Established Evidence Results

Intervention Components (click on component to see a list of all articles that use that intervention): COMMUNITY, Environment Enhancements

Intervention Description: We used data from a 2009 survey (n = 424) that was designed and administered to evaluate neighborhood preferences and behavior-specific physical activity before and after residents moved. Data were grouped and stratified by pre-move physical activity levels into low-, middle-, and high-activity groups. We used Student's paired sample t test and Wilcoxon signed-rank test to compare pre- and post-move scores and used an analysis of variance to compare mean changes as a function of pre-move physical activity level.

Intervention Results: After moving, the high-activity group continued to be significantly more active than the middle- and low-activity groups (P < .001). However, we saw the biggest increase in pre- to post-move total physical activity in the low-activity group (mean increase, 176.3 min/wk) compared with the middle- (mean increase, 69.5 min/wk) and high-activity groups (mean decrease, 67.9 min/wk). All 3 groups had significant increases in walking inside the neighborhood for recreation. The preferred neighborhood features with the most significant pre- to post-move change scores were those associated with greater walkability.

Conclusion: This study supports the role the environment plays in physical activity. These data suggest that moving to an activity-friendly neighborhood can positively affect physical activity levels, particularly among residents who had previously been least active.

Setting: Community

Population of Focus: Children and addults

Intervention Components (click on component to see a list of all articles that use that intervention): COMMUNITY, Environment Enhancements

Intervention Description: Effective population-based approaches implemented in communities can help increase physical activity among all Americans. Evidence suggests that built environment interventions offer one such approach. These interventions aim to create or modify community environmental characteristics to make physical activity easier or more accessible for all people in the places where they live. In 2016, the Community Preventive Services Task Force released a recommendation for built environment approaches to increase physical activity. This recommendation is based on a systematic review of 90 studies (search period, 1980-June 2014) conducted using methods outlined by the Guide to Community Preventive Services.

Intervention Results: The Community Preventive Services Task Force found sufficient evidence of effectiveness to recommend combined built environment strategies. Specifically, these strategies combine interventions to improve pedestrian or bicycle transportation systems with interventions to improve land use and environmental design. Components of transportation systems can include street pattern design and connectivity, pedestrian infrastructure, bicycle infrastructure, and public transit infrastructure and access. Components of land use and environmental design can include mixed land use, increased residential density, proximity to community or neighborhood destinations, and parks and recreational facility access.

Conclusion: Implementing this Community Preventive Services Task Force recommendation in communities across the United States can help promote healthy and active living, increase physical activity, and ultimately improve cardiovascular health.

Setting: Community

Population of Focus: Children and addults

Intervention Components (click on component to see a list of all articles that use that intervention): COMMUNITY, Environment Enhancements

Intervention Description: Active People, Healthy NationSM is an initiative led by the US Centers for Disease Control and Prevention to improve the health of 27 million Americans by 2027 by increasing their level of physical activity.1 An earlier commentary provided the rationale and an overall description of Active People, Healthy NationSM.2 A core goal of this initiative is to galvanize action across communities, government and nongovernmental organizations, and institutions to use a set of proven strategies to increase physical activity (Figure 1). Every Active People, Healthy NationSM strategy can be designed to support equitable and inclusive access to opportunities for physical activity for all people, regardless of age, race, education, socioeconomic position, disability status, sexual orientation, or geographic location.

Intervention Results: The Community Guide has 4 types of findings: recommend against, insufficient evidence, recommend with sufficient evidence, and recommend with strong evidence. Seven strategies recommended as having sufficient or strong evidence of effectiveness by the Community Guide are described next: Activity-Friendly Routes to Everyday Destinations, Access to Places for Physical Activity, School and Youth Programs, Community-Wide Campaigns, Social Support, Individual Supports, and Prompts to Encourage Physical Activity

Conclusion: As illustrated on the signpost in Figure 1, health equity is the foundation of the Active People, Healthy NationSM initiative. Although inequities in physical activity levels persist across population groups, the strategies in Figure 1 can be adapted to address these inequities through changes in programs, policies, systems, and the environment. Some strategies can be used to improve physical activity levels among individuals, whereas others focus on community-wide changes. Communities can also add and combine strategies depending on their resources, needs, and context. Using these proven strategies, Active People, Healthy NationSM is galvanizing action across communities, governmental and nongovernmental organizations, and institutions to increase physical activity levels across the United States. The launch of this initiative marks the beginning of a journey to improve the health of 27 million Americans by 2027 through increases in physical activity.

Setting: Community

Population of Focus: Children and addults

Intervention Components (click on component to see a list of all articles that use that intervention): Environment Enhancements, COMMUNITY

Intervention Description: Play Streets is a place-based intervention that is typically organized by local governments or community organizations and involves temporarily closing streets to create safe places and free opportunities for physical activity. In this descriptive study we examined 162 of Chicago's PlayStreets, held in the summer of 2018, to assess the volume and type of physical activity among youth participants and the variety of services provided to residents.

Intervention Results: We found that PlayStreets provides opportunities for youth physical activity in areas where opportunities do not otherwise always exist. PlayStreets also provides an avenue for residents to access community resources. This research on Chicago's experience with PlayStreets showed how one city is temporarily turning streets into places for youth physical activity to advance health equity.

Conclusion: Local policies that facilitate temporarily closing streets and that provide resources to support opportunities for physical activity and access to community resources can advance health equity in cities nationwide.

Intervention Components (click on component to see a list of all articles that use that intervention): Environment Enhancements, Family Leave, Workplace Policies, State Laws, COMMUNITY

Intervention Description: To reduce the burden of chronic disease, the Centers for Disease Control and Prevention (CDC) funded the Orange County Partnerships to Improve Health (OC-PICH) project in Orange County, California

Intervention Results: The outdoor exercise equipment (OEE) was installed along a walking path in Edison Park (Anaheim) and grouped within a single area (a "fitness zone") in Garden Grove Park. In both parks, there were significantly greater odds of high-intensity physical activity overall after the installation-19% higher odds in Anaheim, and 23% higher odds in Garden Grove. However, the fitness zone area in Garden Grove had substantially higher odds of increased physical activity post-intervention (OR = 5.29, CI: 3.76-7.44, p < 0.001).

Conclusion: While the increases in physical activity levels are consistent with past studies that link OEE to higher levels of physical activity among park users, our findings also suggest that the location and placement of equipment within a park may be an important factor to consider when improving park amenities for physical activity.

Intervention Components (click on component to see a list of all articles that use that intervention): Environment Enhancements, COMMUNITY

Intervention Description: This study investigated the effectiveness of providing physical activity (PA) equipment as an environmental intervention on middle school students' PA levels and stakeholders' perceptions of the effectiveness of equipment provisions during school lunch recess.

Intervention Results: The overall percentage of moderate to vigorous PA levels was increased in both schools (ranging from 8.0% to 24.0%). In school 2, there was a significant difference in seventh- and eighth-grade students' moderate to vigorous PA levels from the baseline. Three major themes were identified: (1) unmotivated, (2) unequipped, and (3) unquestionable changes (with students becoming more active).

Conclusion: Environmental supports (access, equipment, and supervision) significantly and positively influenced middle school students' lunchtime PA levels.