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Anna E. Mathews, Delores Pluto, Olga Ogoussan and Jorge Banda

Background:

When promoting active travel to school, it is important to consider school and district policies as well as attitudes of school and district administrators.

Methods:

School principals and district officials in South Carolina participated in the School Travel Survey. Frequency distributions and Chi-squared tests were used to analyze the data.

Results:

Three hundred fourteen persons responded to the survey (53.2% response rate). Sixty-five percent of district officials reported having a clear position about students walking to school, 80.0% of which were supportive. Seventy-two percent of principals reported having a clear position about walking to school, 67% of which were supportive. These positions were most commonly communicated either orally or through memos or other written documentation rather than through official, written policies or directives. Respondents who personally supported walking to school were more likely to believe that walking to school benefited students' health (χ2 = 8.82, df = 1, P = .003) and academic performance (χ2 = 14.87, df = 1, P < .0001).

Conclusions:

Promotion of walking to school should encourage schools and districts to develop official, written directives or policies. Promotional efforts may benefit from linking active travel to academic performance and health.

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Amy Eyler, Tina Lankford, Jamie Chriqui, Kelly R. Evenson, Judy Kruger, Nancy Tompkins, Carolyn Voorhees, Susan Zieff, Semra Aytur and Ross Brownson

Background:

Trails provide opportunities for recreation, transportation and activity. The purpose of this article is to describe state legislation related to community trails, to analyze legislation content, and to evaluate legislation on inclusion of evidence-informed elements.

Methods:

State trail legislation from 2001 to 2008 was identified using online legislative databases. An analysis of evidence-informed elements included in the legislation was conducted. These elements included: funding, liability, accessibility, connectivity, and maintenance.

Results:

Of the total 991 trail bills, 516 (52.0%) were appropriations bills, of which 167 (32.2%) were enacted. We analyzed 475 (48%) nonappropriation trail bills of which 139 (29.3%) were enacted. The percentage of enactment of appropriations bills decreased over time while enactment of nonappropriations trail bills increased. Over half of the nonappropriations trail bills included at least 1 evidence-informed element, most commonly funding. Few bills contained liability, connectivity, accessibility, or maintenance.

Conclusions:

There is opportunity for providing evidence-informed information to policy-makers to potentially influence bill content. The number of bills with a funding element demonstrates that fiscal support for trails is an important policy lever that state legislatures may use to support trails. Lastly, trails should be considered in over-all state-level physical activity legislation to provide opportunities for communities to be active.

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Gavin Newsom

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Katherine A. Stamatakis, Timothy D. McBride and Ross C. Brownson

Background:

While effective interventions to promote physical activity have been identified, efforts to translate these interventions into policy have lagged behind. To improve the translation of evidence into policy, researchers and public health practitioners need to consider new ways for communicating health promoting messages to state and local policymakers.

Methods:

In this article, we describe issues related to the translation of evidence supporting physical activity promotion, and offer some communication approaches and tools that are likely to be beneficial in translating research to policy.

Results:

We discuss the use of narrative (ie, stories) and describe its potential role in improving communication of research in policy-making settings. In addition, we provide an outline for the development and design of policy briefs on physical activity, and for how to target these briefs effectively to policy-oriented audiences.

Conclusions:

Improvements in researchers' and practitioners' abilities to translate the evidence they generate into high-quality materials for policy makers can greatly enhance efforts to enact policies that promote physical activity.

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Cheryl Carnoske, Christine Hoehner, Nicholas Ruthmann, Lawrence Frank, Susan Handy, James Hill, Sherry Ryan, James Sallis, Karen Glanz and Ross Brownson

Background:

Although public support for physical activity-friendly Traditional Neighborhood Developments (TNDs) appears to be growing, information is lacking on private sector perspectives and how economic factors (eg, fuel prices) might influence the development and sale of TNDs.

Methods:

A sample of realtors from the National Association of Realtors (n = 4950) and developers from the National Association of Home Builders (n = 162) were surveyed in early 2009 to assess factors influencing homebuyers' decisions; incentives and barriers to developing TNDs; effects of depressed housing market conditions and financing on sales; trends in buying; and energy considerations (eg, green building).

Results:

Realtors believed that homebuyers continue to rank affordability, safety and school quality higher than TND amenities. Developers reported numerous barriers to TNDs, including the inability to overcome governmental/political hurdles, lack of cooperation between government agencies, and lack of market demand. Yet, realtors believed clients are increasingly influenced by gas and oil prices, and developers reported that clients are looking for energy efficient homes, reduced commute time, and walkable neighborhoods. Respondents reported consumers are more interested in living in a TND than 5 years ago.

Conclusions:

Activity-friendly TNDs appear to be increasing in demand, but developers and realtors reported significant barriers to creating these communities.

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Carole V. Harris, Andrew S. Bradlyn, Nancy O. Tompkins, Melanie B. Purkey, Keri A. Kennedy and George A. Kelley

Background:

The West Virginia Healthy Lifestyles Act contained 5 school-based mandates intended to reduce childhood obesity. These addressed the sale of healthy beverages, physical education time, fitness assessment, health education and assessment, and Body Mass Index measurement. This article describes the processes and methods used to evaluate efforts to implement the legislation.

Methods:

University researchers and state public health and education staff formed the collaborative evaluation team. To assess perceptions and practices, surveys were completed with school personnel (53 superintendents, 586 principals, 398 physical education teachers, 214 nurses) and telephone interviews were conducted with a multistage, stratified sample of 1500 parents and 420 students statewide. Healthcare providers (N = 122) were surveyed regarding current child weight practices and interactions with families. Statewide data reflecting fitness, physical education plans, local wellness policies, and health knowledge were included in the evaluation.

Results:

The evaluation was facilitated by state officials and agencies, resulting in good access to survey groups and high survey response rates for school personnel (57% to 95% response rates); a substantially lower response rate was obtained for healthcare providers (22%).

Conclusions:

Collaborative design and implementation was a key factor in the successful conduct of this obesity policy evaluation.

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Sonja Kahlmeier, Francesca Racioppi, Nick Cavill, Harry Rutter and Pekka Oja

Background:

There is growing interest in “Health in All Policies” approaches, aiming at promoting health through policies which are under the control of nonhealth sectors. While economic appraisal is an established practice in transport planning, health effects are rarely taken into account. An international project was carried out to develop guidance and tools for practitioners for quantifying the health effects of cycling and walking, supporting their full appraisal.

Development Process:

A systematic review of existing approaches was carried out. Then, the products were developed with an international expert panel through an extensive consensus finding process.

Products and Applications:

Methodological guidance was developed which addresses the main challenges practitioners encounter in the quantification of health effects from cycling and walking. A “Health Economic Assessment Tool (HEAT) for cycling” was developed which is being used in several countries.

Conclusions:

There is a need for a more consistent approach to the quantification of health benefits from cycling and walking. This project is providing guidance and an illustrative tool for cycling for practical application. Results show that substantial savings can be expected. Such tools illustrate the importance of considering health in transport policy and infrastructure planning, putting “Health in All Policies” into practice.

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Lawrence Frank, Jacqueline Kerr, Dori Rosenberg and Abby King

Background:

Suburban development patterns may impede physical activity (PA) and mobility and affect healthy aging. This paper investigates the relationships between neighborhood design and walking, driving, PA, and obesity in adults over age 65 years.

Methods:

Data from the SMARTRAQ (Atlanta region) survey provided measures of PA, BMI, SES, and travel patterns. Neighborhood design was measured using a walkability index (residential density, street connectivity, retail density, and land use mix). Chi square and regression was used to evaluate relationships.

Results:

Increased walkability was related with more walking (OR 2.02), less time spent traveling in a car (OR .53), and lower odds of being overweight (OR .68). Those with 1 or no cars were more likely to walk (OR 2.9) and spend less time in cars (OR .53); but also less likely to get recommended levels of PA (OR .55). Visiting a fast food outlet was associated with increased odds of obesity (OR 1.81).

Conclusions:

Policies are needed to bring older Americans closer to shops and services and healthy food outlets as a means of encouraging regular walking and healthy body weight. Incentives to encourage neighborhood grocery stores and affordable housing in central areas along with regulatory reform through zoning can encourage PA and healthy body weight in the elderly.

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Genevieve F. Dunton, Michael Cousineau and Kim D. Reynolds

Background:

Policy strategies aimed at modifying aspects of the social, physical, economic, and educational environments have been proposed as potential solutions to the growing problem of physical inactivity. To develop effective physical activity policies in these and other areas, greater understanding of how and why policies successfully impact behavior change is needed.

Methods:

The current paper proposes a conceptual framework explaining how policy strategies map onto health behavior theoretical variables and processes thought to lead to physical activity change. This framework is used to make hypotheses about the potential effectiveness of different policy strategies.

Results:

Health behavior theories suggest that policies providing information may be particularly useful for individuals who are not yet considering or have only recently begun to consider becoming more physically active. Policies that provide opportunities may be less effective for individuals who do not find physical activity to be inherently fun and interesting. Policies that offer incentives or require the behavior may not be particularly useful at promoting long-term changes in physical activity.

Conclusion:

Exploring possible connections between policy strategies and theoretical constructs can help to clarify how each approach might work and for whom it may be the most appropriate to implement.