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Walking and bicycling for daily transportation are important ways to get regular physical activity, but such active travel has decreased dramatically over the past few decades. Investing transportation funds in sidewalks, traffic-calming devices, greenways, trails and public transit make it easier for people to walk and bike within their own neighborhoods and to other places they need to go. Designing communities that support active travel also creates recreational opportunities, promotes health and can even lower health care costs. Research that shows how infrastructure improvements promote active travel can help policy-makers, planners and other professionals create healthier communities for residents of all ages.

Download our Transportation-related Resources Sheet for the best evidence available about a variety of transportation-based strategies for promoting physical activity.

You can also view and download our The Role of Transportation in Promoting Physical Activity infographic.

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Examining How a Community Coalition Creates and Implements Policy Changes to Promote Physical Activity: The Case of Get Fit Kauai

Date: 
02/25/2015
Description: 

Presentation at the 2015 Active Living Research Annual Conference.

Abstract: 

Background
Get Fit Kauai is the Nutrition and Physical Activity Coalition of Kauai County, a rural island community in Hawaii. Since 2009, Get Fit Kauai has made significant progress in addressing the built environment through multiple policy and program strategies. For example, Get Fit Kauai was instrumental in helping to pass a Complete Streets county resolution, Safe Routes to School state legislation, and, most recently, a change to the county subdivision ordinance that requires sidewalks and shorter block lengths. The purpose of this study is to understand how Get Fit Kauai was able to successfully catalyze policy changes that impact the built environment and what the role of a community coalition is in policy implementation..

Objectives
The primary objective of this study was to gain an understanding of the process through which a community coalition was able to create and implement policy changes that impact the built environment. Secondary objectives of the study included identifying the enabling factors as well as the barriers to policy change and implementation, examining the influence of community context, and determining ways that the coalition could improve its efforts.

Methods
This qualitative study consisted of in-depth interviews with 25 coalition stakeholders. Interview participants were purposefully selected for their unique insights into coalition activities. Interviews were semi-structured, framed by an interview guide, and lasted approximately one hour. A grounded theory approach guided data collection and analysis (Charmaz, 2006). To help validate the interview findings, multiple member checks were conducted (Creswell, 2013), including presenting preliminary results to coalition groups and asking for feedback from interview participants on a draft report. In addition, other data sources such as coalition progress reports, news articles, and policy documents were reviewed to fill in gaps in information obtained from interviews.

Results
Of the 25 interview participants, 52% were women, 64% were at least 45 years old, 56% identified as Caucasian, 48% had a Master’s or other graduate degree, and 68% were involved with the coalition as part of their jobs. Nearly half (44%) worked for county government agencies, including Planning and Public Works.   Participants viewed Get Fit Kauai as critical to achieving the policy changes because of the resources it contributed to capacity building efforts, its activities to increase public awareness of the link between the environment and active lifestyles, and how it coordinated member testimony before County Council. In addition to the policy changes, Get Fit Kauai organized Walk to School Days through its Safe Routes to School Task Force; held annual Mayor-a-thon events in which hundreds of community members celebrated using the coastal path; trained coalition members to lead community planning charrettes; and developed performance measures to track the progress of Complete Streets policy implementation.   One of the major themes to emerge was capacity building, which was seen as an essential first step in the process of policy change. Get Fit Kauai had the resources to hire a progression of national consultants that provided education, training, and targeted technical assistance to the County of Kauai departments and coalition members. The capacity building helped to break down silos between departments and generated support for policy changes. Other contributing factors to policy change were political support from the Mayor and County Council, an effective coalition director, garnering significant local media coverage, and using the Built Environment Task Force as a vehicle for discussion and decision-making for policy strategies.   The community context was mostly supportive of the built environment policy changes. As a small, rural community, people knew each other and cared deeply about preserving the unique character of the island. To overcome a barrier to implementation, one of the identified next steps for Get Fit Kauai was helping to educate communities about the Complete Streets policy and how implementation would not ruin the rural island character.

Conclusions
Get Fit Kauai played a critical role in helping to pass policy changes addressing Complete Streets and Safe Routes to School. For policy implementation, the role of the coalition is evolving into a more supportive one as the county government takes over the lead. Nevertheless, Get Fit Kauai still has meaningful functions to carry out, including community education and holding the county accountable for implementation.

Implications
Other coalitions undertaking similar efforts can learn several lessons from Get Fit Kauai. One of the lessons is to have patience: it will take time to see changes on the ground. Although the County is working hard to implement pilot projects, community members need to understand how long the process takes. Another lesson is that multiple champions are needed at different levels and in different places to keep pushing the work forward. Finally, Get Fit Kauai’s director was identified as the driving force behind the coalition, and other leaders can learn from her approaches in recruiting and motivating people to do the coalition work.

References

  1. Charmaz, K. (2006). Constructing Grounded Theory: A Practical Guide Through Qualitative Analysis. Thousand Oaks, CA: Sage Publications, Inc.
  2. Creswell, J. W. (2013). Qualitative Inquiry & Research Design: Choosing Among Five Approaches. Thousand Oaks, CA: Sage Publications, Inc.

 

Support / Funding Source
This study was funded by the Hawaii State Department of Health, Healthy Hawaii Initiative, through Tobacco Settlement Special Funds. Get Fit Kauai is funded by the Healthy Hawaii Initiative and received additional funding through Communities Putting Prevention to Work, Centers for Disease Control and Prevention.

Authors: 
Lehua Choy, MPH, University of Hawaii
Location by State: 
Study Type: 

Assessing Community Readiness for Childhood Obesity Prevention: Findings from Georgia

Date: 
02/25/2015
Description: 

Presentation at the 2015 Active Living Research Annual Conference.

Abstract: 

Background
Communities play a critical role in addressing the childhood overweight and obesity epidemic. Community members, organizations, and governments make the decisions that affect land use, nutrition, marketing, community planning, transportation and ultimately the health status of their residents. Communities provide the context, environment, and opportunity for children to eat well and be physically active (CDC,2009). They are ideally positioned to provide resources, promote behaviors fostering change, and develop effective strategies to promote healthy eating, healthy lifestyles, and healthy weight. Recent research highlights the important role collaboratives can play in promoting physical activity (Litt et al.,2013).  In Georgia, little is known about the number of collaboratives at work or their readiness and capacity to implement evidence-based childhood obesity prevention strategies. In 2012, Georgia State University’s School of Public Health (SPH) partnered with the Georgia Family Connection Partnership (GaFCP) to identify local communities in Georgia that have existing capacity and interest in expanding childhood obesity prevention efforts. SPH and GaFCP assessed community readiness related to the existence of collaboratives, leadership, partnerships, community knowledge, and local resources. This study presents findings on the community readiness of 15 communities engaged in childhood obesity prevention efforts across Georgia.

Objectives
To  identify communities in Georgia that have an interest in expanding childhood obesity prevention efforts and assess their capacity and readiness for future implementation of policies and programs to address childhood obesity.

Methods
The Community Readiness Model (CRM) assesses the capacity to which a community is prepared to address an issue (Plested, Edwards, & Jumper-Thurman, 2006). The CRM has been applied to childhood obesity prevention and used to develop effective, culturally-appropriate, community interventions (Findholt,2007;Sliwa et al.,2011). The model is based on the Transtheoretical Model of Behavior Change and assesses six dimensions, including existing efforts, community knowledge of efforts, leadership, community climate, community knowledge of issue, and resources available to support efforts. The model includes prevention/intervention strategies for each stage of readiness.  Fifteen collaboratives across Georgia were identified in this study. Collaboratives with moderate to high levels of interest were included.  Collaboratives that existed within the last three years and were previously active were also included. Seventy-nine key informant interviews were conducted (4-6 interviews per collaborative) using a semi-structured questionnaire assessing the six dimensions of readiness. The key informants represented different sectors of the community (e.g., healthcare, education, community organizers, and policymakers). Data were analyzed using qualitative methods and the CRM scoring system. Researchers discussed and reconciled differences in scores and reached consensus for each dimension. An overall stage of readiness score was reached for each collaborative by taking the total of all calculated scores and dividing by the number of dimensions (6).

Results
Overall, total readiness scores ranged from 2.8 to 5.1 out of 9. Ten out of 15 communities scored in the Preplanning stage (clear recognition that something must be done; efforts are not focused or detailed). One community scored in the Denial/Resistance stage (there is little recognition that the problem is occurring locally); two communities scored in the Vague Awareness stage (a local concern, but no immediate motivation to take action); and two communities scored in the Preparation stage (active leaders with modest support of efforts). The average score across all collaboratives for community efforts was 6.3 (Initiation Stage), community knowledge of efforts was 3.5 (Vague Awareness Stage), leadership was 4.6 (Preplanning Stage), community climate was 3.1 (Vague Awareness Stage), community knowledge about the issue was 3.5 (Vague Awareness Stage), resources available was 5.1 (Preparation Stage), and total average score was 4.3 (Preplanning Stage).

Conclusions
In Georgia, only 15 out of 159 counties have established collaboratives dedicated to childhood obesity prevention. Efforts were not always coordinated, widely supported, or adequately publicized.  This was reflected in the lower scores in community climate and community knowledge. While many decisions related to nutrition and physical activity are made at an individual level, this is only one piece of the puzzle.  Individuals can only make healthy decisions when they have the resources, environments, and opportunities to do so.  Communities can respond to the obesity epidemic by creating environments that support healthy eating and encourage physical activity.  Evidence supports the efficacy of community involvement in promoting healthy eating and active living, which ultimately benefits the health of residents. The state has a growing number of communities with interest in childhood obesity prevention and many have expressed a need for support on effective approaches. There is a need for state action to catalyze efforts to support the establishment of additional collaboratives and build capacity to implement childhood obesity prevention programs and policies.

Implications
This study has demonstrated the utility of the CRM for understanding community capacity on childhood obesity prevention. Four of the collaboratives subsequently received grants from the Healthcare Georgia Foundation to implement childhood obesity prevention initiatives. GSU and GaFCP are providing technical assistance for implementation of their childhood obesity prevention policies and programs.

References

  1. Centers for Disease Control and Prevention. Recommended Community Strategies and Measurements to Prevent Obesity in the United States. MMWR 2009;58 (No.RR:07).
  2. Litt JS, Reed HL, Tabak RG, Zieff SG, Eyler AA, Lyn R, et al. Active Living Collaboratives in the United States: Understanding Characteristics, Activities, and Achievement of Environmental and Policy Change. Prev Chronic Dis 2013;10:120162.
  3. Plested B, Edwards R, Jumper-Thurman P. Community readiness: a handbook for successful change. Fort Collins (CO): Tri-Ethnic Center for Prevention Research; 2006.
  4. Findholt N. Application of the community readiness model for childhood obesity prevention. PH Nurs 2007, 24(6):565–570.
  5. Sliwa S, Goldberg JP, Clark V, Collins J, Edwards R, Hyatt RR, et al. Using the community readiness model to select communities for a community-wide obesity prevention intervention. Prev Chronic Dis 2011, 8(6):A150.

Support / Funding Source
The Healthcare Georgia Foundation funded this study.

Authors: 
Erica Sheldon, MPH, Georgia State University
Location by State: 
Population: 

Road Safety Policy Implementation for Improving Pedestrian Environment: Lessons from France and Sweden

Date: 
02/24/2015
Description: 

Presentation at the 2015 Active Living Research Annual Conference.

Abstract: 

Background
For more than a decade, efforts to evaluate the impact of the built environment on human health have been central to the planning field. Substantial attention has been devoted to the areas of New Urbanism, Smart Growth, and Active Living to improve health conditions by increasing physical activity. However, crash prevention are becoming more critical, as there are increasing demands to proactively improve pedestrian safety on roads. This research aims to inform policy-makers of the factors that affect pedestrian safety by examining how road safety policies in France and Sweden have substantially reduced the number of pedestrian fatalities and exploring potential implementations for the United States.

Description
Based on the available government documents, published studies, and pedestrian fatality data in European countries, this study explored the French and Swedish approaches of improving general road and pedestrian safety over particular periods: between 2002 and 2005 for the French case, and between 1997 and 2006 for Swedish safety program.

Lessons Learned
In France and Sweden, public officials hold the main responsibility for road safety and undertake rigorous and innovative interventions to improve safety awareness and to reduce pedestrian deaths on roads. In the French road safety program, the primary responsibility for road crashes is on “everyone”, including road users, policy-makers, road designers, and other population groups. Less blame is put on road users, and the government took on the main responsibilities for road collisions. This principle of responsibility-share helps alter individuals’ attitudes toward road safety. In Sweden, the road system designers hold the main responsibility for traffic safety. When road users violate traffic rules or if any crashes occur, the system designers are required to take any necessary further steps.

Conclusions
A major similarity between the two nations’ programs was the emphasis on improving the traffic safety culture of the society, particularly by shifting the responsibility of road safety from road users to decision-makers. However, France focused more on improving road behavior through campaigns and education programs. In comparison, Sweden focused more on improving error-tolerant roadway design combined with stricter road enforcement by heavily placing road safety responsibility on road system designers. The findings suggest that the strategies from the cases of France and Sweden can potentially be modified and implemented in the United States. It is true that the U.S. is a much larger country than France and Sweden, and most cities in the U.S. were designed to encourage auto-oriented development over the decades, while those two European countries were not. Also, land use patterns, traffic systems, and the policy-making process among the countries are different. However, in general, the implementation of new safety interventions in the U.S. should involve raising awareness among the public and encouraging policy-makers to more effectively improve walking environments. All in all, legitimate road safety interventions must be consistent with the overall goals for the transportation planning system.

Next Steps
Along these lines, further research on how planners and professionals in other fields, including architecture, public health, and public policy, can support pedestrian safety should be carried out. Today, in the U.S., pedestrian safety is considered a transportation and public health problem, however, safety components should be addressed along with land-use, design, and policy issues. Therefore, future research is needed that examines how planners, safety program coordinators, and other policy-makers can help raise the salience of pedestrian safety and shift the balance of responsibility to reflect experts’ roles in system risk.

References

  1. Ewing, R., and E. Dumbaugh. 2009. “The Built Environment and Traffic Safety: A Review of Empirical Evidence.” Journal of Planning Literature 23 (4) (May 21): 347–367.
  2. Gerondeau, Christian. 2006. “Road Safety in France: Reflections on Three Decades of Road Safety Policy.” FIA Foundation for the Automobile and Society.
  3. Whitelegg, John, and Gary Haq. 2006. “VISION ZERO: Adopting a Target of Zero for Road Traffic Fatalities and Serious Injuries”. Stockholm Environment Institute.
  4. Zegeer, Charlie, William Hunter, Loren Staplin, Fran Bents, Richard Huey, and Janet Barlow. 2010. “White Papers for ‘Toward Zero Deaths’, A National Strategy on Highway Safety: 5. Safer Vulnerable Road Users : Pedestrians , Bicyclists , Motorcyclists , and Older Users”. Washington, D.C.
Authors: 
Jean Kim, Master of Urban Planning, University of Washington
Location by State: 
Population: 
Study Type: 

Contributions of Neighborhood Street Scale Elements to Physical Activity in Mexican School Children

Date: 
02/24/2015
Description: 

Presentation at the 2015 Active Living Research Annual Conference.

Abstract: 

Background
Residence in neighborhoods where streets are safe, attractive, and connected has been related to physical activity (PA).[1,2] Research has focused more on adults and has been conducted in high income countries.[3] This relationship is as yet undocumented in most low and middle income countries, such as Mexico, an emerging influence on North American countries, and burdened with the highest childhood obesity rate in the world. Specific types of environmental factors might influence particular types of PA (eg, recreational, transportation) differently;[4] however, many of these findings are based on perceived or resident self-reported environmental variables with few studies using objective, in-person audits of the environment.

Objectives
This study investigated the relationship of objectively assessed street scale data with PA among Mexican children.

Methods
Neighborhoods were an 800 meter radial buffer circumscribed[5] around public schools selected by the State of Jalisco Secretary of Education (Guadalajara n=12; Puerto Vallarta n=5) or from another study of policy implementation in Mexico (Mexico City n=18). Trained American and Mexican field assessors measured5 25% of residential and all arterial street segments[3] within the radial buffer were coded using an adapted version of the Pedestrian Environment Data Scan.[6] Traffic buffers (eg, fence, trees, grass), path connections, traffic control devices, traffic lanes, crossing aids, amenities (eg, benches, trash cans, street vendors), bicycle facilities and traffic speed limit were measured to represent street scale features. Assessments were conducted in teams of at least 2 people following established data collection and safety protocols.[5, 6]   Mexican school children participated in a multisite investigation of neighborhood and health in Mexican school children in Guadalajara (n=804), Mexico City (n=703) and Puerto Vallarta (n=207) in 2012. Demographic characteristics of child’s age, gender, and the number of children in the home and PA were measured using a translated version of the 4th grade School Physical Activity and Nutrition (SPAN) survey that was distributed to parents for completion.[7] Parents completed items measuring the days of outdoor play, participation on sports teams (yes/no) and participation in other organized PA (yes/no).[8] Children provided assent and parents provided consent following approved IRB protocols.   Descriptive, bivariable analyses were conducted using correlation, t, one-way ANOVA or Chi Square tests. Initial bivariable associations (correlations) conducted for PEDS variables determined high multicollinearity; therefore, each PEDS variable was tested in a separate model for each of the three PA outcomes. Street segment data were aggregated to the neighborhood level by taking the mean across street segments for each neighborhood, using established protocols for ecologic analyses.[9] Hierarchical regression models were used to estimate the effect of aggregated environmental factors on individual days played outside, and hierarchical logistic regression models were used to determine associations with participation in sports teams and other organized physical activities. All models were controlled for individual child age, gender, number of children in household, and city of residence.

Results
The sample (M=9.6±1.0 years) was nearly evenly divided by gender (n=817 boys, 46.9%; n= 924 girls, 53.1%), with an average of 2.5±1.6 children per household. On average, parents reported that their child played outdoors for 30 minutes about twice a week (M=2.4±2.3), nearly half participated in at least one sports team (n=619, 47.2%) and over one third participated in other organized physical activities (n=566, 40.6%). Gender was consistently associated with PA participation, with girls spending fewer days playing outdoors (m=2.1±2.1 vs.  m=2.6±2.3, p

Conclusions
Outdoor play may occur on streets with fewer street elements that focus on pedestrian safety and comfort (buffers, connectivity, crossing aids, amenities), on streets that may have less traffic (fewer lanes, control devices). Perhaps these are quieter streets with less traffic and fewer pedestrian enhancements. Participation in sports and other organized activities was related to few neighborhood variables. Participating in other organized activities was associated with having more children in the household (not shown). Perhaps participation in extracurricular activities is driven by time and access to resources.

Implications
The lower levels of participation in play, sports and other activities suggest that strategies at all levels are needed to increase PA among Mexican children. Increasing access to safe and pleasant areas in neighborhoods may help to increase PA.

References

  1. Giles-Corti B, Donovan RJ. Relative influences of individual, social environmental, and physical environmental correlates of walking. Am J Public Health. 2003;93:1583–9.
  2. Handy SL, Boarnet MG, Ewing R, Killingsworth RE. How the built environment affects physical activity: views from urban planning. Am J Prev Med. 2002;23:64–73.
  3. Giles-Corti B, Kelty SF, Zubrick SR, Villanueva KP. Encouraging walking for transport and physical activity in children and adolescents: how important is the built environment? Sports Med. 2009;39(12):995-1009. doi: 10.2165/11319620-000000000-00000. Review. PubMed PMID: 19902982. http://www.ncbi.nlm.nih.gov/pubmed/19902982.
  4. Cain KL, Millstein RA, Sallis JF, Conway TL, Gavand KA, Frank LD, Saelens BE, Geremia CM, Chapman J, Adams MA, Glanz K, King AC. Contribution of streetscape audits to explanation of physical activity in four age groups based on the Microscale Audit of Pedestrian Streetscapes (MAPS). Soc Sci Med. 2014 Sep;116:82-92. doi: 10.1016/j.socscimed.2014.06.042. Epub 2014 Jun 24. PubMed PMID: 24983701.
  5. Lee RE, Booth KM, Reese-Smith JY, Regan G, Howard HH. The Physical Activity Resource Assessment (PARA) instrument: evaluating features, amenities and incivilities of physical activity resources in urban neighborhoods. Int J Behav Nutr Phys Act. 2005 Sep 14;2:13. PubMed PMID: 16162285; PubMed Central PMCID: PMC1262748.
  6. McMillan TE, Cubbin C, Parmenter B, Medina AV, Lee RE. Neighborhood sampling: how many streets must an auditor walk? Int J Behav Nutr Phys Act. 2010 Mar 12;7:20. doi: 10.1186/1479-5868-7-20. PubMed PMID: 20226052; PubMed Central PMCID: PMC3224902.
  7. Thiagarajah K, Fly AD, Hoelscher DM, Bai Y, Lo K, Leone A, Shertzer JA. Validating the food behavior questions from the elementary school SPAN questionnaire. J Nutr Educ Behav. 2008 Sep-Oct;40(5):305-10. doi: 10.1016/j.jneb.2007.07.004. PubMed PMID: 18725149.
  8. Penkilo M, George GC, Hoelscher DM. Reproducibility of the School-Based Nutrition Monitoring Questionnaire among fourth-grade students in Texas. J Nutr Educ Behav. 2008 Jan-Feb;40(1):20-7. doi: 10.1016/j.jneb.2007.04.375. PubMed PMID: 18174100.
  9. Heinrich KM, Lee RE, Suminski RR, Regan GR, Reese-Smith JY, Howard HH, Haddock CK, Poston WS, Ahluwalia JS. Associations between the built environment and physical activity in public housing residents. Int J Behav Nutr Phys Act. 2007;4:56.

 

Support / Funding Source
This work made possible by a Fulbright-García Robles Core Scholar Fellowship awarded to Dr. Lee, the Canadian Institutes for Health Research and the Public Health Agency of Canada.

Authors: 
Rebecca Lee, PhD, Arizona State University
Location by State: 
Population: 
Study Type: 

Do Personal-Level Characteristics Moderate Neighborhood Correlates of Physical Activity among Adult Latinas?

Date: 
02/24/2015
Description: 

Presentation at the 2015 Active Living Research Annual Conference.

Abstract: 

Background
Latinas are less likely to engage in the recommended levels of physical activity (PA) for health compared to women of other racial/ethnic backgrounds (CDC, 2012). The reasons for these disparities are unknown but several studies suggest that factors across various levels of the socio-ecological model influence PA (López et al., 2008; Martinez et al., 2009). To date, few studies have examined the influence of factors at both the individual- and environmental- levels on either domain-specific activities (e.g., leisure time PA) or accelerometer-assessed moderate-to-vigorous physical activity (MVPA) among Latinos. Therefore, the purpose of this study was to test a principle of the socio-ecological model by assessing the moderating influence of personal-level characteristics on neighborhood-level correlates of self-report leisure-time MVPA (LTMVPA) and accelerometer-assessed MVPA among Latina women in San Diego, CA.

Objectives
The objective of this study was to assess whether Latinas with more advantaged personal-level characteristics (higher income, education, and acculturation levels and lower body weight status) and favorable perceptions of neighborhood features (built and social environment) were more likely to meet the Physical Activity Guidelines for Americans (PA Guidelines) using LTMVPA and accelerometer-assessed MVPA than those with less-advantaged characteristics.

Methods
This study used cross-sectional baseline data obtained from 437 Latina women participating in a multilevel intervention for PA promotion in San Diego, CA, Fe en Acción [Faith in Action].  Participants were recruited from 16 churches that met the inclusion criteria and were randomized to either the PA intervention or attention-control group. After providing informed consent, participants had their anthropometric measures taken, completed a face-to-face interview, and wore an accelerometer for at least 5 complete days (i.e., 10 or more valid hours/day). Subscales from the Neighborhood Walkability Scale were used to examine five neighborhood features (e.g., safety from crime, safety from traffic, and aesthetics). Mixed effects models accounting for church clustering effects, and adjusted for confounders, examined the associations of neighborhood features with whether or not participants met the PA Guidelines using LTMVPA and accelerometer-assessed MVPA. To test for moderation by income, education, acculturation, and body weight status on the associations of neighborhood features with LTMVPA and accelerometer-assessed MVPA, interaction terms were created between each personal-level characteristic and neighborhood feature.

Results
Latinas with higher levels of perceived safety from crime were more likely to meet the PA Guidelines using LTMVPA than those with lower levels of perceived safety (ORadj = 1.27, 95% CI: 1.03-1.58). None of the neighborhood features were significantly related to meeting the PA Guidelines using accelerometer-assessed MVPA. Tests for moderation showed that the associations between neighborhood features and meeting the PA Guidelines varied by personal-level characteristics. Specifically, Latinas were significantly more likely to meet the PA Guidelines using LTMVPA if they had at least a high school education and higher levels of perceived safety from crime compared to those with lower education (ORadj=1.69, 95% CI: 1.16-2.45); had more assimilated acculturation levels and higher perceived safety from crime compared to less acculturated women (ORadj=1.93, 95% CI: 1.19-3.15); had a normal body weight and favorable neighborhood aesthetics compared to overweight/obese women (ORadj=2.73, 95% CI: 1.37-5.42); and had a monthly household income of $2000 or higher and better sidewalk maintenance compared to lower income women (ORadj = 2.05, 95% CI: 1.05-4.01). In addition, Latinas with more assimilated acculturation levels and higher levels of perceived safety from crime were twice as likely to meet the PA Guidelines using accelerometer-assessed MVPA as less acculturated Latinas (ORadj=2.11, 95% CI: 1.16-3.82).

Conclusions
Higher perceived safety from crime was the only significant correlate of meeting PA Guidelines using LTMVPA among Latinas. Of 20 interactions tested for LTMVPA, four personal-level characteristics were found to moderate neighborhood features: income, education, acculturation, and body weight status. None of the neighborhood features were significantly associated with meeting PA Guidelines using accelerometer-assessed MVPA; however, of the 20 interactions tested for accelerometer-assessed MVPA, acculturation was found to moderate perceived safety from crime. Our findings provide support for the socio-ecological model with significant interactions found across levels of influence of PA among Latinas.

Implications
Improvements in the neighborhood environment may only increase PA among subgroups of Latinas, such as women with higher income and education, more assimilated acculturation levels, or normal body weight. Subgroup differences among Latinas should be considered when developing interventions and policies targeting improvements of the neighborhood environment to promote PA. In addition, those with lower education and less acculturated to the US may need interventions beyond environmental changes.

References

  1. Centers for Disease Control and Prevention (CDC). Behavioral Risk Factor Surveillance System Survey Data. 2012.
  2. López IA, Bryant CA, McDermott RJ. Influences on physical activity participation among Latinas: an ecological perspective. American Journal of Health Behavior. 2008;32(6):627-639.
  3. Martinez SM, Arredondo EM, Perez G, Baquero B. Individual, social, and environmental barriers to and facilitators of physical activity among Latinas living in San Diego County: Focus group results. Family & Community Health. 2009;32(1):22-33.

 

Support / Funding Source
This study was supported by a diversity supplement from the National Cancer Institute of the National Institutes of Health (3R01CA138894-04S1).

Authors: 
Lilian Perez, MPH, University of California, San Diego / San Diego State University
Location by State: 
Study Type: 

Evaluation of Complete Streets Policy Implementation by Metropolitan Planning Organizations: From Policy Adoption to Implementation

Date: 
02/23/2015
Description: 

Presentation at the 2015 Active Living Research Annual Conference.

Abstract: 

Background
Over the last ten years, communities around the country have begun to implement comprehensive reforms designed to ensure that roadway users of all ages and abilities can safely utilize the transportation system. This complete streets policy framework has emerged as an important tool for communities to improve opportunities for active living with over 500 policies adopted nationwide. Complete streets policy diffusion has been rapid, but uneven, and the extent to which policy adoption is making a difference in the implementation of projects at the local and regional level is unclear (Lenhing 2011, Handy and McCann 2011). This research seeks to address this need through a national survey of the 385 metropolitan planning organizations (MPOs) around the country. MPOs represent a vital regional organization for the distribution of federal transportation funds. Despite this potential importance, the role of MPOs in transportation planning innovation remains relatively understudied (Handy and McCann 2011).This research evaluates the extent to which complete streets policies are being adopted and implemented at MPO level, what opportunities and barriers to complete streets exist, and implications for future policy diffusion and innovation efforts.

Objectives
The study objectives were: 1) describe the extent to which complete streets policies are being adopted and implemented at MPO level, 2) analyze the impact of local governmental and local advocacy support in relation to key complete streets policy indicators, and 3) describe the key opportunities and barriers to complete streets adoption and implementation at MPO level.

Methods
To answer these questions, the study team crafted a targeted survey directed at all 385 MPOs across the nation. Questions were designed to ascertain basic descriptive characteristics of the extent of policy adoption at the MPO level and, at a deeper level, the extent and potential reasons for full or limited implementation of key complete streets policy metrics (LaPlante and McCann 2011, Handy et al 2009, and Handy and McCann 2010). Postcards announcing the survey were sent out to all U.S. MPOs and a survey website was created as a platform for response. The survey was open from April to June 2014. Survey results were compiled and then analyzed using SPSS.

Results
In all, 132 of the 385 MPOs substantially completed the survey (response rate 34%). Three key themes emerged from the survey analysis. First, while MPO respondents were very familiar with complete streets concepts (79.6%), this familiarity was not translating into broad adoption of complete streets policies. Only 18% of responding MPOs reported that they had formally adopted a complete streets policy. The most common barrier reported by MPOs to policy adoption was cost (cited by 80.3% of respondents). The next most common response was lack of political will (cited by 48% of respondents). Second, we found that agencies that had formally adopted complete streets policies were not systematically implementing the policies. We tracked nine key characteristics of successful complete streets policies drawn from the literature cited above. We found limited diffusion of these key characteristics. Bicycle plan adoption was the only characteristic to be broadly implemented by adopting agencies (cited by 57% of agencies that implemented a complete streets policy). Finally, we sought to understand how political support from key groups might help to create a supportive environment for policy adoption and implementation. We created both a local governmental support index based on levels of support indicated for key local transportation organizations and an advocacy support index based on levels of support indicated for key complete streets advocacy coalitions. We ran separate Analysis of Variance models using the local governmental support index and the advocacy support index as predictors for the key complete streets policy implementation characteristics discussed above. We found that the relationship was significant in both cases, but the explanation of variance was limited for key complete streets characteristics.

Conclusions
While MPOs provide an important organizational platform to improve physical activity through improved activity transportation access, most MPOs across the United States have not adopted complete streets policies. Those MPOs that have formally adopted policies have not broadly implemented key characteristic of strong complete streets policies, but opportunities exist to help build more supportive coalitions to enhance complete streets implementation.

Implications
While complete streets policy adoption is an important policy issues, implementation appears to be lacking in MPOs across the U.S. More concerted focus on broadly diffusing the full suite of key complete streets policy actions appears to be a key area of future research and advocacy attention.

References

  1. LaPlante, J. N., & McCann, B. (2012). Complete streets in the United States. In 91st Annual Transportation Research Board Annual Meeting. Washington, DC. Lehning, A. J. (2012). City Governments and Aging in Place: Community Design, Transportation and Housing Innovation Adoption. The Gerontologist, 52(3), 345-356.
  2. Handy, S., & McCann, B. (2011). The regional response to federal funding for bicycle and pedestrian projects. Journal of the American Planning Association, 77(1), 23-38.
  3. Handy, S., & McCann, B. (2010). The regional response to federal funding for bicycle and pedestrian projects: an exploratory study. Journal of the American Planning Association, 77(1), 23-38.

 

Support / Funding Source
This research was made possible through a grant from the federal University Transportation Center program through the Southwest Region University Transportation Center.

Authors: 
Billy Fields, PhD, Texas State University
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Influencing Active Living Policy and Practice: How Can I Improve My Pitch?

Description: 

Workshop at the 2015 Active Living Research Annual Conference.

Date: 
02/22/2015
Abstract: 

Researchers are often disappointed or frustrated that their research is ignored by policy-makers and practitioners. This partly stems from ‘the gap’ between researchers and policy-makers and a lack of understanding of the policy-making process. The aim of this workshop was to assist participants to understand how to better ‘pitch’ their ideas and research to active living decision-makers:  bureaucrats, practitioners and politicians. Workshop participants were invited to write a letter or email to a policy-makers, practitioner or bureaucrat requesting an opportunity to meet to discuss an issue, an opportunity for a collaboration, and/or a need for policy-reform. The letters were reviewed and all participants received feedback on their written communication. Four participants were also invited to present a five minute ‘pitch’. After receiving feedback, workshop participants worked together in four teams to discuss and distill key lessons about how a future pitch could be improved to achieve one’s goal.

Download the summary notes from the workshop: Strategies for an Effective Pitch

Authors: 
Billie Giles-Corti, PhD, McCaughey VicHealth Centre for Community Wellbeing, The University of Melbourne; Peter McCue, Executive Officer, NSW Premier's Council for Active Living, Sydney, Australia; Tracy Delaney, PhD, Public Health Alliance of Southern California; William Fulton, Kinder Institute for Urban Research, Rice University
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Community Commons: A National Data, Mapping and Reporting Platform to Support Policy Implementation

Date: 
02/22/2015
Description: 

Workshop at the 2015 Active Living Research Annual Conference.

Abstract: 

A wealth of data is readily available from Federal and State Data Warehouses for communities across the United States; however, many organizations often lack the time, expertise, or technological infrastructure to make the best use of data resources for policy implementation. Community Commons, which is an evolving interactive mapping, networking, and learning utility for the broad-based healthy, sustainable, livable communities movement, strives to overcome these constraints by providing easy-to-use, democratized access to data, GIS-generated maps, and reporting tools. This workshop highlighted two Robert Wood Johnson Foundation-funded Community Commons Hubs: The Childhood Obesity GIS (COGIS) and the Salud America! Growing Healthy Change Hub that includes a policy-mapping tool.

Authors: 
Chris Fulcher, PhD, CARES-University of Missouri; Roxanne Median-Fulcher, JD, Institute for People, Place and Possibility (IP3)
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Getting Them To Listen: Tools for Community and Decision Maker Engagement

Description: 

Workshop at the 2015 Active Living Research Annual Conference.

Date: 
02/22/2015
Abstract: 

Building community champions and getting funding are crucial for change.  In order to do so, both researchers and practitioners must engage all of the stakeholders. This workshop provided a strong overview of many community engagement tools, along with an exercise and action plan outline for helping attendees determine their approach for any given outreach or planning effort. Through small group activity and individual action planning templates, participants learned how to determine best outreach, engagement, and communication strategies given their own particular research or planning efforts. In person participatory, surveying, and web-based interactive methods were reviewed.

Authors: 
Teresa Penbrooke, MAOM, CPRE, North Carolina State University, GP RED, and GreenPlay LLC
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Making the Case for Designing Active Cities

Date: 
02/15/2015
Description: 

Sallis, J.F., Spoon, C., Cavill, N., Engelberg, J., Gebel, K., Lou, D., Parker, M., Thornton, C.M., Wilson, A., Cutter, C.L., Ding, D. (2015). Making the Case for Designing Active Cities. San Diego, CA: Active Living Research.

A peer-reviewed paper based on this report is available online through open access in the International Journal of Behavioral Nutrition and Physical Activity.

Abstract: 

Creating "activity-friendly environments" is recommended to promote physical activity, but potential co-benefits of such environments have not been well described. An extensive but non-systematic review of scientific and "gray" literature was conducted to explore a wide range of literature to understand the co-benefits of activity-friendly environments on physical health, mental health, social benefits, safety/injury prevention, environmental sustainability, and economics. Five physical activity settings were defined: parks/trails, urban design, transportation, schools, and workplaces/buildings.

KEY FINDINGS

  • A total of 418 higher-quality findings were summarized based on direction of association and quality of source.
  • The overall summary indicated 22 of 30 setting by outcome combinations showed “strong” evidence of co-benefits.
  • Each setting had strong evidence of at least 3 of the 6 co-benefits, and parks and trails had strong evidence of all 6 co-benefits. Thus, for each setting there are multiple features that can be designed to both facilitate physical activity and produce co-benefits.
  • All five physical activity settings could be designed so they have positive effects on economic outcomes, including increased home value, greater retail activity, reduced health care costs, and improved productivity.
  • Activity-friendly design in all settings had strong evidence of environmental co-benefits based on reduced pollution and carbon emissions.
  • There were many gaps in evidence of co-benefits in the schools and workplace settings as well the health consequences of environments that support active travel.
  • Overall, there was little evidence of negative consequences of activity-friendly environments.

 

IMPLICATIONS

The most important conclusion of this review is that creating communities, transportation systems, schools, and buildings that make physical activity attractive and convenient also produces a wide range of other benefits for communities. Rather than thinking that designing one feature of a transportation system or school is sufficient, we encourage decision-makers and designers to consider how features in all settings can be optimized for physical activity and multiple other benefits. We urge mayors, other city officials, and staff in multiple departments to consult these findings as an aid in decision-making.

DESIGNED TO MOVE: ACTIVE CITIES

The findings from our Making the Case for Designing Active Cities is prominently featured in Designed to Move: Active Cities, a guide for city leaders that provides a comprehensive summary of the evidence base to-date, along with bright spots and specific recommendations for leaders to make any city an active city.

 

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