"Getting Ireland Active"-Application of a Systems Approach to Increase Physical Activity in Ireland Using the GAPPA Framework.

Physical activity (PA) promotion is a complex challenge, with the Global Action Plan on Physical Activity (GAPPA) endorsing a systems approach and recommending countries assess existing areas of progress which can be strengthened. This paper reports a process facilitating a systems approach for identifying current good practice and gaps for promoting PA in Ireland. Elements of participatory action research were enabled through 3 stages: (1) aligning examples of actions from Irish policy documents (n = 3) to the GAPPA, (2) workshop with stakeholders across multiple sectors, and (3) review of outputs. Data collected through the workshop were analyzed using a deductive thematic analysis guided by the GAPPA. The policy context in Ireland aligns closely to the GAPPA with the creation of Active Systems the most common strategic objective across policy documents. Forty participants (50% male) took part in the systems approach workshop, which after revision resulted in 80 examples of good practice and 121 actions for greater impact. A pragmatic and replicable process facilitating a systems approach was adopted and showed current Irish policy and practices align with the GAPPA "good practices." The process provides existing areas of progress which can be strengthened, as well as the policy opportunities and practice gaps.

Public and Stakeholder Engagement and the Built Environment: a Review.

PURPOSE OF REVIEW: We review 50 articles from 2015 and 2016 that focus upon public and stakeholder engagement as it pertains to the built environment. Our purpose is to understand the current state of the literature and approaches being used to better enable public and stakeholder engagement. As part of this review, we consider whether recent digital and mobile technologies have enabled advances for stakeholder and public participation. RECENT FINDINGS: The literature suggests some positive and some challenging developments. Researchers clearly suggest that most policy-makers and planners understand, and to some extent, aspire toward enabling more inclusive participatory planning processes. That said, there is far less consensus as to how to make meaningful inclusive participatory processes possible even with digital, as well as more traditional, tools. This lack of consensus is true across all academic disciplines reviewed. We discuss these issues as well as current solutions offered by many scholars. We find that no single solution can be applied to different situations, as contextual factors create different problems in different situations, and that the participation process itself can create biases that can-intentionally or unintentionally-benefit some participants over others. We conclude with a series of questions for practitioners and researchers to consider when evaluating inclusive engagement.

Does the environment moderate the impact of a mass media campaign to promote walking?

PURPOSE: To examine if a mass media campaign influenced walking differently in people in different physical environments. DESIGN: Quasi-experimental study. Setting . Wheeling, West Virginia. PARTICIPANTS: Random sample of adults age 50 to 65 years, response rate: 72.1% (n  =  719 in intervention community, n  =  753 in comparison community). INTERVENTION: Mass media campaign. MEASURES: Self-reported measures were used in before and after telephone surveys for walking and the physical environment. Measures included 11 environmental walkability items, from which two subscales (i.e., usable sidewalks/aesthetics and facilities) were extracted. ANALYSIS: Multiple linear regression. RESULTS: Overall, walking increased by 2.7 minutes per week (standard deviation [SD]  =  231.1, not significant [NS]). When confined to those insufficiently active at baseline (i.e., <30 minutes per day) the minutes walked increased by 92.1 minutes (SD  =  152.9, p < .001). For the insufficiently active at baseline in the top half of the environmental factor of usable sidewalks, walking increased by 19 minutes more than in the bottom half (NS). For the factor of aesthetics and facilities, people in the more walkable environment increased walking by 87 minutes more than those in the bottom half (p < .001). CONCLUSION: In this community-wide physical activity, intervention changes in walking after the campaign were significantly moderated by some environmental attributes. This contributes to the limited evidence on the impact of the environment in enhancing community physical activity interventions. This finding needs to be replicated in other community interventions with greater environmental variation.

Improving health through policies that promote active travel: a review of evidence to support integrated health impact assessment.

BACKGROUND: Substantial policy changes to control obesity, limit chronic disease, and reduce air pollution emissions, including greenhouse gasses, have been recommended. Transportation and planning policies that promote active travel by walking and cycling can contribute to these goals, potentially yielding further co-benefits. Little is known, however, about the interconnections among effects of policies considered, including potential unintended consequences. OBJECTIVES AND METHODS: We review available literature regarding health impacts from policies that encourage active travel in the context of developing health impact assessment (HIA) models to help decision-makers propose better solutions for healthy environments. We identify important components of HIA models of modal shifts in active travel in response to transport policies and interventions. RESULTS AND DISCUSSION: Policies that increase active travel are likely to generate large individual health benefits through increases in physical activity for active travelers. Smaller, but population-wide benefits could accrue through reductions in air and noise pollution. Depending on conditions of policy implementations, risk tradeoffs are possible for some individuals who shift to active travel and consequently increase inhalation of air pollutants and exposure to traffic injuries. Well-designed policies may enhance health benefits through indirect outcomes such as improved social capital and diet, but these synergies are not sufficiently well understood to allow quantification at this time. CONCLUSION: Evaluating impacts of active travel policies is highly complex; however, many associations can be quantified. Identifying health-maximizing policies and conditions requires integrated HIAs.

The importance of being parsimonious: reliability of a brief community walkability assessment instrument.

This research presents the Leyden Walkability Instrument (LWI), a brief survey checklist designed to measure the perceived walkability of a neighborhood or community where a respondent lives. The reliability of this instrument was tested using the intra-class correlation and found to be moderately substantially reliable (Landis-Koch rating) in every survey item (ranging from .54 to .76 and ranging in observed agreement from 72.8% to 93.9% with an overall instrument score of .71 and an observed agreement of 81.6%). The LWI is discussed in the context of other survey instruments designed to measure perceived walkability and found to be a useful addition because of its brevity and ease of use.

Priority of activity-friendly community issues among key decision makers in Hawaii.

BACKGROUND: The U.S. Community Guide to Preventive Services strongly recommends changes in urban design, land use, and accessibility to increase physical activity. To achieve these goals, policy change is often needed. This study assessed attitudes of decision makers in Hawaii to determine if physical activity-related issues are among their priorities. METHODS: State and county officials (n = 179) were mailed surveys. Respondents listed the three most important problems (open-ended) in Hawaii and rated the importance of 23 specified problems, of which six directly related to physical activity. RESULTS: The survey was completed by 126 (70.4%) respondents. The most frequently mentioned categories for the open-ended questions were affordable housing, environment/sustainability, sprawl/traffic/population growth, and healthcare. Among the closed-ended physical activity related items, increasing traffic was ranked highest (43.9%) and fourth overall. Less than 12% of decision makers rated other physical activity issues as important. CONCLUSIONS: Future work is needed to increase the visibility and importance of physical activity related issues among policymakers.

Changing the hearts and minds of policy makers: an exploratory study associated with the West Virginia Walks campaign.

PURPOSE: To pilot test whether West Virginia Walks changed local policy makers' awareness of walking-related issues. DESIGN: A quasi-experimental design with preintervention and postintervention mail surveys. SETTING: Morgantown, WV (intervention community), and Huntington, WV (comparison community). SUBJECTS: One hundred thirty-three and 134 public officials in Morgantown and 120 and 116 public officials in Huntington at baseline and at follow-up, respectively. INTERVENTION: An 8-week mass media social ecological campaign designed to encourage moderate-intensity walking among insufficiently active persons aged 40 to 65 years. MEASURES: Policy makers listed three problems they believed needed to be addressed in their community. They then rated the severity of several problems that many communities face using a Likert scale, with 1 representing "not a problem" and 5 representing "an extremely important problem." ANALYSIS: Independent sample t-tests were used to examine differences in mean responses at baseline and at follow-up. RESULTS: Statistically significant increases in the perceived importance of walking-related issues were observed among policy makers in Morgantown but not in the comparison community. CONCLUSIONS: Integrated communitywide health promotion campaigns designed to influence the public can also affect the perceptions of policy makers. Future research should examine this linkage and determine whether resource allocation and policy changes follow such interventions.