activelivingresearch.org), and using policy relevance as a funding criterion. Two independent evaluations were accomplished, and they concluded that ALR made progress on all three goals. ALR has been renewed through 2012. The new mission is to use a $15.4 million research budget to contribute to reversing the childhood obesity epidemic, especially among youth in the highest-risk groups.

This paper argues that substantive and sustainable population-wide improvements in physical activity can be achieved only through the large scale adoption and implementation of policies and practices that make being active the default choice and remaining inactive difficult. Meta-volition refers to the volition and collective agency of early adopter leaders who implement such changes in their own organizations to drive productivity and health improvements. Leaders, themselves, are motivated by strong incentives to accomplish their organizational missions. The meta-volition model (MVM) specifies a cascade of changes that may be sparked by structural integration of brief activity bouts into organizational routine across sectors and types of organizations. MVM builds upon inter-disciplinary social ecological change models and frameworks such as diffusion of innovations, social learning and social marketing. MVM is dynamic rather than static, integrating biological influences with psychological factors, and socio-cultural influences with organizational processes. The model proposes six levels of dissemination triggered by organizational marketing to early adopter leaders carried out by “sparkplugs,” boisterous leaders in population physical activity promotion: initiating (leader– leader), catalyzing (organizational–individual), viral marketing (individual–organizational), accelerating (organizational–organizational), anchoring (organizational–community) and institutionalizing (community– individual). MVM embodies public–private partnership principles, a collective investment in the high cost of achieving and maintaining active lifestyles.

Background: Physical Activity Across the Curriculum (PAAC) was a three-year cluster randomized controlled trial to promote physical activity and diminish increases in overweight and obesity in elementary school children.

Methods: Twenty-four elementary schools were cluster randomized to the Physical Activity Across the Curriculum intervention or served as control. All children in grades two and three were followed to grades four and five. Physical Activity Across the Curriculum promoted 90 min/wk of moderate to vigorous intensity physically active academic lessons delivered by classroom teachers. Body Mass Index was the primary outcome, daily Physical activity and academic achievement were secondary outcomes.

Results: The three-year change in Body Mass Index for Physical Activity Across the Curriculum was 2.0 ± 1.9 and control 1.9±1.9, respectively (NS). However, change in Body Mass Index from baseline to 3 years was significantly influenced by exposure to Physical Activity Across the Curriculum. Schools with ≥ 75 min of Physical Activity Across the Curriculum/wk showed significantly less increase in Body Mass Index at 3 years compared to schools that had b75 min of Physical Activity Across the Curriculum (1.8±1.8 vs. 2.4±2.0, p = 0.02). Physical Activity Across the Curriculum schools had significantly greater changes in daily Physical activity and academic achievement scores.

Conclusions: The Physical Activity Across the Curriculum approach may promote daily Physical activity and academic achievement in elementary school children. Additionally, 75 min of Physical Activity Across the Curriculum activities may attenuate increases in Body Mass Index.