Active living by design sustainability strategies.

BACKGROUND: Despite substantial increases in improving the translation of health promotion research into practice, community initiatives still struggle with maintaining changes once grant funding has ended. Researchers, funders, and community practitioners are interested in practices that maintain and sustain their efforts. PURPOSE: This qualitative study conducted a content analysis of evaluation findings from Active Living by Design (ALbD) to identify activities that community coalitions implemented to maintain their initiative and secure ongoing influence in communities. METHODS: Investigators analyzed data from interviews, focus groups, and the Progress Reporting System to identify sustainability approaches clustering into five areas: partnership expansion, sustainable funding, permanent advisory committees, policy change, and institution/organization change. RESULTS: Partnership expansion occurred across sectors and disciplines and into broader geographic areas. Additional funding extended beyond grants to earned income streams and dedicated tax revenues. Permanent advisory committees were established to inform decision makers about a range of active living impacts. Policy changes in zoning and comprehensive plans ensured maintenance of health-promoting built environments. Sustainability through institution/organization changes led to allocation of dedicated staff and incorporation of active living values into agency missions. CONCLUSIONS: Active Living by Design partnerships defined and messaged their projects to align with policymakers' interests and broad partnership audiences. They found innovative supporters and adapted their original vision to include quality of life, nonmotorized transport, and other complementary efforts that expanded their reach and influence. These sustainability strategies altered awareness within communities, changed community decision-making processes, and created policy changes that have the potential to maintain environments that promote physical activity for years to come.

The Active Living Research program: six years of grantmaking.

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. Coordination 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.

Active living as an institutional challenge: lessons from the Robert Wood Johnson Foundation's "Celebrate Fitness" program.

Native American youth suffer disproportionately from a range of adverse health conditions. Empowering youth leaders to work on community-based solutions has proved effective in reducing tobacco use and gun violence and is now emerging as a promising approach to improving fitness and health. This article, based on direct observation and interviews with key informants, examines the implementation of a Robert Wood Johnson Foundation-funded project that gave tribal youth councils minigrants to design and run diverse projects that encourage physical activity in their communities. The article highlights the institutional challenges that confront health-promotion strategies for disadvantaged populations. Unless they take proper account of organizational, political, environmental, and cultural forces, funders' interventions have limited chances for success and sustainability.

An ecological approach to creating active living communities.

The thesis of this article is that multilevel interventions based on ecological models and targeting individuals, social environments, physical environments, and policies must be implemented to achieve population change in physical activity. A model is proposed that identifies potential environmental and policy influences on four domains of active living: recreation, transport, occupation, and household. Multilevel research and interventions require multiple disciplines to combine concepts and methods to create new transdisciplinary approaches. The contributions being made by a broad range of disciplines are summarized. Research to date supports a conclusion that there are multiple levels of influence on physical activity, and the active living domains are associated with different environmental variables. Continued research is needed to provide detailed findings that can inform improved designs of communities, transportation systems, and recreation facilities. Collaborations with policy researchers may improve the likelihood of translating research findings into changes in environments, policies, and practices.

Environmental Justice: Obesity, Physical Activity, and Healthy Eating.

BACKGROUND: The term "environmental justice" refers to efforts to address the disproportionate exposure to and burden of harmful environmental conditions experienced by low-income and racial/ethnic minority populations. METHODS: Based on computer and manual searches, this paper presents a review of articles in the published literature that discuss disparities in physical activity, dietary habits, and obesity among different populations. RESULTS: This paper provides evidence that economically disadvantaged and racial/ethnic minority populations have substantial environmental challenges to overcome to become physically active, to acquire healthy dietary habits, and to maintain a healthy weight. For example, residents living in poorer areas have more environmental barriers to overcome to be physically active. CONCLUSIONS: We propose a research agenda to specifically address environmental justice with regard to improving physical activity, dietary habits, and weight patterns.

Moving mountains together: strategic community leadership and systems change.

Traditional leadership practice frameworks to guide systems change often fall short in today's practice environment. Reclaiming Futures is a national initiative to create an integrated, comprehensive, seamless system of care for teens with substance abuse problems involved in juvenile justice. It uses leadership and systems reform strategies to improve public health institutions. The premise is that interruption of the destructive cycle of drugs and delinquency can only be attained through the cultivation of shared strategic leadership. This article presents the limitations of traditional practice frameworks of leadership, describes the theory of this new approach to leadership development, and clarifies collaborative leadership and system change. The article includes an example of the framework in action, a discussion of lessons learned, and recommendations for community leadership development initiatives.

The adolescent addiction treatment workforce: status, challenges, and strategies to address their particular needs.

Treating youth with substance use problems presents unique challenges, distinct from those of adults, that add to the complexity of recruiting and retaining a qualified adolescent treatment workforce. Youth who need treatment are often involved in an array of systems (i.e., health, legal, and social) and use substances for a variety of reasons, requiring providers to have a unique set of treatment practices and proficiencies. The intent of this article is to highlight the current understanding of the issues facing the alcohol and other drug treatment workforce and to provide an overview of strategies people are or could be using to build and maintain a workforce that can effectively deliver care for adolescents.