The Physical Activity Environment Policy Index for monitoring government policies and actions to improve physical activity

Abstract

Background A multifaceted response, including government action, is essential to improve population levels of physical activity (PA). This article describes the development process of the ‘Physical Activity Environment Policy Index’ (PA-EPI) monitoring framework, a tool to assess government policies and actions for creating a healthy PA environment. Methods An iterative process was undertaken. This involved a review of policy documents from authoritative organizations, a PA policy audit of four European countries, and a systematic review of scientific literature. This was followed by an online consultation with academic experts (N = 101; 20 countries, 72% response rate), and policymakers (N = 40, 4 EU countries). During this process, consensus workshops were conducted, where quantitative and qualitative data, alongside theoretical and pragmatic considerations, were used to inform PA-EPI development. Results The PA-EPI is conceptualized as a two-component ‘policy’ and ‘infrastructure support’ framework. The two-components comprise eight policy and seven infrastructure support domains. The policy domains are education, transport, urban design, healthcare, public education (including mass media), sport-for-all, workplaces and community. The infrastructure support domains are leadership, governance, monitoring and intelligence, funding and resources, platforms for interaction, workforce development and health-in-all-policies. Forty-five ‘good practice statements’ or indicators of ideal good practice within each domain conclude the PA-EPI. A potential eight-step process for conducting the PA-EPI is described. Conclusions Once pre-tested and piloted in several countries of various sizes and income levels, the PA-EPI good practice statements will evolve into benchmarks established by governments at the forefront of creating and implementing policies to address inactivity.

What policies are there and what policies are missing? A Photovoice study of adolescents' perspectives on obesity‐prevention policies in their local environment

“…23 Prioritizing education policies (over, e.g., changes in urban design and broadening cycling paths) may be related to policymakers' perceptions that such policies are easier to implement and thus are more feasible. 26 Adolescents' focus on structural policies in our study might be influenced by the procedures of our study. Photovoice was preceded by Youth Alliance meetings where young people were asked to discuss policies that help "everyone" in their community, which could sensitize adolescents to actions that affect those people who have less resources (e.g., time) or limited capabilities (e.g., learning skills) and thus are less likely to enroll in extracurricular education programs (or other agentic policies, requiring their own resources and effort).…”

“…25 Another recent study using a different PA framework and conducted by means of interviews with European policymakers and researchers from the field of PA policies indicated that the most important policy domains refer to transport and urban design (both refer mostly to structural policies) as well as PA education policies. 26 Besides similarities that indicate that the critical awareness of youth is shared by other stakeholders involved, youth clearly prioritize structural policies that may have the highest potential to reduce health inequalities. 23 Prioritizing education policies (over, e.g., changes in urban design and broadening cycling paths) may be related to policymakers' perceptions that such policies are easier to implement and thus are more feasible.…”

“…A recent analysis of PA‐promoting public policies in Poland indicated that across domains, Polish policies that are relatively well implemented include structural policies (developing team‐sports facilities for youth in each commune), along with agentic policies (PA promotion via local sport animators and education programs at schools to attend physical exercise classes) 25 . Another recent study using a different PA framework and conducted by means of interviews with European policymakers and researchers from the field of PA policies indicated that the most important policy domains refer to transport and urban design (both refer mostly to structural policies) as well as PA education policies 26 . Besides similarities that indicate that the critical awareness of youth is shared by other stakeholders involved, youth clearly prioritize structural policies that may have the highest potential to reduce health inequalities 23 .…”

A critical analysis of walking policy in Ireland and its contribution to both national and international development goals

“…Bellew and colleagues (20) identify multidisciplinary action and consultation as necessities in successful PA related policy. However, ensuring strong monitoring mechanisms are embedded in PA policy is of utmost importance to the overall effectiveness of a policy (34,35). There were very few examples of effective evaluation and monitoring mechanisms in local and national walking policies identified in the current content analysis.…”

Dietary behaviour and physical activity policies in Europe: learnings from the Policy Evaluation Network (PEN)

“… 16 An unhealthy physical activity environment may be caused by a lack of ‘upstream’ policy progress in domains known to have a positive impact on physical activity behaviour, and when combined with a lack of effective infrastructure support for policy implementation, then the inactivity pandemic is likely to sustain, as the ‘system’ or environment remains unchanged despite best ‘downstream’ or programmatic efforts. 17 …”