Sustained impact of community-based physical activity interventions: key elements for success

BMC Public Health

Heather A McKay³  Kaitlyn Gutteridge³  Meghan Winters²  Joanie Sims-Gould³  Callista Haggis¹ 

[1] Centre for Hip Health and Mobility, 2635 Laurel Street, Vancouver, BC V5Z 1M9, Canada;Faculty of Health Sciences, Simon Fraser University, Burnaby, BC V5A 1S6, Canada;Faculty of Medicine, University of British Columbia, Vancouver, BC V6T 1Z4, Canada

关键词: Stakeholders;    Framework;    Participatory action research;    Social ecological model;    Community-based research;    Built environment;    Physical activity;   

Others  :  1161730
DOI  :  10.1186/1471-2458-13-892

 received in 2013-05-22, accepted in 2013-09-20,  发布年份 2013

【 摘 要 】

Background

Compelling evidence supports the cost effectiveness and potential impact of physical activity on chronic disease prevention and health promotion. Quality of evidence is one piece, but certainly not the sole determinant of whether public health interventions, physical activity focused or otherwise, achieve their full potential for impact. Health promotion at both population and community levels must progress beyond health intervention models that isolate individuals from social, environmental, and political systems of influence.

We offer a critical evaluation of lessons learned from two successful research initiatives to provide insights as to how health promotion research contributes to sustained impact. We highlight factors key to success including the theoretical and methodological integration of: i) a social ecological approach; ii) participatory action research (PAR) methods; and iii) an interdisciplinary team.

Methods

To identify and illustrate the key elements of our success we layered an evaluation of steps taken atop a review of relevant literature.

Results

In the school-based case study (Action Schools! BC), the success of our approach included early and sustained engagement with a broad cross-section of stakeholders, establishing partnerships across sectors and at different levels of government, and team members across multiple disciplines. In the neighbourhood built environment case study, the three domains guided our approach through study design and team development, and the integration of older adults’ perspectives into greenway design plans. In each case study we describe how elements of the domains serve as a guide for our work.

Conclusion

To sustain and maximize the impact of community-based public health interventions we propose the integration of elements from three domains of research that acknowledge the interplay between social, environmental and poilitical systems of influence. We emphasize that a number of key factors determine whether evidence from public health interventions in school and built environment settings is applied in practice and policy sectors. These include relationship building at individual, community, and societal levels of the social ecological model, using participatory action research methods, and involving an engaged and committed interdisciplinary team.

【 授权许可】

   
2013 Haggis et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Kohl HW 3rd, Craig CL, Lambert EV, Inoue S, Alkandari JR, Leetongin G, Kahlmeier S, Lancet Physical Activity Series Working G: The pandemic of physical inactivity: global action for public health. Lancet 2012, 380(9838):294-305.
• [2]Huberty JL, Balluff M, O’Dell M, Peterson K: From good ideas to actions: a model-driven community collaborative to prevent childhood obesity. Prev Med 2010, 50(Suppl 1):S36-S43.
• [3]Culyer AJ, Lomas J: Deliberative processes and evidence-informed decision making in healthcare: do they work and how might we know? Evid Policy 2006, 2(3):357-371.
• [4]Brownson RC, Jones E: Bridging the gap: translating research into policy and practice. Prev Med 2009, 49(4):313-315.
• [5]Durlak JA, DuPre EP: Implementation matters: a review of research on the influence of implementation on program outcomes and the factors affecting implementation. Am J Commun Psychol 2008, 41(3–4):327-350.
• [6]Glasgow RE, Green LW, Taylor MV, Stange KC: An evidence integration triangle for aligning science with policy and practice. Am J Prev Med 2012, 42(6):646-654.
• [7]Rose G: Sick individuals and sick populations. Int J Epidemiol 1985, 14(1):32-38.
• [8]Lomas J: The in-between world of knowledge brokering. BMJ 2007, 334(7585):129-132.
• [9]Schiller C, Winters M, Hanson H, Ashe M: A framework for stakeholder identification in concept mapping and health research: a novel process and its application to older adult mobility and the built environment. BMC Public Health 2013, 13(1):428. BioMed Central Full Text
• [10]Best A, Stokols D, Green LW, Leischow S, Holmes B, Buchholz K: An integrative framework for community partnering to translate theory into effective health promotion strategy. Am J Health Promot 2003, 18(2):168-176.
• [11]Petticrew M, Whitehead M, Macintyre SJ, Graham H, Egan M: Evidence for public health policy on inequalities: 1: the reality according to policymakers. J Epidemiol Commun H 2004, 58(10):811-816.
• [12]Rogers Everett M: Diffusion of innovations. New York: Free Press; 1995.
• [13]Blair SN: Physical inactivity: the biggest public health problem of the 21st century. Brit J Sport Med 2009, 43(1):1-2.
• [14]Sun F, Norman I, While A: Physical activity in older people: a systematic review. BMC Public Health 2013, 13(1):449. BioMed Central Full Text
• [15]Das P, Horton R: Rethinking our approach to physical activity. Lancet 2012, 380(9838):189-190.
• [16]Khan KM, Thompson AM, Blair SN, Sallis JF, Powell KE, Bull FC, Bauman AE: Sport and exercise as contributors to the health of nations. Lancet 2012, 380(9836):59-64.
• [17]Roux L, Pratt M, Tengs TO, Yore MM, Yanagawa TL, Van Den Bos J, Rutt C, Brownson RC, Powell KE, Heath G, et al.: Cost effectiveness of community-based physical activity interventions. Am J Prev Med 2008, 35(6):578-588.
• [18]World Health Organization (WHO): Global Strategy on Diet, Physical Activity and Health. Geneva, Switzlerand: World Health Organization; 2004.
• [19]Cunningham G, Michael YL: Concepts guiding the study of the impact of the built environment on physical activity for older adults: a review of the literature. Am J Health Promot 2004, 18(6):435-443.
• [20]Bradbury-Jones C: Enhancing rigour in qualitative health research: exploring subjectivity through Peshkin’s I’s. J Adv Nurs 2007, 59(3):290-298.
• [21]Koch T: Establishing rigour in qualitative research: the decision trail. J Adv Nurs 2006, 53(1):91-100.
• [22]Cutcliffe JR, McKenna HP: Expert qualitative researchers and the use of audit trails. J Adv Nurs 2004, 45(2):126-133.
• [23]Chow CK, Lock K, Teo K, Subramanian S, McKee M, Yusuf S: Environmental and societal influences acting on cardiovascular risk factors and disease at a population level: a review. Int J Epidemiol 2009, 38(6):1580-1594.
• [24]Mozaffarian D, Afshin A, Benowitz NL, Bittner V, Daniels SR, Franch HA, Jacobs DR Jr, Kraus WE, Kris-Etherton PM, Krummel DA, et al.: Population approaches to improve diet, physical activity, and smoking habits: a scientific statement from the American heart association. Circulation 2012, 126(12):1514-1563.
• [25]McLeroy KR, Bibeau D, Steckler A, Glanz K: An ecological perspective on health promotion programs. Health Educ Quart 1988, 15(4):351-377.
• [26]Sallis JF, Owen N, Fisher EB: Ecological models of health behavior. Health Behav Health Educ: Theory, Res, Pract 2008, 4:465-486.
• [27]Stokols D: Translating social ecological theory into guidelines for community health promotion. Am J Health Promot 1996, 10(4):282-298.
• [28]Kumanyika S, Jeffery RW, Morabia A, Ritenbaugh C, Antipatis VJ, Public Health Approaches to the Prevention of Obesity Working Group of the International Obesity Task F: Obesity prevention: the case for action. Int J Obes Relat Metab Disord 2002, 26(3):425-436.
• [29]Paschal AM, Oler-Manske J, Kroupa K, Snethen E: Using a community-based participatory research approach to improve the performance capacity of local health departments: the Kansas immunization technology project. J Community Health 2008, 33(6):407-416.
• [30]Whitehead M, Petticrew M, Graham H, Macintyre SJ, Bambra C, Egan M: Evidence for public health policy on inequalities: 2: assembling the evidence jigsaw. J Epidemiol Commun H 2004, 58(10):817-821.
• [31]Jones RJ, Santaguida P: Evidence-based practice and health policy development: the link between knowledge and action. Physiotherapy 2005, 91(1):14-21.
• [32]Gray B: Enhancing transdisciplinary research through collaborative leadership. Am J Prev Med 2008, 35(2 Suppl):S124.
• [33]Stokols D, Misra S, Moser RP, Hall KL, Taylor BK: The ecology of team science: understanding contextual influences on transdisciplinary collaboration. Am J Prev Med 2008, 35(2 Suppl):S96-S115.
• [34]Hall KL, Stokols D, Moser RP, Taylor BK, Thornquist MD, Nebeling LC, Ehret CC, Barnett MJ, McTiernan A, Berger NA, et al.: The collaboration readiness of transdisciplinary research teams and centers findings from the national cancer institute’s TREC year-one evaluation study. Am J Prev Med 2008, 35(2 Suppl):S161-S172.
• [35]Borner K, Contractor N, Falk-Krzesinski HJ, Fiore SM, Hall KL, Keyton J, Spring B, Stokols D, Trochim W, Uzzi B: A multi-level systems perspective for the science of team science. Sci Transl Med 2010, 2(49):cm24.
• [36]Tucker S, Lanningham-Foster L, Murphy J, Olsen G, Orth K, Voss J, Aleman M, Lohse C: A school based community partnership for promoting healthy habits for life. J Community Health 2011, 36(3):414-422.
• [37]Active Healthy Kids Canada: Is active play extinct? The Active Healthy Kids Canada 2012 report card on physical activity for children and youth. Toronto, Canada: Active Healthy Kids; 2012:1-109.
• [38]Kriemler S, Meyer U, Martin E, van Sluijs EM, Andersen LB, Martin BW: Effect of school-based interventions on physical activity and fitness in children and adolescents: a review of reviews and systematic update. Brit J Sport Med 2011, 45(11):923-930.
• [39]Groffik D, Sigmund E, Fromel K, Chmelik F, Novakova Lokvencova P: The contribution of school breaks to the all-day physical activity of 9- and 10-year-old overweight and non-overweight children. Int J Pub Health 2012, 57:711-718.
• [40]Masse LC, McKay H, Valente M, Brant R, Naylor PJ: Physical activity implementation in schools: a 4-year follow-up. Am J Prev Med 2012, 43(4):369-377.
• [41]Naylor PJ, Macdonald HM, Warburton DE, Reed KE, McKay HA: An active school model to promote physical activity in elementary schools: action schools! BC. Brit J Sport Med 2008, 42(5):338-343.
• [42]Naylor PJ, Macdonald HM, Reed KE, McKay HA: Action Schools! BC: a socioecological approach to modifying chronic disease risk factors in elementary school children. Prev Chronic Dis 2006, 3(2):A60.
• [43]Sporta JW: Action Schools! BC. Year-end report - July 1, 2011 to June 30, 2012. British Columbia: Ministry of Health; 2012.
• [44]Naylor P: Action schools! BC…providing more opportunities for more children to make health choices more often. [http://www.actionschoolsbc.ca webcite]
• [45]King L, Hawe P, Wise M: Making dissemination a two-way process. Health Promot Int 1998, 13(3):237-244.
• [46]Brownson RC, Hoehner CM, Day K, Forsyth A, Sallis JF: Measuring the built environment for physical activity: state of the science. Am J Prev Med 2009, 36(4 Suppl):S99-123 e112.
• [47]Sallis JF, Glanz K: The role of built environments in physical activity, eating, and obesity in childhood. The Future of children / Center for the Future of Children, the David and Lucile Packard Foundation 2006, 16(1):89-108.
• [48]Public Health Advisory Committee: Healthy Places, Healthy Lives: Urban environments and wellbeing. Wellington: Ministry of Health; 2010.
• [49]Frumkin H, Frank L, Jackson RJ: Urban sprawl and public health: Designing, planning, and building for healthy communities. Washington, DC: Island Press; 2004.
• [50]World Health Organization (WHO): Healthy Urban Planning. Report of a Consultation Meeting. Kobe, Japan: World Health Organization; 2011.
• [51]Corburn J: Confronting the challenges in reconnecting urban planning and public health. Am J Public Health 2004, 94(4):541-546.
• [52]Rydin Y, Bleahu A, Davies M, Davila JD, Friel S, De Grandis G, Groce N, Hallal PC, Hamilton I, Howden-Chapman P, et al.: Shaping cities for health: complexity and the planning of urban environments in the 21st century. Lancet 2012, 379(9831):2079-2108.
• [53]Owen N, Glanz K, Sallis JF, Kelder SH: Evidence-based approaches to dissemination and diffusion of physical activity interventions. Am J Prev Med 2006, 31(4 Suppl):S35-S44.
• [54]Yousefian A, Ziller E, Swartz J, Hartley D: Active living for rural youth: addressing physical inactivity in rural communities. J Public Health Manage Pract : JPHMP 2009, 15(3):223-231.
• [55]Rosso AL, Auchincloss AH, Michael YL: The urban built environment and mobility in older adults: a comprehensive review. J Aging Res 2011, 2011:816106.
• [56]Sims Gould J, Winters M, Haggis C: Active Streets, Active People (ASAP). Research Brief[http://www.hiphealth.ca/our_research/research-programs/ webcite]
• [57]ASAP(AsapActive) [http://www.twitter.com/AsapActive webcite]
• [58]City of Vancouver: Development of the Comox-Helmcken greenway section 1. Vancouver, BC: City of Vancouver; 2012:1-40.
• [59]Hoehner CM, Brennan LK, Brownson RC, Handy SL, Killingsworth R: Opportunities for integrating public health and urban planning approaches to promote active community environments. Am J Health Promot 2003, 18(1):14-20.
• [60]The Canadian Institute of Planners: Healthy Communities. [http://www.cip-icu.ca/web/la/en/pa/c0aba8d17df149d9bb1ea1bd2d2203e4/template.asp webcite]
• [61]City of Vancouver: A healthy city for all: Vancouver’s Healthy City Strategy 2012–2020. [https://vancouver.ca/people-programs/healthy-city-strategy.aspx webcite]
• [62]Rittel HW, Webber MM: Dilemmas in a general theory of planning. Policy Sci 1973, 4(2):155-169.
• [63]Signal LN, Walton MD, Mhurchu CN, Maddison R, Bowers SG, Carter KN, Gorton D, Heta C, Lanumata TS, McKerchar CW: Tackling ‘wicked’ health promotion problems: a New Zealand case study. Health Promot Int 2013, 28(1):84-94.
• [64]Conklin J: Dialogue mapping: Building shared understanding of wicked problems. New York, NY: John Wiley & Sons, Inc.; 2005.