Background
The US Task Force on Community Preventive Services has concluded that there is sufficient and strong evidence that environmental and policy change interventions increase physical activity.(1) In 2010, 12 NYC government agencies along with academics, professional associations, private sector design professionals, and community organizations collaborated to develop the Active Design Guidelines (ADG), evidence-based and best-practice strategies for increasing opportunities for physical activity in the design of buildings, neighborhoods, and streets.(2) Over 25,000 copies of the ADG have been distributed to architects, urban planners, developers, and other built environment and health professionals globally. Using grant funding obtained by the Department of Health and Mental Hygiene (DOHMH), government agencies collaborated with the local chapters of professional associations such as the American Institute of Architects, the American Planning Association, and the US Green Building Council to develop trainings for the design community, and with community partners to encourage incorporation of ADG strategies into building and urban design projects.  NYC government designs, builds, renovates, and maintains neighborhoods, streets, parks, and buildings that are used by millions of people. As such, local government can act as an agent of change by incorporating ADG strategies routinely into its own practices.

Description
In 2012, NYC’s Obesity Task Force, comprised of representatives from 11 City agencies and the Mayor’s Office, recommended that the City increase opportunities for active living by establishing a policy to require review of all City projects for incorporation of ADG strategies. Many City agencies had already begun voluntarily incorporating ADG strategies into projects, demonstrating the feasibility of more broadly implementing a policy to incorporate these concepts into City practice. In June 2013, Executive Order (EO) No. 359, Incorporating Active Design Principles in City Construction, was signed into effect by Mayor Bloomberg.(3) Under the EO, City agencies are instructed to review all City capital projects, including construction and major renovations, to identify opportunities for incorporating active design strategies per the ADG and the City’s Street Design Manual. The EO requires that information be provided on the ADG and encourages the use of active design strategies in relevant City guidelines, standards, and handbooks used for the design and construction of the City’s built projects. Projects undergoing LEED green building certification are also directed to incorporate, wherever applicable, the Pilot Credit “Design for Active Occupants,” which offers a menu of building features to promote stair use and active recreation. The EO also requires agencies to assess opportunities to promote stair use in City buildings, including designating a stairway for public access and installing signage encouraging stair use. Finally, the EO requires the Department of Design and Construction (DDC), in consultation with DOHMH, to coordinate trainings on the ADG for staff of City agencies involved in design and construction.  City construction and renovation projects for offices, public buildings, and streets are now reviewed for inclusion of active living-promoting strategies during the design process. Requests for proposals, like those issued by the NYC Department of Housing Preservation and Development, will also include reference to the ADG where practicable. To continue trainings for relevant City agency staff, DDC contracted with the Center for Active Design, a nonprofit organization that promotes active design.

Lessons Learned
Garnering input and buy-in from impacted City agencies was important to the success of the policy. The EO was developed and vetted by all City agencies that play key roles in building, renovating, and maintaining City buildings and streets. To educate City agencies about the EO, a kick-off meeting was hosted by the Deputy Mayors of Health and Human Services and of Operations, demonstrating commitment from Mayor’s leadership. Trainings for both City agency staff and design professionals are necessary to increase understanding of the policy and build demand for buildings that incorporate active design elements. Partnerships with relevant non-profit and professional organizations are valuable for promoting active design strategies and training the design community.

Conclusions
In NYC, executive authority was used to encourage the integration of evidence-based active design strategies into public policy, potentially impacting a wide variety of settings and promoting use of these strategies in the City’s built environment for decades to come. This is one example of how health-promoting strategies can be routinely integrated throughout city practice. Other jurisdictions should consider the use of executive action to increase systematic incorporation of evidence-based active living elements into their built environment.

Next Steps
DOHMH and DDC are collaborating to track incorporation of ADG strategies in the design of City office buildings and public facilities. Future policy efforts may be informed by these data.

References

1. Guide to Community Preventive Services. Increasing physical activity: environmental and policy approaches. Last updated: September 27, 2013.
2. Lee KK. Developing and implementing the Active Design Guidelines in New York City. Health and Place. 2012;18(1):5-7.
3. Executive Order No. 359. Incorporating Active Design Principles in City Construction. June 27, 2013.