What we know about the actual implementation process of public physical activity policies: results from a scoping review.

Lara Christianson, Sarah Forberger, Lucia A Reisch, Biljana Meshkovska, Karolina Lobczowska, Daniel A Scheller, Janine Wendt, Jennifer Frense, Jürgen M Steinacker, Catherine B Woods, Aleksandra Luszczynska, Hajo Zeeb

Journal: European journal of public health 2022;32(Suppl 4):iv59-iv65

PMID: 36444100

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Abstract

BACKGROUND

Physical inactivity rates have remained high worldwide since 2001. Public policies are an essential upstream lever to target individual physical activity (PA) behaviour. However, implementers have different strategies and face implementation challenges that are poorly understood. The present study analyzes the implementation processes of public policies to promote PA in terms of: (i) the policies covered and their legal quality, (ii) the actors and stakeholders involved in the implementation process and (iii) the used implementation strategies (vertical, horizontal or a mix).

METHODS

A scoping review was systematically conducted (registered Open Science Framework: osf.io/7w84q/), searching 10 databases and grey literature until March 2022. Of the 7741 titles and abstracts identified initially, 10 studies were included.

RESULTS

The current evidence includes high-income countries (USA, n = 7; UK, New Zealand and Oman, n = 1 each). Policy areas covered are education (school sector) and PA promotion in general (national PA plans or city-wide approaches). The legal classification ranges from laws (school sector) to coordination and budgeting to non-legally binding recommendations. The jurisdictions covered were federal (n = 4), state (n = 1), county (n = 1), school district (n = 1) and city (n = 3). Implementation strategies for city-wide approaches are characterized by a coordinated approach with vertical and horizontal integration; federal PA policies by a mix of implementation strategies; and the school sector by a strict horizontal top-down integration without the involvement of other actors.

CONCLUSION

Implementation strategies differ by policy field. Therefore, continuous evaluation of the implementation process is necessary to align policy implementation with policy goals to promote individual PA behaviour.

Address: Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany.; Behavioural Economics and Policy, University of Cambridge, Cambridge, UK.; Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway.; Domus Medica, Oslo, Norway.; Department of Psychology in Wroclaw, SWPS University of Social Sciences and Humanities, Wroclaw, Poland.; Division of Sports and Rehabilitation Medicine, Department of Internal Medicine, Ulm University Medical Center, Ulm, Germany.; School of Health and Human Performance, Dublin City University, Dublin, Ireland.; Department of Physical Education and Sport Sciences, Physical Activity for Health Research Cluster, Health Research Institute, University of Limerick, Limerick, Ireland.; Melbourne Centre for Behavior Change, Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, VIC, Australia.; Health Sciences Bremen, University of Bremen, Bremen, Germany.

DOI: 10.1093/eurpub/ckac089

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MeSH Terms: Humans, Public Policy, Exercise, Sedentary Behavior, Schools, Educational Status