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Strengthening the evidence base for maternal and child health programs

New: MCH Best strategies database for sample ESMs

Evidence Tools
MCH Best. NPM 8: Physical Activity

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Strategy. Policies Regarding the Use and Promotion of Local Locations and Resources

Approach. Develop policies for the use of local locations and resources (e.g., sporting clubs, community centers, shopping malls, schools) and promote physical activity events at these locations.

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Overview. Community strategies, especially those rooted in the social-ecological model for behavior change [[link to or explain]], have shown to be effective in increasing levels of physical activity.1

Evidence. Mixed Evidence. Under certain circumstances, community-based strategies, such as those conducted at sporting clubs, community centers, shopping malls, and schools have been shown to be effective in increasing levels of physical activity, especially by providing an opportunity to reach disadvantage persons. This strategy has been tested more than once, and most studies produced results that trend positive. Access the peer-reviewed evidence through the MCH Digital Library. Access additional peer-reviewed evidence through the Cochrane Library. (Read more about understanding evidence ratings).

Target Audience. Community.

Outcome. Policies for use of local locations and increased level of physical activity. 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. There are currently 14 ESMs across all states/jurisdictions that use this strategy directly or intervention components that align with this strategy. Access descriptions of these ESMs through the MCH Digital Library. You can use these ESMs to see how other Title V agencies are addressing the NPM.

Sample ESMs. Using the approach “Adopt policies regarding open community use of school recreational areas,” 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 schools that adopt a policy regarding open community use of school recreational areas.

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

  • Percent of schools that adopt a policy regarding open community use of school recreational areas.

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

  • Number of schools that adopt a policy regarding open community use of school recreational areas that have an increase of play-space use during non-school hours.

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

  • Percent of schools that adopt a policy regarding open community use of school recreational areas that have an increase of play-space use during non-school hours.

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.


Reference:

1 Ockene, J. K., Edgerton, E. A., Teutsch, S. M., Marion, L. N., Miller, T., Genevro, J. L., ... & Briss, P. A. (2007). Integrating evidence-based clinical and community strategies to improve health. American Journal of Preventive Medicine, 32(3), 244-252.

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.