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Published in:

01-08-2011

Public Policy Actions Needed to Promote Physical Activity

Authors: Bill Bellew, Adrian Bauman, Brian Martin, Fiona Bull, Victor Matsudo

Published in: Current Cardiovascular Risk Reports | Issue 4/2011

Abstract

Physical inactivity is a major risk factor for cardiovascular disease, and strategies to increase activity levels are as important to population health as smoking cessation, cholesterol control, or preventing obesity. The World Health Organization has identified that governments and non-government agencies have a central role in the creation of environments that facilitate physical activity changes by individuals, families, and communities. This article describes recent policy-related programs at a large-scale or national level to promote physical activity. This is proposed within a framework that codifies evidence-based policy actions, based on the International Physical Activity Recommendations. Examples are provided of current policy actions from diverse settings around the world. Finally, future policy directions needed for the promotion of physical activity are discussed and related research needs identified.

Caspersen CJ, Powell KE, et al. Physical activity, exercise, and physical fitness: definitions and distinctions for health-related research. Public Health Rep. 1985;100(2):126–31.PubMed

Foster C. Guidelines for health-enhancing physical activity promotion programmes. Tampere: the UKK Institute for Health Promotion Research; 2000.

Hagströmer M. Assessment of health-enhancing physical activity at population level. Stockholm: Karolinska Institute; 2007.

World Health Organisation. World Health Report 2002: reducing risks, promoting healthy life. Geneva: WHO; 2002. Available at http://www.who.int/whr/2002/en/. Accessed 13 January 2011.

• World Health Organisation. Global health risks: mortality and burden of disease attributable to selected major risks. Geneva: WHO; 2009. Available at http://www.who.int/healthinfo/global_burden_disease/GlobalHealthRisks_report_full.pdf. Accessed 13 January 2011. This report identifies physical inactivity as the fourth leading risk factor for global mortality (6% of deaths globally).

• World Health Organization. Global recommendations on physical activity for health. 2010. Available at http://www.who.int/dietphysicalactivity/publications/en/. Accessed 13 January 2011. This report sets out the first global evidence-based recommendations for the amount, duration, frequency, and intensity of Health Enhancing Physical Activity for three age groups: 5 to 17 years of age, 18 to 64 years of age, and ≥65 years of age. These are global versions of, and are similar to, the US Health and Human Services physical activity recommendations in 2007 and 2008 [see references 7,8, 11].

Haskell WL, Lee IM, et al. Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Circulation. 2007;116(9):1081–93.PubMedCrossRef

Nelson ME, Rejeski WJ, et al. Physical activity and public health in older adults: recommendation from the American College of Sports Medicine and the American Heart Association. Circulation. 2007;116(9):1094–105.PubMedCrossRef

Janssen I, Leblanc AG. Systematic review of the health benefits of physical activity and fitness in school-aged children and youth. Int J Behav Nutr Phys Act. 2010;7:40.PubMedCrossRef

10.

LeBlanc AG, Janssen I. Dose-response relationship between physical activity and dyslipidemia in youth. Can J Cardiol. 2010;26(6):201–5.PubMedCrossRef

11.

Physical Activity Guidelines Advisory Committee (PAGAC). Physical activity guidelines advisory committee report. Washington: US Department of Health and Human Services; 2008. Available at http://www.health.gov/paguidelines/committeereport.aspx. Accessed 13 January 2011.

12.

World Health Organisation. Health promotion glossary. Geneva: WHO; 1998. Available at http://www.who.int/entity/healthpromotion/about/HPR%20Glossary%201998.pdf. Accessed 13 January 2011.

13.

Schmid T, Pratt M, Witmer L. A framework for physical activity policy research. J Phys Activ Health. 2006;3 Suppl 1:S20–9.

14.

O’Dwyer L. A critical review of evidence-based policy making. Australian Housing and Urban Research Institute; 2004. Available at http://www.ahuri.edu.au/publications/download/40185_fr. Accessed 13 January 2011.

15.

World Health Organization. The global strategy on diet, physical activity and health. Geneva: World Health Organisation; 2004. Available at http://www.who.int/entity/dietphysicalactivity/strategy/eb11344/strategy_english_web.pdf. Accessed 13 January 2011.

16.

• Schilling JM, Giles-Corti B, et al. Connecting active living research and public policy: transdisciplinary research and policy interventions to increase physical activity. J Public Health Policy. 2009;30 Suppl 1:S1–S15. This article gives an overview of several derived from a conference whose theme was “Connecting Active Living Research to Policy Solutions.” Translation of research into physical activity policy is an emerging science; the commentary proposes principles for improving the translation of research to policy. This is an important idea emanating from this area of research—policy actions are often implementing evidence-based physical activity interventions on a much larger scale, to reach a whole population.PubMedCrossRef

17.

• Global Advocacy Council for Physical Activity and Health [International Society for Physical Activity and Health]. The Toronto charter for physical activity: a global call to action. Toronto; 2010. May 20 2010. Available at http://www.globalpa.org.uk/pdf/torontocharter-eng-20may2010.pdf. Accessed 13 January 2011. The Toronto Charter sets out four priority actions based on nine guiding principles for a population approach to the promotion of physical activity. Principle seven of this Charter is explicit about the importance of advocacy to decision makers for an increase in political commitment to and resources for physical activity.

18.

World Health Organization. A guide for population-based approaches to increasing levels of physical activity: implementation of the WHO global strategy on diet, physical activity and health. Geneva: WHO; 2007. Available at http://www.who.int/dietphysicalactivity/PA-promotionguide-2007.pdf. Accessed 13 January 2011.

19.

World Health Organization. Interventions on diet and physical activity: what works: summary report. Geneva: WHO; 2009. Available at http://www.who.int/entity/dietphysicalactivity/summary-report-09.pdf. Accessed 13 January 2011.

20.

Kahn EB, Ramsey LT, et al. The effectiveness of interventions to increase physical activity. A systematic review. Am J Prev Med. 2002;22(4 Suppl):73–107.PubMedCrossRef

21.

Heath GW, Brownson RC, Kruger J, Miles R, Powell KE, Ramsey LT, et al. The effectiveness of urban design and land use and transport policies and practices to increase physical activity: a systematic review. J Phys Activ Health. 2006;3 Suppl 1:S55–76.

22.

National Institute for Health and Clinical Excellence (NICE). Interventions that use the environment to encourage physical activity. Evidence review; 2006.

23.

National Institute for Health and Clinical Excellence (NICE). Transport interventions promoting safe cycling and walking. Evidence briefing; 2006.

24.

National Institute for Health and Clinical Excellence (NICE). Four commonly used methods to increase physical activity: brief interventions in primary care, exercise referral schemes, pedometers and community-based exercise programmes for walking and cycling. Public health intervention guidance No. 2; 2006. Available at http://www.nice.org.uk/nicemedia/live/11373/31838/31838.pdf. Accessed 13 January 2011.

25.

National Institute for Health and Clinical Excellence (NICE). Promoting and creating built or natural environments that encourage and support physical activity. NICE Public Health Guidance 8; 2008.

26.

National Institute for Health and Clinical Excellence (NICE). Workplace health promotion: how to encourage employees to be physically active. Public health guidance No 13; 2008. Available at http://www.nice.org.uk/nicemedia/live/11981/40672/40672.pdf. Accessed 13 January 2011.

27.

National Institute for Health and Clinical Excellence (NICE). Promoting physical activity, active play and sport for pre-school and school-age children and young people in family, pre-school, school and community settings. NICE Public Health Guidance 17; 2009.

28.

National Institute for Health and Clinical Excellence (NICE). Dietary interventions and physical activity interventions for weight management before, during and after pregnancy. NICE Public Health Guidance 27; 2010.

29.

National Institute for Health and Clinical Excellence (NICE). Prevention of cardiovascular disease at population level. NICE Public Health Guidance 25; 2010.

30.

Wakefield MA, Loken B, et al. Use of mass media campaigns to change health behaviour. Lancet. 2010;376(9748):1261–71.PubMedCrossRef

31.

Ogilvie RS, Zimmerman J. Opening school grounds to the community after hours. A toolkit for increasing physical activity through joint use agreements. 2010. Available at http://www.phlpnet.org/healthy-planning/products/joint_use_toolkit. Accessed 13 January 2010.

32.

City of New York; Bloomberg M, Burney D, Farley T, Sadik-Khan J, Burden A. Active design guidelines: promoting physical activity and health in design. 2010. Available at http://ddcftp.nyc.gov/adg/downloads/adguidelines.pdf. Accessed 13 January 2011.

33.

UK Department of Health. Be active be healthy: a plan for getting the nation moving. London: Department of Health; 2009. Available at http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/documents/digitalasset/dh_094359.pdf. Accessed 13 January 2011.

34.

Kline GM, Porcari JP, et al. Estimation of VO2max from a one-mile track walk, gender, age, and body weight. Med Sci Sports Exerc. 1987;19(3):253–9.PubMed

35.

Bauman A, Chau J. The role of media in promoting physical activity. J Phys Act Health. 2009;6 Suppl 2:S196–210.PubMed

36.

Craig CL, Bauman A, Gauvin L, Robertson J, Murumets K. ParticipACTION: a mass media campaign targeting parents of inactive children; knowledge, saliency, and trialing behaviours. Int J Behav Nutr Phys Act. 2009;6:88.PubMedCrossRef

37.

Kelly P, Cavill N, Foster C. An analysis of national approaches to promoting physical activity and sports in children and adolescents—full report. British Heart Foundation Health promotion Research Group. Oxford: WHO; 2010. Available at http://www.euro.who.int/__data/assets/pdf_file/0009/119295/HEPA_children_analysis_report.pdf. Accessed 13 January 2011.

38.

Conn VS, Hafdahl AR, et al. Meta-analysis of workplace physical activity interventions. Am J Prev Med. 2009;37(4):330–9.PubMedCrossRef

39.

Bull F, Adams E, Hooper P. Well@Work: promoting active and healthy workplaces: final evaluation report. 2008. Available at http://www.bhfactive.org.uk/files/115/W@W_EVALUATION_REPORT.pdf. Accessed 13 January 2011.

40.

Taylor WC. Booster breaks: an easy to implement workplace policy designed to improve employee health, increase productivity, and lower health care costs. J Workplace Behav Health. 2011;26(1):70–84.CrossRef

41.

Yancey T. Instant recess, building a fit nation 10 min at a time. Berkeley: Univ of Calif Press; 2010.

42.

Heath EM, Coleman KJ. Adoption and institutionalization of the Child and Adolescent Trial for Cardiovascular Health (CATCH) in El Paso, Texas. Health Promot Pract. 2003;4(2):157–64.PubMedCrossRef

43.

Franks A, Kelder SH, Dino GA, Horn KA, Gortmaker SL, Wiecha JL, et al. School-based programs: lessons learned from CATCH, Planet Health, and Not-On-Tobacco. Prev Chronic Dis. 2007;4(2):A33.PubMed

44.

Hoelscher DM, Springer AE, Ranjit N, Perry CL, Evans AE, Stigler M, et al. Reductions in child obesity among disadvantaged school children with community involvement: the Travis County CATCH Trial. Obesity (Silver Spring). 2010;18 Suppl 1:S36–44.CrossRef

45.

The CATCH Partnership. CATCH website. 2011. Available at http://www.catchinfo.org. Accessed 13 January 2011.

46.

Cycling England. Cycling demonstration towns; surveys of cycling and physical activity 2006 to 2009. London; 2009. Available at http://www.dft.gov.uk/cyclingengland/site/wp-content/uploads/2010/02/cdts-surveys-of-cycling-and-physical-activity-2006-09.pdf. Accessed 13 January 2011.

47.

Martin-Diener E, Anrig P, Capirone M, Martin BW. SwitzerlandMobility, the national network for non-motorized traffic: a model project of intersectoral collaboration. In; Mutrie N, Fitzsimons C, editors. 1st Annual Conference of HEPA Europe. European network for the promotion of health-enhancing physical activity. Glasgow, Scotland, United Kingdom, 8–9 September 2008. Programme & Abstracts. Glasgow, University of Strathclyde 2008: 104 [see also http://www.schweizmobil.ch]; 2008.

48.

Grandes G, Sanchez A, Torcal J, Sanchez-Pinilla RO, Lizarraga K, Serra J. Targeting physical activity promotion in general practice: characteristics of inactive patients and willingness to change. BMC Public Health. 2008;8:172.PubMedCrossRef

49.

Bull FC, Milton KE. A process evaluation of a “physical activity pathway” in the primary care setting. Association of physical activity with all-cause and cardiovascular mortality: a systematic review and meta-analysis. BMC Public Health. 2010;10:463.PubMedCrossRef

50.

Professional Associations for Physical Activity (Sweden). Physical activity in the prevention and treatment of disease. 2010. Available at http://www.fhi.se/PageFiles/10682/Physical-Activity-Prevention-Treatment-Disease-webb.pdf. Accessed 13 January 2011.

51.

Nocon M, Hiemann T, et al. Association of physical activity with all-cause and cardiovascular mortality: a systematic review and meta-analysis. Eur J Cardiovasc Prev Rehabil. 2008;15(3):239–46.PubMedCrossRef

52.

Sofi F, Capalbo A, et al. Physical activity during leisure time and primary prevention of coronary heart disease: an updated meta-analysis of cohort studies. Eur J Cardiovasc Prev Rehabil. 2008;15(3):247–57.PubMedCrossRef

53.

Angevaren M, Vanhees L, et al. Physical activity and 5-year cognitive decline in the Doetinchem cohort study. Ann Epidemiol. 2010;20(6):473–9.PubMedCrossRef

54.

Lee DC, Sui X, et al. Comparisons of leisure-time physical activity and cardiorespiratory fitness as predictors of all-cause mortality in men and women. Br J Sports Med. 2010.

55.

Wanless D. Securing good health for the whole population; final report. HM Treasury: HMSO. UK Government; 2004. Available at http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4074426. Accessed 13 January 2011.

56.

Bull FC, Bellew B, et al. Developments in National Physical Activity Policy: an international review and recommendations towards better practice. J Sci Med Sport. 2004;7(1 Suppl):93–104.PubMedCrossRef

57.

Bellew B, Schoeppe S, et al. The rise and fall of Australian physical activity policy 1996–2006: a national review framed in an international context. Aust New Zealand Health Policy. 2008;5:18.PubMedCrossRef

58.

Western Australia—Premiers Physical Activity Task Force. Strategic Plan 2007–2011. 2007. Available at http://www.beactive.wa.gov.au/docs/Strategic%20Plan%202007%20-%202011%20Online%20Version.PDF. Accessed 13 January 2011.

59.

• Merom D, van der Ploeg HP, et al. Public health perspectives on household travel surveys active travel between 1997 and 2007. Am J Prev Med. 2010;39(2):113–21. This article provides a good example from Sydney, Australia, of cross-sectoral/cross-disciplinary research on transportation and travel policies. Transportation surveys can be used to assess the contribution of active travel to changes in physical activity levels assessed by public health surveillance and to identify subgroups for active travel interventions. This article shows that despite all the interest in “active travel” as a method for promoting physical activity, over the past decade population shifts have been small.PubMedCrossRef

60.

Bauman A, Finegood DT, Matsudo V. International perspectives on the physical inactivity crisis–structural solutions over evidence generation? Prev Med. 2009;49(4):309–12.PubMedCrossRef

61.

• Sallis JF, Story M, et al. Study designs and analytic strategies for environmental and policy research on obesity, physical activity, and diet: recommendations from a meeting of experts. Am J Prev Med. 2009;36(2 Suppl):S72–7. This article presents expert consensus recommendations for methods to enhance environmental and policy research. Expert recommendations included use of prospective studies and economic studies and evaluation of natural experiments; training in statistical methods for complex designs and interdisciplinary collaboration; and development of measures of policy, health impact assessments, and the investigation of policy adoption and implementation. This provides a research framework, and policy-led programs can also use this typology.PubMedCrossRef

62.

• Cobiac LJ, Vos T, et al. Cost-effectiveness of interventions to promote physical activity: a modelling study. PLoS Med. 2009;6(7):e1000110. This article describes the use of an innovative cost-effectiveness research methodology used in Australia to examine not only the cost-effectiveness of individual policies but the most cost-effective mix of policy actions. For Australia, the authors suggest programs encouraging the use of pedometers and mass media–based community campaigns as the two most cost-effective strategies to implement and that are very likely to be cost-saving.PubMedCrossRef

63.

• Cecchini M, Sassi F, et al. Tackling of unhealthy diets, physical inactivity, and obesity: health effects and cost-effectiveness. Lancet. 2010;376(9754):1775–84. This article presents an assessment of public health strategies designed to tackle behavioral risk factors (including physical inactivity) for chronic diseases in several countries. Several population-based prevention policies can be expected to generate substantial health gains while entirely or largely paying for themselves through future reductions of health care expenditures. These policies include health information and communication strategies that improve population awareness about the benefits of physical activity.PubMedCrossRef

64.

Rovniak LS, Sallis JF, et al. Adults’ physical activity patterns across life domains: cluster analysis with replication. Health Psychol. 2010;29(5):496–505.PubMedCrossRef

65.

Owen N, Glanz K, et al. Evidence-based approaches to dissemination and diffusion of physical activity interventions. Am J Prev Med. 2006;31(4 Suppl):S35–44.PubMedCrossRef

66.

Bauman AE, Nelson D, Pratt M, Matsudo V, Schoeppe S. Dissemination of physical activity evidence, programs, policies, and surveillance in the international public health arena. Am J Prev Med. 2006;31(4 Suppl):S57–65.PubMedCrossRef

67.

Dearing JW, Maibach EW, Buller DB. A convergent diffusion and social marketing approach for disseminating proven approaches to physical activity promotion. Am J Prev Med. 2006;31(4 Suppl):S11–23.PubMedCrossRef

68.

Estabrooks PA, Glasgow RE. Translating effective clinic-based physical activity interventions into practice. Am J Prev Med. 2006;31(4 Suppl):S45–56.PubMedCrossRef

69.

• Eyler A, Brownson R, et al. Understanding policies and physical activity: frontiers of knowledge to improve population health. J Phys Act Health. 2010;7 Suppl 1:S9–S12. Scientific literature on the policy development process for physical activity is sparse; this article provides a framework that organizes and conceptualizes policy interventions and priorities for public health efforts to promote physical activity. In the United States, the Physical Activity Policy Research Network (PAPRN) was formed as a way to operationalize the framework.PubMed

70.

Ainsworth BE, Haskell WL, et al. Compendium of physical activities: an update of activity codes and MET intensities. Med Sci Sports Exerc. 2000;32(9 Suppl):S498–504.PubMed

71.

Sarmiento O, Torres A, et al. The Ciclovia-Recreativa: a mass-recreational program with public health potential. J Phys Act Health. 2010;7 Suppl 2:S163–80.PubMed

72.

Walk England. Walk 4 Life initiative—website. 2011. Available at http://www.walk4life.info/about-walk4life/walk4life-miles. Accessed 13 January 2011.

73.

Buhrmann S. New seamless mobility services—public bicycles: policy notes. NICHES for the European Commission. 2010. Available at http://niches-transport.org/fileadmin/archive/Deliverables/D4.3b_5.8_b_PolicyNotes/14397_pn4_public_bikes_ok_low.pdf. Accessed 13 January 2011.

74.

Australian Government. Measure up campaign—website. 2010. Available at http://www.measureup.gov.au/internet/abhi/publishing.nsf/content/home. Accessed 13 January 2011.

75.

Health Department (Western Australia); National Heart Foundation of Australia; WA Premiers Physical Activity Taskforce. Find thirty everyday campaign website. 2011. Available at http://www.findthirtyeveryday.com.au/ [see also http://www.beactive.wa.gov.au/]. Accessed 13 January 2011.

76.

ParticipACTION. ParticipACTION website.2007. Available at http://www.participaction.com. Accessed 14 January 2011.

77.

Bauman A, Cavill N, Brawley L. ParticipACTION: the future challenges for physical activity promotion in Canada. Int J Behav Nutr Phys Act. 2009;6:89.PubMedCrossRef

78.

American College of Sports Medicine. Exercise is medicine—website. 2010. Available at http://exerciseismedicine.org/. Accessed 14 January 2011.

Title: Public Policy Actions Needed to Promote Physical Activity
Authors: Bill Bellew
Adrian Bauman
Brian Martin
Fiona Bull
Victor Matsudo
Publication date: 01-08-2011
Publisher: Current Science Inc.
Published in: Current Cardiovascular Risk Reports / Issue 4/2011
Print ISSN: 1932-9520
Electronic ISSN: 1932-9563
DOI: https://doi.org/10.1007/s12170-011-0180-6

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