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The Role of the Public Health Sector in Promoting Physical Activity: National, State, and Local Applications

Gregory W. Heath

Background:

Regular physical activity has been demonstrated to protect against coronary heart disease, Type 2 diabetes mellitus, selected cancers, hypertension, obesity, and other chronic conditions. Therefore, the public health significance of promoting physical activity and preventing inactivity has become a well-established agenda for public health agencies at all levels.

Methods:

A secondary search of the literature, focusing on existing evidence reviews, was conducted to identify effective or promising public health physical activity interventions. Further examination of published evidence-based programs also was carried out to supplement the known evidence base. Intervention strategies were selected using criteria prescribed by each of the systematic reviews to yield categories of intervention effectiveness.

Key recommendations:

The selected physical activity interventions conformed to the domains identified by The Guide to Community Preventive Services. Recommended evidenced-based strategies from within the domain of informational approaches include 2 exemplary community-wide campaigns; mass media campaigns, represented by VERB; and an emerging practice of delivery of short physical activity messages at key community sites. Exemplary representative behavioral/social interventions include social support through organized walking clubs/partners within communities. Exemplary environmental/policy approaches include creating/enhancing access to places for physical activity with informational outreach activities and the emerging strategy of community-wide policies and planning.

Cover Journal of Physical Activity and Health

In Journal of Physical Activity and Health Volume 6 (2009): Issue s2 (Jan 2009)

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Recommended Levels of Physical Activity and Health-Related Quality of Life Among Overweight and Obese Adults in the United States, 2005

Gregory W. Heath and David W. Brown

Background:

Since overweight (25 ≤ BMI < 30) and obesity (BMI ≥ 30 Kg/m2) are associated with poor health-related quality of life (HRQOL) and regular physical activity is associated with higher levels of HRQOL, the authors examined the relationship between physical activity and HRQOL among overweight and obese adults (age ≥ 18 years) residing in the United States.

Methods:

Using the 2005 BRFSS survey, they examined the independent relationship between recommended physical activity and measures of HRQOL developed by the Centers for Disease Control and Prevention among 283,562 adults age 18 years or older with overweight or obesity. Measures of physical activity, height, weight, and HRQOL were self-reported. Multivariable logistic regression was used to obtain odds ratios and 95% confidence intervals adjusted for age, race/ethnicity, sex, education, smoking status, chronic disease, and body-mass index.

Results:

The proportion of adults with overweight and obesity who attained recommended levels of physical activity had higher levels of HRQOL than physically inactive adults for all age, racial/ethnic, and sex groups. After multi-variable adjustment, overweight and obese adults who met the recommended level of physical activity had higher levels of HRQOL than physically inactive adults across all age strata.

Conclusions:

These results highlight the HRQOL role that physical activity can have among overweight and obese persons despite their excess body weight.

Cover Journal of Physical Activity and Health

In Journal of Physical Activity and Health Volume 6 (2009): Issue 4 (Jul 2009)

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Grow Healthy Together: Effects of Policy and Environmental Interventions on Physical Activity Among Urban Children and Youth

Gregory W. Heath and John Bilderback

Background: There is a paucity of studies, especially among diverse populations, demonstrating the effects of policy and environmental interventions to increase regular physical activity. The Grow Healthy Together Chattanooga project provided the opportunity to assess the impact of physical activity policy and environmental interventions on the physical activity among predominately African American children living in the inner city. Methods: Using the System for Observing Physical Activity and Recreation in Communities (SOPARC), the authors examined the physical activity of children along urban pedestrian/bike routes/trails and recreational park areas within the boundaries of the Grow Healthy Together Chattanooga communities. SOPARC data were collected at baseline (fall 2010/spring 2011) and repeated (spring 2014) in each community. Results: The SOPARC assessments yielded a total of 692 child/youth observations in 2010 and 806 observations in 2014. Children/youth observed in 2014 were greater than 2 times the odds of engaging in moderate/vigorous physical activity compared with their 2010 counterparts (odds ratio  = 2.75, 95% confidence interval, 1.43–5.32). Conclusions: The present findings support the hypothesis that policy and environmental interventions can contribute to increased physical activity levels among children/youth over ∼3-year period. These results provide evidence that improved access to “urban” pedestrian/bicycle routes/trails appears to translate into increased opportunities for physical activity among inner city children/youth.

Cover Journal of Physical Activity and Health

In Journal of Physical Activity and Health Volume 16 (2019): Issue 2 (Feb 2019)

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Relationships Between Engaging in Recommended Levels of Physical Activity and Health-Related Quality of Life Among Hypertensive Adults

David W. Brown, David R. Brown, Gregory W. Heath, David G. Moriarty, Lina Balluz, and Wayne H. Giles

Background:

Hypertension (HTN), which affects more than 65 million Americans, is associated with poor health-related quality of life (HRQOL). Regular physical activity (PA) has been shown to reduce blood pressure and is associated with higher levels of HRQOL.

Methods:

Using self-reports from 60,321 hypertensive adults age 18 y or older who participated in the 2003 Behavioral Risk Factor Surveillance Survey, we examined the independent relationship between engaging in recommended levels of moderate or vigorous PA and four measures of HRQOL developed by the Centers for Disease Control and Prevention.

Results:

For all age and racial/ethnic groups and both sexes, the proportion of hypertensive adults with 14 or more unhealthy days (physical or mental) in the past month was significantly lower among those who attained recommended levels of PA than among physically inactive adults.

Conclusions:

Participation in regular PA is one of several lifestyle strategies available to control and prevent HTN. These results suggest that PA is associated with higher levels of HRQOL among adults with HTN and highlight the importance of health programs that promote participation in regular PA.

Cover Journal of Physical Activity and Health

In Journal of Physical Activity and Health Volume 3 (2006): Issue 2 (Apr 2006)

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The Effectiveness of Urban Design and Land Use and Transport Policies and Practices to Increase Physical Activity: A Systematic Review

Gregory W. Heath, Ross C. Brownson, Judy Kruger, Rebecca Miles, Kenneth E. Powell, Leigh T. Ramsey, and the Task Force on Community Preventive Services*

Background:

Although a number of environmental and policy interventions to promote physical activity are being widely used, there is sparse systematic information on the most effective approaches to guide population-wide interventions.

Methods:

We reviewed studies that addressed the following environmental and policy strategies to promote physical activity: community-scale urban design and land use policies and practices to increase physical activity; street-scale urban design and land use policies to increase physical activity; and transportation and travel policies and practices. These systematic reviews were based on the methods of the independent Task Force on Community Preventive Services. Exposure variables were classified according to the types of infrastructures/policies present in each study. Measures of physical activity behavior were used to assess effectiveness.

Results:

Two interventions were effective in promoting physical activity (community-scale and street-scale urban design and land use policies and practices). Additional information about applicability, other effects, and barriers to implementation are provided for these interventions. Evidence is insufficient to assess transportation policy and practices to promote physical activity.

Conclusions:

Because community- and street-scale urban design and land-use policies and practices met the Community Guide criteria for being effective physical activity interventions, implementing these policies and practices at the community-level should be a priority of public health practitioners and community decision makers.

Cover Journal of Physical Activity and Health

In Journal of Physical Activity and Health Volume 3 (2006): Issue s1 (Jan 2006): The Second Active Living Research Conference

Open access

Status and Trends of Physical Activity Surveillance, Policy, and Research in 164 Countries: Findings From the Global Observatory for Physical Activity—GoPA! 2015 and 2020 Surveys

Andrea Ramírez Varela, Pedro C. Hallal, Juliana Mejía Grueso, Željko Pedišić, Deborah Salvo, Anita Nguyen, Bojana Klepac, Adrian Bauman, Katja Siefken, Erica Hinckson, Adewale L. Oyeyemi, Justin Richards, Elena Daniela Salih Khidir, Shigeru Inoue, Shiho Amagasa, Alejandra Jauregui, Marcelo Cozzensa da Silva, I-Min Lee, Melody Ding, Harold W. Kohl III, Ulf Ekelund, Gregory W. Heath, Kenneth E. Powell, Charlie Foster, Aamir Raoof Memon, Abdoulaye Doumbia, Abdul Roof Rather, Abdur Razzaque, Adama Diouf, Adriano Akira Hino, Albertino Damasceno, Alem Deksisa Abebe, Alex Antonio Florindo, Alice Mannocci, Altyn Aringazina, Andrea Backović Juričan, Andrea Poffet, Andrew Decelis, Angela Carlin, Angelica Enescu, Angélica María Ochoa Avilés, Anna Kontsevaya, Annamaria Somhegyi, Anne Vuillemin, Asmaa El Hamdouchi, Asse Amangoua Théodore, Bojan Masanovic, Brigid M. Lynch, Catalina Medina, Cecilia del Campo, Chalchisa Abdeta, Changa Moreways, Chathuranga Ranasinghe, Christina Howitt, Christine Cameron, Danijel Jurakić, David Martinez-Gomez, Dawn Tladi, Debrework Tesfaye Diro, Deepti Adlakha, Dušan Mitić, Duško Bjelica, Elżbieta Biernat, Enock M. Chisati, Estelle Victoria Lambert, Ester Cerin, Eun-Young Lee, Eva-Maria Riso, Felicia Cañete Villalba, Felix Assah, Franjo Lovrić, Gerardo A. Araya-Vargas, Giuseppe La Torre, Gloria Isabel Niño Cruz, Gul Baltaci, Haleama Al Sabbah, Hanna Nalecz, Hilde Liisa Nashandi, Hyuntae Park, Inés Revuelta-Sánchez, Jackline Jema Nusurupia, Jaime Leppe Zamora, Jaroslava Kopcakova, Javier Brazo-Sayavera, Jean-Michel Oppert, Jinlei Nie, John C. Spence, John Stewart Bradley, Jorge Mota, Josef Mitáš, Junshi Chen, Kamilah S Hylton, Karel Fromel, Karen Milton, Katja Borodulin, Keita Amadou Moustapha, Kevin Martinez-Folgar, Lara Nasreddine, Lars Breum Christiansen, Laurent Malisoux, Leapetswe Malete, Lorelie C. Grepo-Jalao, Luciana Zaranza Monteiro, Lyutha K. Al Subhi, Maja Dakskobler, Majed Alnaji, Margarita Claramunt Garro, Maria Hagströmer, Marie H. Murphy, Matthew  Mclaughlin, Mercedes Rivera-Morales, Mickey Scheinowitz, Mimoza Shkodra, Monika Piątkowska, Moushumi Chaudhury, Naif Ziyad Alrashdi, Nanette Mutrie, Niamh Murphy, Norhayati Haji Ahmad, Nour A. Obeidat, Nubia Yaneth Ruiz Gómez, Nucharapon Liangruenrom, Oscar Díaz Arnesto, Oscar Flores-Flores, Oscar Incarbone, Oyun Chimeddamba, Pascal Bovet, Pedro Magalhães, Pekka Jousilahti, Piyawat Katewongsa, Rafael Alexander Leandro Gómez, Rawan Awni Shihab, Reginald Ocansey, Réka Veress, Richard Marine, Rolando Carrizales-Ramos, Saad Younis Saeed, Said El-Ashker, Samuel Green, Sandra Kasoma, Santiago Beretervide, Se-Sergio Baldew, Selby Nichols, Selina Khoo, Seyed Ali Hosseini, Shifalika Goenka, Shima Gholamalishahi, Soewarta Kosen, Sofie Compernolle, Stefan Paul Enescu, Stevo Popovic, Susan Paudel, Susana Andrade, Sylvia Titze, Tamu Davidson, Theogene Dusingizimana, Thomas E. Dorner, Tracy L. Kolbe-Alexander, Tran Thanh Huong, Vanphanom Sychareun, Vera Jarevska-Simovska, Viliami Kulikefu Puloka, Vincent Onywera, Wanda Wendel-Vos, Yannis Dionyssiotis, and Michael Pratt

Background: Physical activity (PA) surveillance, policy, and research efforts need to be periodically appraised to gain insight into national and global capacities for PA promotion. The aim of this paper was to assess the status and trends in PA surveillance, policy, and research in 164 countries. Methods: We used data from the Global Observatory for Physical Activity (GoPA!) 2015 and 2020 surveys. Comprehensive searches were performed for each country to determine the level of development of their PA surveillance, policy, and research, and the findings were verified by the GoPA! Country Contacts. Trends were analyzed based on the data available for both survey years. Results: The global 5-year progress in all 3 indicators was modest, with most countries either improving or staying at the same level. PA surveillance, policy, and research improved or remained at a high level in 48.1%, 40.6%, and 42.1% of the countries, respectively. PA surveillance, policy, and research scores decreased or remained at a low level in 8.3%, 15.8%, and 28.6% of the countries, respectively. The highest capacity for PA promotion was found in Europe, the lowest in Africa and low- and lower-middle-income countries. Although a large percentage of the world’s population benefit from at least some PA policy, surveillance, and research efforts in their countries, 49.6 million people are without PA surveillance, 629.4 million people are without PA policy, and 108.7 million live in countries without any PA research output. A total of 6.3 billion people or 88.2% of the world’s population live in countries where PA promotion capacity should be significantly improved. Conclusion: Despite PA is essential for health, there are large inequalities between countries and world regions in their capacity to promote PA. Coordinated efforts are needed to reduce the inequalities and improve the global capacity for PA promotion.

Cover Journal of Physical Activity and Health

In Journal of Physical Activity and Health Volume 20 (2023): Issue 2 (Feb 2023)