Priorities and Indicators for Economic Evaluation of Built Environment Interventions to Promote Physical Activity

in Journal of Physical Activity and Health

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Angie L. Cradock
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David Buchner
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Hatidza Zaganjor
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John V. Thomas
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James F. Sallis
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Kenneth Rose
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Leslie Meehan
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Megan Lawson
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René Lavinghouze
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Mark Fenton
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Heather M. Devlin
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Susan A. Carlson
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Torsha Bhattacharya
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Janet E. Fulton
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DOI:
https://doi.org/10.1123/jpah.2021-0191
Keywords:
policy; exercise; transportation; city planning
First Published Online:
09 Jul 2021
In Print:
Volume 18: Issue 9
Page Range:
1088–1096
Restricted access

Background: Built environment approaches to promoting physical activity can provide economic value to communities. How best to assess this value is uncertain. This study engaged experts to identify a set of key economic indicators useful for evaluation, research, and public health practice. Methods: Using a modified Delphi process, a multidisciplinary group of experts participated in (1) one of 5 discussion groups (n = 21 experts), (2) a 2-day facilitated workshop (n = 19 experts), and/or (3) online surveys (n = 16 experts). Results: Experts identified 73 economic indicators, then used a 5-point scale to rate them on 3 properties: measurement quality, feasibility of use by a community, and influence on community decision making. Twenty-four indicators were highly rated (≥3.9 on all properties). The 10 highest-rated “key” indicators were walkability score, residential vacancy rate, housing affordability, property tax revenue, retail sales per square foot, number of small businesses, vehicle miles traveled per capita, employment, air quality, and life expectancy. Conclusion: This study identified key economic indicators that could characterize the economic value of built environment approaches to promoting physical activity. Additional work could demonstrate the validity, feasibility, and usefulness of these key indicators, in particular to inform decisions about community design.

Cradock is with the Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA. Buchner is with the University of Illinois at Urbana-Champaign, Urbana, IL, USA. Zaganjor is with the Social Marketing and Communications Department, FHI 360, Atlanta, GA, USA. Thomas is with the Community Assistance and Research Division, U.S. Environmental Protection Agency, Washington, DC, USA. Sallis is with the Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, CA, USA; and Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, Australia. Rose, Lavinghouze, Devlin, Carlson, and Fulton are with the Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, GA, USA. Meehan is with the Office of Primary Prevention, Tennessee Department of Health, Commissioner’s Office, Nashville, TN, USA. Lawson is with the Headwaters Economics, Bozeman, MT, USA. Fenton is with the Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA. Carlson is also with the Division of Population Health, Centers for Disease Control and Prevention, Atlanta, GA, USA. Bhattacharya is with the Rails-to-Trails Conservancy, Washington, DC, USA.

Cradock (acradock@hsph.harvard.edu) is corresponding author.

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