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Strengthen the Evidence for Maternal and Child Health Programs

New: MCHbest strategies database for sample ESMs

Evidence Tools
MCHbest. NPM 8: Physical Activity

MCH Best Logo five children on bicycles

Strategy. Activity-Friendly Routes to Everyday Destinations

Approach. Use built environment approaches to create or enhance community characteristics to make physical activity easier, more appealing, and more accessible.

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Overview. Research indicates that communities with activity-friendly features, such as Complete Streets policies and streetscape design initiatives, zoning policies, comprehensive or master plans, and Safe Routes to Schools and Safe Routes to Parks, report higher physical activity among residents, including children, than those without these features.1, 2 Examples of studies with positive outcomes were those where routes such as sidewalks, walking and hiking trails, bicycle lanes, and public transit connected to destinations such as parks, green spaces, stores, homes, schools, worksites, and libraries.3

Evidence. Scientifically Rigorous. There is strong evidence that streetscape design improvements and improvements to pedestrian or bicycle transportation systems and environmental design interventions increase physical activity. These strategies have been tested more than once and results trend positive overall. Access the peer-reviewed evidence through the MCH Digital Library. (Read more about understanding evidence ratings).

Target Audience. Community.

Outcome. Increase in overall physical activity in children. For detailed outcomes related to each study supporting this strategy, click on the peer-reviewed evidence link above and read the “Intervention Results” for each study.

Examples from the Field. Access descriptions of current ESMs that use this strategy directly or intervention components that aligns with this strategy. You can use these ESMs to see how other Title V agencies are addressing the NPM.

Sample ESMs. Using the approach “Use built environment approaches to create or enhance community characteristics to make physical activity easier, more appealing, and more accessible,” here are sample ESMs you can use as a model for your own measures using the Results-Based Accountability framework (for suggestions on how to develop programs to support this strategy, see The Role of Title V in Adapting Strategies):

Quadrant 1:
Measuring Quantity of Effort
("What/how much did we do?")

  • Number of communities that have implemented Complete Streets policies to support safe and convenient access to streets.
  • Number of communities that have comprehensive or master plans for zoning to promote physical activity.

Quadrant 2:
Measuring Quality of Effort
("How well did we do it?")

  • Percent of communities that have implemented Complete Streets policies to support safe and convenient access to streets.
  • Percent of communities that have evaluated active transportation options for elementary and school age children.

Quadrant 3:
Measuring Quantity of Effect
("Is anyone better off?")

  • Number of school districts that promote active transportation options.
  • Number of families who know about active travel to school.

Quadrant 4:
Measuring Quality of Effect
("How are they better off?")

  • Number of families surveyed who indicate knowledge about active travel to school.
  • Percent of families who report increased walking, biking, or use of other forms of active transportation to get to and from school.

Note. ESMs become stronger as they move from measuring quantity to measuring quality (moving from Quadrants 1 and 3, respectively, to Quadrants 2 and 4) and from measuring effort to measuring effect (moving from Quadrants 1 and 2, respectively, to Quadrants 3 and 4).

Learn More. Read how to create stronger ESMs and how to measure ESM impact more meaningfully through Results-Based Accountability.


References:

1 Calise TV, Heeren T, DeJong W, Dumith SC, Kohl HW 3rd. Do neighborhoods make people active, or do people make active neighborhoods? Evidence from a planned community in Austin, Texas. Prev Chronic Dis. 2013;10:E102.

2 Lee C, Zhu X, Xu M, Lee H, Ory M. Moving to an activity-friendly community can increase physical activity. Paper presented at: Active Living Conference; February 5, 2020; Orlando, FL.

3 Guide to Community Preventive Services. Physical activity: built environment approaches combining transportation system interventions with land use and environmental design. Systematic Review. 2016.

This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U02MC31613, MCH Advanced Education Policy, $3.5 M. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.