Physical activity and environment programme guidance : fieldwork report

This quick reference guide presents the recommendations on &lsquo;Promoting and creating built or natural environments that encourage and support physical activity&rsquo;. It is for NHS and other professionals who have a direct or indirect role in &ndash; and responsibility for &ndash; the built or natural environment. This includes those working in local authorities and the education, community, voluntary and private sectors. It may also be of interest to members of the public. The guidance offers the first national, evidence-based recommendations on how to improve the physical environment to encourage physical activity. It demonstrates the importance of such improvements and the need to evaluate how they impact on the public&rsquo;s health.<br /

Intersectoral partnership: a potential legacy success of the London 2012 Olympic and Paralympic Games

The 2008 Legacy Action Plan stated the government’s intention to make the United Kingdom (UK) a ‘world-leading sporting nation’ by using the London 2012 Olympic and Paralympic Games to inspire population changes in physical activity. It set a goal of encouraging two million more people to be active, and responsibility for achieving the target was divided between the sport and health sectors. However, data from the Active People Survey do not confirm a ‘legacy effect’ on participation as a result of the Games. Despite failure to achieve the target, the Legacy Action Plan was the first UK policy to set a shared national goal for the health and sport sectors and since its publication, the agendas of the two sectors have become increasingly aligned. This presents an unprecedented opportunity for the two sectors to work collaboratively towards the common goal of improving population health through physical activity. It is possible that this coalescence, if maintained, has the potential to create a more sustained legacy on physical activity than may have resulted from the short-lived ‘inspiration effect’ of hosting the London Olympic and Paralympic Games. Rather than dwelling on the ‘failure’ of the Olympics to achieve the legacy target, efforts should focus on the policy congruence that has developed since the Games, and how to maximise partnership working to achieve a sustained shift in population levels of physical activity

Engaging communities in changing the environment to promote transport-related walking: evaluation of route use in the ‘Fitter for Walking’ project

Promoting walking for transport may help to increase physical activity levels. Associations between the built environment and walking for transport have been well reported. Engaging communities in making small-scale changes to local routes is one potential low-cost strategy to improve neighbourhood environments. The purpose of this study was to evaluate changes in pedestrian use of local routes following environmental changes made by communities and local authorities (LAs) in the ‘Fitter for Walking’ (FFW) project, to assess route users’ awareness of the environmental improvements which were implemented and to make recommendations for future evaluation. FFW targeted deprived communities in twelve LA areas in England. Coordinators worked with communities and LA partners to improve local route environments based on identified barriers to walking. Route user counts and intercept surveys were conducted in five FFW case studies at baseline, 12 months and 14-20 months after the project activities had commenced. A wide range of environmental improvements were undertaken. After 12 months, there was a decrease in pedestrian route use overall (-19.4%) and in four case studies (range -42.1% to -10.4%). However, after 14-20 months, an increase in pedestrian route user overall (14.9%) and in all case studies (range 5.4% to 58.9%) was observed compared to baseline. Route users’ awareness of environmental improvements made to routes varied across case studies and was very low for some of the improvements which had been made. Engaging communities in making small-scale environmental improvements to key routes in local neighbourhoods may be an effective, low-cost strategy for increasing walking for transport. Increasing the number of people walking on newly improved routes may take a long time and require additional promotional initiatives. Evaluating these types of initiatives is challenging. These factors should be considered by health and transport professionals developing initiatives and by researchers interested in measuring behaviour change

Economic impact of reduced mortality due to increased cycling.

Increasing regular physical activity is a key public health goal. One strategy is to change the physical environment to encourage walking and cycling, requiring partnerships with the transport and urban planning sectors. Economic evaluation is an important factor in the decision to fund any new transport scheme, but techniques for assessing the economic value of the health benefits of cycling and walking have tended to be less sophisticated than the approaches used for assessing other benefits. This study aimed to produce a practical tool for estimating the economic impact of reduced mortality due to increased cycling. The tool was intended to be transparent, easy to use, reliable, and based on conservative assumptions and default values, which can be used in the absence of local data. It addressed the question: For a given volume of cycling within a defined population, what is the economic value of the health benefits? The authors used published estimates of relative risk of all-cause mortality among regular cyclists and applied these to levels of cycling defined by the user to produce an estimate of the number of deaths potentially averted because of regular cycling. The tool then calculates the economic value of the deaths averted using the "value of a statistical life." The outputs of the tool support decision making on cycle infrastructure or policies, or can be used as part of an integrated economic appraisal. The tool's unique contribution is that it takes a public health approach to a transport problem, addresses it in epidemiologic terms, and places the results back into the transport context. Examples of its use include its adoption by the English and Swedish departments of transport as the recommended methodologic approach for estimating the health impact of walking and cycling

Enablers and barriers to older people’s participation in strength and balance activities:a review of reviews

Objectives This review sought to investigate the question: what are the key barriers to, and enablers for, older adults undertaking muscle strengthening and balance activities, and how can these be addressed by individuals and practitioners?Methods A search of PubMed for review-level evidence on professional and personal barriers and motivators for strength and balance activities among older people. Results The search and expert consultation found 46 studies; after screening, twelve papers were included. Many of the barriers and motivators to strength and balance activities are familiar ones that can also apply to physical activity more generally, such as not having the time. More specific barriers to strength and balance activities for older people were perceived risk of a heart attack, stroke, or death, and fear of looking too muscular; with motivators being improved ability to complete daily activities, preventing deterioration and disability, and decreasing the risk or fear of falling. Conclusions This review of reviews has found a small but consistent body of literature describing the motivators and barriers to older adults taking part in strength and balance activities. This may be used as the basis for planning and delivering physical activity programmes for older adults. <br/

Evaluation of Living Streets’ Fitter for Walking project

Evaluation of Living Streets’ Fitter for Walking projec

Evaluation of the implementation of an intervention to improve the street environment and promote walking for transport in deprived neighbourhoods

Background Levels of physical activity remain low, particularly in deprived areas. Improving the street environment to promote walking for transport using a community engagement approach is a potential strategy to increase physical activity. An understanding of the implementation of this intervention approach is needed to facilitate further research, replication and scale-up. The aim of this study was to evaluate the implementation of the Fitter for Walking (FFW) intervention in deprived neighbourhoods. Methods FFW was delivered in five regions of England between August 2008 and March 2012 and aimed to use a community engagement approach to improve the street environment to promote walking for transport. Implementation was assessed in relation to reach; dosage; implementation processes and adaptation; and factors influencing implementation. Three data sources were used: focus groups and face-to-face interviews with coordinators; implementation logs; and participation records. Results Reach: 155 community groups participated in FFW engaging 30,230 local residents. Dosage: A wide variety of environmental improvements were implemented by local authorities (LAs) (42 projects) and by communities (46 projects). Examples of LA-led improvements included removal of encroaching vegetation, new/improved pedestrian signage, new dropped kerbs/kerb improvements and new, repaired or improved footpaths. Examples of community-led improvements include planting bulbs, shrubs or bedding plants, clean-up days and litter pick-ups. In 32 projects, no environmental improvements were implemented. Promotional and awareness-raising activities were undertaken in 81 projects. Examples included led walks, themed walks, development of maps/resources to promote improved routes and community events. Processes and adaptation: The need for a planning phase, a preparatory phase, and a delivery phase with a four step process were identified. Adaptability to local context was important. Factors influencing implementation: Five key themes were identified in relation to the barriers and facilitators of implementing FFW: local knowledge and contacts; intervention delivery; coordinator role; working with LAs and other partners; and working with communities. Conclusions FFW is one of few reported interventions which have used a community engagement approach to change the street environment to promote walking for transport in deprived neighbourhoods. Delivering these types of interventions is complex and requires considerable resource and time. A set of recommendations and an implementation framework are proposed for future delivery of this and similar types of programme