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Uche UI, Stearns J, Lee K. Capabilities, opportunities, motivations, and practices of different sector professionals working on community environments to improve health. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2024; 115:132-142. [PMID: 37919543 PMCID: PMC10853135 DOI: 10.17269/s41997-023-00824-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 09/27/2023] [Indexed: 11/04/2023]
Abstract
OBJECTIVE With rising healthcare costs in Canada from chronic conditions, individual behaviour change interventions in the clinical settings need to be complemented by a determinants of health approach, where multi-sector professionals assist in the creation of healthier community environments. This study sought to gain insights into capabilities, opportunities, motivations, and behaviours (COM-B) of Canadian multi-sector professionals for working together to improve built environments (BE) for health. METHODS A cross-sectional study was conducted with 61 multi-sector professionals. A 49-item questionnaire measuring constructs of COM-B for healthy BE practices was administered. RESULTS Public health (PH) professionals were more motivated by personal interest/values in healthy BE and the presence of scientific evidence on BE design health impacts as compared with planning and policy/program development (PPD) professionals. Planning professionals were more likely to be motivated by healthy BE legislation/regulations/codes than PPD professionals. The practice of taking responsibility for the inclusion of healthy features into BE designs was reported more often by planning and other professionals compared to PH professionals. Results trended towards significance for opportunities as a predictor of healthy BE practices among all professionals. CONCLUSION Though motivators vary among different sector professionals, opportunities may be the most important driver of healthy BE practices and potentially a target to improve multi-sector professional practices in Canada. Future research should confirm findings of this first study of professional practice drivers guided by a theoretical behaviour change framework.
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Affiliation(s)
- Uloma Igara Uche
- Housing for Health, Division of Preventive Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada.
| | - Jodie Stearns
- Housing for Health, Division of Preventive Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Karen Lee
- Housing for Health, Division of Preventive Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
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Dam JL, Nagorka-Smith P, Waddell A, Wright A, Bos JJ, Bragge P. Research evidence use in local government-led public health interventions: a systematic review. Health Res Policy Syst 2023; 21:67. [PMID: 37400905 DOI: 10.1186/s12961-023-01009-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Accepted: 05/13/2023] [Indexed: 07/05/2023] Open
Abstract
BACKGROUND Local governments play an important role in improving public health outcomes globally, critical to this work is applying the best-available research evidence. Despite considerable exploration of research use in knowledge translation literature, how research is practically applied by local governments remains poorly understood. This systematic review examined research evidence use in local government-led public health interventions. It focused on how research was used and the type of intervention being actioned. METHODS Quantitative and qualitative literature published between 2000 and 2020 was searched for studies that described research evidence use by local governments in public health interventions. Studies reporting interventions developed outside of local government, including knowledge translation interventions, were excluded. Studies were categorised by intervention type and their level of description of research evidence use (where 'level 1' was the highest and 'level 3' was the lowest level of detail). FINDINGS The search identified 5922 articles for screening. A final 34 studies across ten countries were included. Experiences of research use varied across different types of interventions. However, common themes emerged including the demand for localised research evidence, the legitimising role of research in framing public health issues, and the need for integration of different evidence sources. CONCLUSIONS Differences in how research was used were observed across different local government public health interventions. Knowledge translation interventions aiming to increase research use in local government settings should consider known barriers and facilitators and consider contextual factors associated with different localities and interventions.
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Affiliation(s)
- Jennifer L Dam
- Monash Sustainable Development Institute, Monash University, 8 Scenic Boulevard, Clayton Campus, Clayton, VIC, 3800, Australia.
| | - Phoebe Nagorka-Smith
- School of Health and Social Development, Institute for Health Transformation, Deakin University, 1 Gheringhap Street, Geelong, VIC, 3220, Australia
| | - Alex Waddell
- Action Lab, Monash University, 8 Scenic Boulevard, Clayton Campus, Clayton, VIC, 3800, Australia
| | - Annemarie Wright
- Victorian Department of Health and Human Services, 50 Lonsdale Street, Melbourne, VIC, 3000, Australia
- Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie Street, VIC, 3053, Carlton, Australia
| | - Joannette J Bos
- Monash Sustainable Development Institute, Monash University, 8 Scenic Boulevard, Clayton Campus, Clayton, VIC, 3800, Australia
| | - Peter Bragge
- Monash Sustainable Development Institute, Monash University, 8 Scenic Boulevard, Clayton Campus, Clayton, VIC, 3800, Australia
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Melo G, Aguilar-Farias N, López Barrera E, Chomalí L, Moz-Christofoletti MA, Salgado JC, Swensson LJ, Caro JC. Structural responses to the obesity epidemic in Latin America: what are the next steps for food and physical activity policies? LANCET REGIONAL HEALTH. AMERICAS 2023; 21:100486. [PMID: 37096192 PMCID: PMC10122054 DOI: 10.1016/j.lana.2023.100486] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 02/12/2023] [Accepted: 03/20/2023] [Indexed: 04/26/2023]
Abstract
Obesity is among the most complex public health challenges, particularly in Latin America, where obesity rates have increased faster than in any other region. Many countries have proposed or enacted comprehensive policies to promote adequate diet and physical activity under a structural framework. We summarize articles discussing the scope and impact of recently implemented obesity-related interventions in the light of a structural response framework. Overall, we find that: (1) market-based food interventions, including taxes on junk food, nutrition labelling, and marketing restrictions, decrease the consumption of targeted foods, (2) programs directly providing healthy foods are effective in reducing obesity, and (3) the construction of public areas for recreation increases the average frequency of physical activity. Although obesity-related interventions in the region have somewhat improved health behaviours, obesity prevalence remains on an upward trend. We discuss some opportunities to continue tackling the obesity epidemic in LATAM under a structural framework.
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Affiliation(s)
- Grace Melo
- Accountability, Climate, Equity, and Scholarship (ACES), Department of Agricultural Economics, Texas A&M, College Station, TX, USA
| | - Nicolas Aguilar-Farias
- Department of Physical Education, Sports and Recreation, Universidad de la Frontera, Chile
| | | | | | | | - Juan Carlos Salgado
- Center for Nutrition and Health Research, National Institute of Public Health and National Council for Science and Technology, Mexico
| | - Luana Joppert Swensson
- Policy and Legal Specialist for Sustainable Public Procurement, Food and Agriculture Organization, Italy
| | - Juan Carlos Caro
- Department of Industrial Engineering, University of Concepción, Chile
- Corresponding author. Department of Industrial Engineering, University of Concepción, Chile, Edmundo Larenas 219, Concepción, Chile.
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Lytvyak E, Straube S, Modi R, Lee KK. Trends in obesity across Canada from 2005 to 2018: a consecutive cross-sectional population-based study. CMAJ Open 2022; 10:E439-E449. [PMID: 35609927 PMCID: PMC9259440 DOI: 10.9778/cmajo.20210205] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Obesity is increasingly prevalent worldwide and is becoming an epidemic in many countries, including Canada. We sought to describe and analyze temporal obesity trends in the Canadian adult population from 2005 through 2018 at the national and provincial or territorial levels. METHODS We conducted a consecutive, cross-sectional study using data from 7 sequential Canadian Community Health Survey (CCHS) cycles (2005 to 2017/18). We included data from Canadian adults (age ≥ 18 yr) who participated in at least 1 of the 7 consecutive CCHS cycles and who had body mass index values (calculated by Statistics Canada based on respondents' self-reported weight and height). Obesity prevalence (adjusted body mass index ≥ 30) was a primary outcome variable. We analyzed temporal trends in obesity prevalence using Pearson χ2 tests with Bonferroni adjustment, and the Cochran-Armitage test of trend. RESULTS We included data from 746 408 (403 582 female and 342 826 male) CCHS participants. Across Canada, the prevalence of obesity increased significantly between 2005 and 2017/18, from 22.2% to 27.2% (p < 0.001). We observed increases across both sexes, all age groups and all Canadian provinces and territories (p < 0.001). In 2017/18, the prevalence of obesity was higher among males than females (28.9% v. 25.4%; p < 0.001); the prevalence among adults aged 40-69 years exceeded 30%. In 2017/18, Newfoundland and Labrador had the highest prevalence (39.4%), and British Columbia had the lowest (22.8%) prevalence of obesity. Over the 14-year study period, Quebec and Alberta exhibited the largest relative increases in obesity. INTERPRETATION In 2017/18, more than 1 in 4 adult Canadians lived with obesity, and from 2005 to 2017/18, the prevalence of obesity among adults in Canada increased substantially across sexes, age groups and all Canadian provinces and territories to 27.2%. Our findings call for urgent actions to identify, implement and evaluate solutions for obesity prevention and management in all Canadian provinces and territories.
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Affiliation(s)
- Ellina Lytvyak
- Division of Preventive Medicine (Lytvyak, Straube, Lee); Department of Family Medicine (Modi), University of Alberta; Edmonton Adult Bariatric Specialty Clinic (Modi), Alberta Health Services, Edmonton, Alta.
| | - Sebastian Straube
- Division of Preventive Medicine (Lytvyak, Straube, Lee); Department of Family Medicine (Modi), University of Alberta; Edmonton Adult Bariatric Specialty Clinic (Modi), Alberta Health Services, Edmonton, Alta
| | - Renuca Modi
- Division of Preventive Medicine (Lytvyak, Straube, Lee); Department of Family Medicine (Modi), University of Alberta; Edmonton Adult Bariatric Specialty Clinic (Modi), Alberta Health Services, Edmonton, Alta
| | - Karen K Lee
- Division of Preventive Medicine (Lytvyak, Straube, Lee); Department of Family Medicine (Modi), University of Alberta; Edmonton Adult Bariatric Specialty Clinic (Modi), Alberta Health Services, Edmonton, Alta
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Petrovskis A, Baquero B, Bekemeier B. Involvement of Local Health Departments in Obesity Prevention: A Scoping Review. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2022; 28:E345-E353. [PMID: 33729187 PMCID: PMC8781226 DOI: 10.1097/phh.0000000000001346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Local health department (LHD) obesity prevention (OP) efforts, particularly by rural LHDs, are seemingly uncommon, in part, due to limited infrastructure, workforce capacity, accessible data, and available population-level interventions aimed at social determinants of health (SDOH). METHODS We conducted a scoping review to determine LHD roles in OP efforts and interventions. Inclusion criteria were articles including evidence-based OP and LHD leaders or staff. Articles were coded by type of LHD involvement, data use, intervention characteristics, use of an SDOH lens, and urban or rural setting. RESULTS We found 154 articles on LHD OP-52 articles met inclusion criteria. Typically, LHDs engaged in only surveillance, initial intervention development, or evaluation and were not LHD led. Data and SDOH lens use were infrequent, and interventions typically took place in urban settings. CONCLUSION LHDs could likely play a greater role in OP and population-level interventions and use data in intervention decision making. However, literature is limited. Future research should focus on LHD capacity building, including academic-public health partnerships. Studies should include rural populations, data, and SDOH frameworks addressing "upstream" factors.
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Affiliation(s)
- Anna Petrovskis
- School of Nursing (Ms Petrovskis and Dr Bekemeier), and Department of Health Services, School of Public Health (Dr Baquero), University of Washington, Seattle, Washington
| | - Barbara Baquero
- School of Nursing (Ms Petrovskis and Dr Bekemeier), and Department of Health Services, School of Public Health (Dr Baquero), University of Washington, Seattle, Washington
| | - Betty Bekemeier
- School of Nursing (Ms Petrovskis and Dr Bekemeier), and Department of Health Services, School of Public Health (Dr Baquero), University of Washington, Seattle, Washington
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Omura JD, Kochtitzky CS, Galuska DA, Fulton JE, Shah S, Carlson SA. Public Health Representation on Active Transportation Bodies Across US Municipalities. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2022; 28:E119-E126. [PMID: 32487920 PMCID: PMC10939047 DOI: 10.1097/phh.0000000000001170] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
CONTEXT Municipal bodies such as planning or zoning commissions and active transportation advisory committees can influence decisions made by local governments that support physical activity through active transportation. Public health professionals are encouraged to participate in and inform these processes. However, the extent of such collaboration among US municipalities is currently unknown. OBJECTIVE To estimate the prevalence of active transportation bodies among US municipalities and the proportion with a designated public health representative. DESIGN A cross-sectional survey administered from May through September 2014. SETTING Nationally representative sample of US municipalities with populations of 1000 or more people. PARTICIPANTS Respondents were the city or town manager, planner, or person with similar responsibilities (N = 2018). MAIN OUTCOME MEASURES The prevalence of planning or zoning commissions and active transportation advisory committees among municipalities and whether there was a designated public health representative on them. RESULTS Approximately 90.9% of US municipalities have a planning or zoning commission, whereas only 6.5% of these commissions have a designated public health representative. In contrast, while 16.5% of US municipalities have an active transportation advisory committee, 22.4% of them have a designated public health representative. These active transportation bodies are less common among municipalities that are smaller, rural, located in the South, and where population educational attainment is lower. Overall, few US municipalities have a planning or zoning commission (5.9%) or an active transportation advisory committee (3.7%) that also has a designated public health representative. CONCLUSIONS Approximately 9 in 10 US municipalities have a planning or zoning commission, whereas only 1 in 6 has an active transportation advisory committee. Public health representation on active transportation bodies across US municipalities is low. Increasing the adoption of active transportation advisory committees and ensuring a designated public health representative on active transportation bodies may help promote the development of activity-friendly communities across the United States.
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Affiliation(s)
- John D. Omura
- Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, GA
| | - Christopher S. Kochtitzky
- Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, GA
| | - Deborah A. Galuska
- Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, GA
| | - Janet E. Fulton
- Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, GA
| | - Sagar Shah
- American Planning Association, Washington, DC
| | - Susan A. Carlson
- Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, GA
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Lemon SC, Goins KV, Sreedhara M, Arcaya M, Aytur SA, Heinrich K, Kerner B, Lyn R, Maddock JE, Riessman R, Schmid TL. Developing Core Capabilities for Local Health Departments to Engage in Land Use and Transportation Decision Making for Active Transportation. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2020; 25:464-471. [PMID: 31348161 PMCID: PMC6684222 DOI: 10.1097/phh.0000000000000948] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To develop a core set of capabilities and tasks for local health departments (LHDs) to engage in land use and transportation policy processes that promote active transportation. DESIGN We conducted a 3-phase modified Delphi study from 2015 to 2017. SETTING We recruited a multidisciplinary national expert panel for key informant interviews by telephone and completion of a 2-step online validation process. PARTICIPANTS The panel consisted of 58 individuals with expertise in local transportation and policy processes, as well as experience in cross-sector collaboration with public health. Participants represented the disciplines of land use planning, transportation/public works, public health, municipal administration, and active transportation advocacy at the state and local levels. MAIN OUTCOME MEASURES Key informant interviews elicited initial capabilities and tasks. An online survey solicited rankings of impact and feasibility for capabilities and ratings of importance for associated tasks. Feasibility rankings were used to categorize capabilities according to required resources. Results were presented via second online survey for final input. RESULTS Ten capabilities were categorized according to required resources. Fewest resources were as follows: (1) collaborate with public officials; (2) serve on land use or transportation board; and (3) review plans, policies, and projects. Moderate resources were as follows: (4) outreach to the community; (5) educate policy makers; (6) participate in plan and policy development; and (7) participate in project development and design review. Most resources were as follows: (8) participate in data and assessment activities; (9) fund dedicated staffing; and (10) provide funding support. CONCLUSIONS These actionable capabilities can guide planning efforts for LHDs of all resource levels.
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Affiliation(s)
- Stephenie C. Lemon
- UMass Worcester Prevention Research Center, University of Massachusetts Medical School, Worcester, Massachusetts (Dr Lemon and Mss Goins and Sreedhara); Department of Urban Studies and Planning, Massachusetts Institute of Technology, Cambridge, Massachusetts (Dr Arcaya); Department of Health Management and Policy, University of New Hampshire, Durham, New Hampshire (Dr Aytur); Department of Kinesiology, Kansas State University, Manhattan, Kansas (Dr Heinrich); National Association of County and City Health Officials, Washington, District of Columbia (Ms Kerner); Division of Health Management and Policy, Georgia State University, Atlanta, Georgia (Dr Lyn); School of Public Health, Texas A&M University, College Station, Texas (Dr Maddock); UMass Transportation Center, University of Massachusetts Amherst, Amherst, Massachusetts (Ms Riessman); and Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, Georgia (Dr Schmid)
| | - Karin Valentine Goins
- UMass Worcester Prevention Research Center, University of Massachusetts Medical School, Worcester, Massachusetts (Dr Lemon and Mss Goins and Sreedhara); Department of Urban Studies and Planning, Massachusetts Institute of Technology, Cambridge, Massachusetts (Dr Arcaya); Department of Health Management and Policy, University of New Hampshire, Durham, New Hampshire (Dr Aytur); Department of Kinesiology, Kansas State University, Manhattan, Kansas (Dr Heinrich); National Association of County and City Health Officials, Washington, District of Columbia (Ms Kerner); Division of Health Management and Policy, Georgia State University, Atlanta, Georgia (Dr Lyn); School of Public Health, Texas A&M University, College Station, Texas (Dr Maddock); UMass Transportation Center, University of Massachusetts Amherst, Amherst, Massachusetts (Ms Riessman); and Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, Georgia (Dr Schmid)
| | - Meera Sreedhara
- UMass Worcester Prevention Research Center, University of Massachusetts Medical School, Worcester, Massachusetts (Dr Lemon and Mss Goins and Sreedhara); Department of Urban Studies and Planning, Massachusetts Institute of Technology, Cambridge, Massachusetts (Dr Arcaya); Department of Health Management and Policy, University of New Hampshire, Durham, New Hampshire (Dr Aytur); Department of Kinesiology, Kansas State University, Manhattan, Kansas (Dr Heinrich); National Association of County and City Health Officials, Washington, District of Columbia (Ms Kerner); Division of Health Management and Policy, Georgia State University, Atlanta, Georgia (Dr Lyn); School of Public Health, Texas A&M University, College Station, Texas (Dr Maddock); UMass Transportation Center, University of Massachusetts Amherst, Amherst, Massachusetts (Ms Riessman); and Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, Georgia (Dr Schmid)
| | - Mariana Arcaya
- UMass Worcester Prevention Research Center, University of Massachusetts Medical School, Worcester, Massachusetts (Dr Lemon and Mss Goins and Sreedhara); Department of Urban Studies and Planning, Massachusetts Institute of Technology, Cambridge, Massachusetts (Dr Arcaya); Department of Health Management and Policy, University of New Hampshire, Durham, New Hampshire (Dr Aytur); Department of Kinesiology, Kansas State University, Manhattan, Kansas (Dr Heinrich); National Association of County and City Health Officials, Washington, District of Columbia (Ms Kerner); Division of Health Management and Policy, Georgia State University, Atlanta, Georgia (Dr Lyn); School of Public Health, Texas A&M University, College Station, Texas (Dr Maddock); UMass Transportation Center, University of Massachusetts Amherst, Amherst, Massachusetts (Ms Riessman); and Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, Georgia (Dr Schmid)
| | - Semra A. Aytur
- UMass Worcester Prevention Research Center, University of Massachusetts Medical School, Worcester, Massachusetts (Dr Lemon and Mss Goins and Sreedhara); Department of Urban Studies and Planning, Massachusetts Institute of Technology, Cambridge, Massachusetts (Dr Arcaya); Department of Health Management and Policy, University of New Hampshire, Durham, New Hampshire (Dr Aytur); Department of Kinesiology, Kansas State University, Manhattan, Kansas (Dr Heinrich); National Association of County and City Health Officials, Washington, District of Columbia (Ms Kerner); Division of Health Management and Policy, Georgia State University, Atlanta, Georgia (Dr Lyn); School of Public Health, Texas A&M University, College Station, Texas (Dr Maddock); UMass Transportation Center, University of Massachusetts Amherst, Amherst, Massachusetts (Ms Riessman); and Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, Georgia (Dr Schmid)
| | - Katie Heinrich
- UMass Worcester Prevention Research Center, University of Massachusetts Medical School, Worcester, Massachusetts (Dr Lemon and Mss Goins and Sreedhara); Department of Urban Studies and Planning, Massachusetts Institute of Technology, Cambridge, Massachusetts (Dr Arcaya); Department of Health Management and Policy, University of New Hampshire, Durham, New Hampshire (Dr Aytur); Department of Kinesiology, Kansas State University, Manhattan, Kansas (Dr Heinrich); National Association of County and City Health Officials, Washington, District of Columbia (Ms Kerner); Division of Health Management and Policy, Georgia State University, Atlanta, Georgia (Dr Lyn); School of Public Health, Texas A&M University, College Station, Texas (Dr Maddock); UMass Transportation Center, University of Massachusetts Amherst, Amherst, Massachusetts (Ms Riessman); and Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, Georgia (Dr Schmid)
| | - Bridget Kerner
- UMass Worcester Prevention Research Center, University of Massachusetts Medical School, Worcester, Massachusetts (Dr Lemon and Mss Goins and Sreedhara); Department of Urban Studies and Planning, Massachusetts Institute of Technology, Cambridge, Massachusetts (Dr Arcaya); Department of Health Management and Policy, University of New Hampshire, Durham, New Hampshire (Dr Aytur); Department of Kinesiology, Kansas State University, Manhattan, Kansas (Dr Heinrich); National Association of County and City Health Officials, Washington, District of Columbia (Ms Kerner); Division of Health Management and Policy, Georgia State University, Atlanta, Georgia (Dr Lyn); School of Public Health, Texas A&M University, College Station, Texas (Dr Maddock); UMass Transportation Center, University of Massachusetts Amherst, Amherst, Massachusetts (Ms Riessman); and Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, Georgia (Dr Schmid)
| | - Rodney Lyn
- UMass Worcester Prevention Research Center, University of Massachusetts Medical School, Worcester, Massachusetts (Dr Lemon and Mss Goins and Sreedhara); Department of Urban Studies and Planning, Massachusetts Institute of Technology, Cambridge, Massachusetts (Dr Arcaya); Department of Health Management and Policy, University of New Hampshire, Durham, New Hampshire (Dr Aytur); Department of Kinesiology, Kansas State University, Manhattan, Kansas (Dr Heinrich); National Association of County and City Health Officials, Washington, District of Columbia (Ms Kerner); Division of Health Management and Policy, Georgia State University, Atlanta, Georgia (Dr Lyn); School of Public Health, Texas A&M University, College Station, Texas (Dr Maddock); UMass Transportation Center, University of Massachusetts Amherst, Amherst, Massachusetts (Ms Riessman); and Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, Georgia (Dr Schmid)
| | - Jay E. Maddock
- UMass Worcester Prevention Research Center, University of Massachusetts Medical School, Worcester, Massachusetts (Dr Lemon and Mss Goins and Sreedhara); Department of Urban Studies and Planning, Massachusetts Institute of Technology, Cambridge, Massachusetts (Dr Arcaya); Department of Health Management and Policy, University of New Hampshire, Durham, New Hampshire (Dr Aytur); Department of Kinesiology, Kansas State University, Manhattan, Kansas (Dr Heinrich); National Association of County and City Health Officials, Washington, District of Columbia (Ms Kerner); Division of Health Management and Policy, Georgia State University, Atlanta, Georgia (Dr Lyn); School of Public Health, Texas A&M University, College Station, Texas (Dr Maddock); UMass Transportation Center, University of Massachusetts Amherst, Amherst, Massachusetts (Ms Riessman); and Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, Georgia (Dr Schmid)
| | - Robin Riessman
- UMass Worcester Prevention Research Center, University of Massachusetts Medical School, Worcester, Massachusetts (Dr Lemon and Mss Goins and Sreedhara); Department of Urban Studies and Planning, Massachusetts Institute of Technology, Cambridge, Massachusetts (Dr Arcaya); Department of Health Management and Policy, University of New Hampshire, Durham, New Hampshire (Dr Aytur); Department of Kinesiology, Kansas State University, Manhattan, Kansas (Dr Heinrich); National Association of County and City Health Officials, Washington, District of Columbia (Ms Kerner); Division of Health Management and Policy, Georgia State University, Atlanta, Georgia (Dr Lyn); School of Public Health, Texas A&M University, College Station, Texas (Dr Maddock); UMass Transportation Center, University of Massachusetts Amherst, Amherst, Massachusetts (Ms Riessman); and Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, Georgia (Dr Schmid)
| | - Thomas L. Schmid
- UMass Worcester Prevention Research Center, University of Massachusetts Medical School, Worcester, Massachusetts (Dr Lemon and Mss Goins and Sreedhara); Department of Urban Studies and Planning, Massachusetts Institute of Technology, Cambridge, Massachusetts (Dr Arcaya); Department of Health Management and Policy, University of New Hampshire, Durham, New Hampshire (Dr Aytur); Department of Kinesiology, Kansas State University, Manhattan, Kansas (Dr Heinrich); National Association of County and City Health Officials, Washington, District of Columbia (Ms Kerner); Division of Health Management and Policy, Georgia State University, Atlanta, Georgia (Dr Lyn); School of Public Health, Texas A&M University, College Station, Texas (Dr Maddock); UMass Transportation Center, University of Massachusetts Amherst, Amherst, Massachusetts (Ms Riessman); and Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, Georgia (Dr Schmid)
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Sreedhara M, Goins KV, Aytur SA, Lyn R, Maddock JE, Riessman R, Schmid TL, Wooten H, Lemon SC. Qualitative Exploration of Cross-Sector Perspectives on the Contributions of Local Health Departments in Land-Use and Transportation Policy. Prev Chronic Dis 2017; 14:E118. [PMID: 29166249 PMCID: PMC5703652 DOI: 10.5888/pcd14.170226] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
INTRODUCTION Transportation and land-use policies can affect the physical activity of populations. Local health departments (LHDs) are encouraged to participate in built-environment policy processes, which are outside their traditional expertise. Cross-sector collaborations are needed, yet stakeholders' perceptions of LHD involvement are not well understood. The objective of this study was to describe the perceived value of LHD participation in transportation and land-use decision making and potential contributions to these processes among stakeholders. METHODS We analyzed qualitative data from 49 semistructured interviews in 2015. Participants were professionals in 13 US states and 4 disciplines: land-use planning (n = 13), transportation/public works (n = 11), public health (n = 19), and other (municipal administration and bike and pedestrian advocacy [n = 6]). Two analysts conducted directed content analysis. RESULTS All respondents reported that LHDs offer valuable contributions to transportation and land-use policy processes. They identified 7 contributions (interrater agreement 91%): 1) physical activity and health perspective (n = 44), 2) data analysis and assessment (n = 41), 3) partnerships in the community and across sectors (n = 35), 4) public education (n = 27), 5) knowledge of the public health evidence base and best practices (n = 23), 6) resource support (eg, grant writing, technical assistance) (n = 20), and 7) health equity (n = 8). CONCLUSION LHDs can leverage their strengths to foster cross-sector collaborations that promote physical activity opportunities in communities. Our results will inform development of sustainable capacity-building models for LHD involvement in built-environment decision making.
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Affiliation(s)
- Meera Sreedhara
- University of Massachusetts Medical School, Worcester, Massachusetts
| | | | | | - Rodney Lyn
- Georgia State University, Atlanta, Georgia
| | | | - Robin Riessman
- University of Massachusetts Amherst, Amherst, Massachusetts
| | - Thomas L Schmid
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Stephenie C Lemon
- UMass Worcester Prevention Research Center, Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, 55 Lake Ave North, Worcester, MA 01655.
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Kelly PM, Davies A, Greig AJM, Lee KK. Obesity Prevention in a City State: Lessons from New York City during the Bloomberg Administration. Front Public Health 2016; 4:60. [PMID: 27064755 PMCID: PMC4812825 DOI: 10.3389/fpubh.2016.00060] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Accepted: 03/18/2016] [Indexed: 11/18/2022] Open
Abstract
Objective To illuminate the key components of multi-sector reform to address the obesogenic environment in New York City during the administration of Mayor Michael Bloomberg from 2002 to 2013, we conducted a case study consisting of interviews with and a critical analysis of the experiences of leading decision makers and implementers. Method Key informant interviews (N = 41) conducted in 2014 were recorded, transcribed, coded, and thematically analyzed. Participants included officials from the Health Department and other New York City Government agencies, academics, civil society members, and private sector executives. Results Participants described Mayor Bloomberg as a data-driven politician who wanted to improve the lives of New Yorkers. He appointed talented Commissioners and encouraged them and their staff to be bold, innovative, and collaborative. Multiple programs spanning multiple sectors, with varied approaches and targets, were supported. This study found that much of the work relied on loose coalitions across City Government, with single agencies responsible for their own agendas, some with health co-benefits. Many policies were implemented through non-legislative mechanisms such as executive orders and the Health Code. Despite support from academic and some civil society groups, strong lobbying from industry and an unfavorable media led to some reforms being modified, legally challenged or blocked completely, particularly food environment modifiers. In contrast, reforms of the physical environment were described as highly consultative across and outside government and resulted in slower but more sustained reform. Conclusion The Bloomberg administration was a “window of opportunity” with the imprimatur of the executive to progress a long-term, multi-faceted obesity prevention strategy, which has successfully reversed childhood trends. Through the involvement of external researchers and the extensive use of empirical data from a wide range of participants, this study offers a unique insight into the ways in which this was achieved. While some of the aspects of the reforms in New York City are unique to that setting at that time, there are important lessons that are transferable to other urban settings. These include: strong and consistent leadership; a commitment to innovative approaches and cross-sectoral collaboration; and a context to support and encourage this approach.
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Affiliation(s)
- Paul M Kelly
- ACT Health, Canberra, ACT, Australia; Australian National University Medical School, Canberra, ACT, Australia
| | | | - Alexandra J M Greig
- ACT Health, Canberra, ACT, Australia; Department of Health, Australian Government, Canberra, ACT, Australia
| | - Karen K Lee
- Dr. Karen Lee Health+Built Environment+Social Determinants Consulting, New York City, NY, USA; School of Public Health, University of Toronto, Toronto, ON, Canada; School of Public Health, University of Alberta, Edmonton, AB, Canada
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Goins KV, Ye J, Leep CJ, Robin N, Lemon SC. Local Health Department Engagement in Community Physical Activity Policy. Am J Prev Med 2016; 50:57-68. [PMID: 26410187 DOI: 10.1016/j.amepre.2015.06.033] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2015] [Revised: 06/10/2015] [Accepted: 07/02/2015] [Indexed: 10/23/2022]
Abstract
INTRODUCTION This study assessed correlates of self-reported local health department (LHD) participation in community policy/advocacy activities that support physical activity. METHODS In 2014, cross-sectional data from the nationally representative 2013 National Profile of Local Health Departments study administered by the National Association of County and City Health Officials were analyzed. Outcomes were participation in policy/advocacy activities related to urban design/land use, active transportation, and access to recreational facilities. Independent variables included structural characteristics, performance improvement efforts, and collaboration. Multivariate logistic regression models were computed. RESULTS Representatives of 490 LHDs participated (79% response rate). Respondents reported similar participation in urban design/land use (25%); active transportation (16%); and recreational facility access (23%) policy/advocacy. LHDs with populations of ≥500,000 were more likely to report urban design/land use (p=0.004) as well as active transportation policy/advocacy participation (p=0.007) compared with those with populations of ≤50,000. LHDs with a community health improvement plan were more likely to participate in urban design/land use policy/advocacy (p=0.001). LHDs who regularly use the Community Guide were more likely to report policy/advocacy activity on active transportation (p=0.007) and expanding access to recreation facilities (p=0.009). LHDs engaged in a land use partnership were more likely to report urban design/land use (p<0.001) and active transportation (p=0.001) policy/advocacy participation. CONCLUSIONS Participation in community physical activity policy/advocacy among LHDs was low in this study and varied by LHD characteristics. Intervention opportunities include assisting smaller LHDs and promoting performance improvement efforts and evidence-based practice resources.
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Affiliation(s)
- Karin V Goins
- Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester, Massachusetts
| | - Jiali Ye
- National Association of County and City Health Officials, Washington, District of Columbia
| | - Carolyn J Leep
- National Association of County and City Health Officials, Washington, District of Columbia
| | - Nathalie Robin
- National Association of County and City Health Officials, Washington, District of Columbia
| | - Stephenie C Lemon
- Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester, Massachusetts.
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Piercy KL, Dorn JM, Fulton JE, Janz KF, Lee SM, McKinnon RA, Pate RR, Pfeiffer KA, Young DR, Troiano RP, Lavizzo-Mourey R. Opportunities for public health to increase physical activity among youths. Am J Public Health 2015; 105:421-6. [PMID: 25602864 PMCID: PMC4330821 DOI: 10.2105/ajph.2014.302325] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/11/2014] [Indexed: 11/04/2022]
Abstract
Despite the well-known benefits of youths engaging in 60 or more minutes of daily physical activity, physical inactivity remains a significant public health concern. The 2008 Physical Activity Guidelines for Americans (PAG) provides recommendations on the amount of physical activity needed for overall health; the PAG Midcourse Report (2013) describes effective strategies to help youths meet these recommendations. Public health professionals can be dynamic change agents where youths live, learn, and play by changing environments and policies to empower youths to develop regular physical activity habits to maintain throughout life. We have summarized key findings from the PAG Midcourse Report and outlined actions that public health professionals can take to ensure that all youths regularly engage in health-enhancing physical activity.
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Affiliation(s)
- Katrina L Piercy
- Katrina L. Piercy is with the Office of Disease Prevention and Health Promotion, US Department of Health and Human Services, Rockville, MD. Joan M. Dorn, Janet E. Fulton, and Sarah M. Lee are with the US Department of Health and Human Services, Centers for Disease Control and Prevention, Atlanta, GA. Kathleen F. Janz is with the Department of Health and Human Physiology, University of Iowa, Iowa City. Robin A. McKinnon and Richard P. Troiano are with the US Department of Health and Human Services, National Institutes of Health, Bethesda, MD. Russell R. Pate is with the Department of Exercise Science, University of South Carolina, Columbia. Karin A. Pfeiffer is with the Department of Kinesiology, Michigan State University, East Lansing. Deborah Rohm Young is with the Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA. Risa Lavizzo-Mourey is with the Robert Wood Johnson Foundation, Princeton, NJ
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Veatch M, Goldstein GP, Sacks R, Lent M, Van Wye G. Institution-to-institution mentoring to build capacity in 24 local US health departments: best practices and lessons learned. Prev Chronic Dis 2014; 11:E168. [PMID: 25275805 PMCID: PMC4184087 DOI: 10.5888/pcd11.140017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Introduction Institutional mentoring may be a useful capacity-building model to support local health departments facing public health challenges. The New York City Department of Health and Mental Hygiene conducted a qualitative evaluation of an institutional mentoring program designed to increase capacity of health departments seeking to address chronic disease prevention. The mentoring program included 2 program models, a one-to-one model and a collaborative model, developed and implemented for 24 Communities Putting Prevention to Work grantee communities nationwide. Methods We conducted semi-structured telephone interviews to assess grantees’ perspectives on the effectiveness of the mentoring program in supporting their work. Two interviews were conducted with key informants from each participating community. Three evaluators coded and analyzed data using ATLAS.ti software and using grounded theory to identify emerging themes. Results We completed 90 interviews with 44 mentees. We identified 7 key program strengths: learning from the New York City health department’s experience, adapting resources to local needs, incorporating new approaches and sharing strategies, developing the mentor–mentee relationship, creating momentum for action, establishing regular communication, and encouraging peer interaction. Conclusion Participants overwhelmingly indicated that the mentoring program’s key strengths improved their capacity to address chronic disease prevention in their communities. We recommend dissemination of the results achieved, emphasizing the need to adapt the institutional mentoring model to local needs to achieve successful outcomes. We also recommend future research to consider whether a hybrid programmatic model that includes regular one-on-one communication and in-person conferences could be used as a standard framework for institutional mentoring.
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Affiliation(s)
- Maggie Veatch
- Nutrition and Physical Activity, Brooklyn District Public Health Office, New York City Department of Health and Mental Hygiene, 485 Throop Ave, Brooklyn NY 11221. E-mail:
| | - Gail P Goldstein
- Bureau of Alcohol and Drug Use Prevention, Care and Treatment, New York City Department of Health and Mental Hygiene, Queens, New York
| | - Rachel Sacks
- Bureau of Chronic Disease Prevention and Tobacco Control, New York City Department of Health and Mental Hygiene, Queens, New York
| | - Megan Lent
- Bureau of Chronic Disease Prevention and Tobacco Control, New York City Department of Health and Mental Hygiene, Queens, New York
| | - Gretchen Van Wye
- Bureau of Vital Statistics, New York City Department of Health and Mental Hygiene, New York, New York
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