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Strengthen the Evidence for Maternal and Child Health Programs

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Evidence Tools
MCHbest. Physical Activity.

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Strategy. Policies to Promote Physical Activity

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. Local and national wellness policies effect school district-level goals for improving nutrition and physical activity settings.[1,2,3] Strongly worded local wellness policies coupled with active school wellness committees have effectively enforced wellness policies, improved activity and eating settings, and led to positive student body mass index and nutrition outcomes.[4]

Evidence. Mixed Evidence. Strategies based on mixed/limited evidence have produced varied results and their effectiveness is dependent on specific contexts and settings. Use pilot testing and monitoring to determine if these strategies achieve desired impact in local communities.

Access the peer-reviewed evidence through the MCH Digital Library or related evidence source.

Potential Data Sources. Data to support this strategy can be accessed through:

  • Policy adoption and implementation records
  • Community feedback surveys
  • Internal staff reports

Outcome Components. This strategy has shown to have impact on the following outcomes (Read more about these categories):

  • Environmental Health. This strategy improves the impact of physical, chemical, and biological factors in the environment on health.
  • Health and Health Behaviors/Behavior Change. This strategy improves individuals' physical and mental health and their adoption of healthy behaviors (e.g., healthy eating, physical activity).

Detailed Outcomes. For specific outcomes related to each study supporting this strategy, access the peer-reviewed evidence and read the Intervention Results for each study.

Intervention Type. Policy Development and Enforcement (Read more about intervention types and levels as defined by the Public Health Intervention Wheel).

Intervention Level. Community-Focused

Examples from the Field. Access descriptions of ESMs that use this strategy or aligned components.

Sample ESMs. Here are sample ESMs to use as models for your own measures using the RBA framework (see The Role of Title V in Adapting Strategies).

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

  • Number of new policies promoted by Title V developed to promote physical activity in schools, workplaces, and community settings. (Assesses policy creation)
  • Number of partnerships led by Title V formed with local organizations to implement physical activity policies. (Evaluates collaborative approach)

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

  • Percent of new policies promoted by Title V developed to promote physical activity in schools, workplaces, and community settings. (Assesses policy creation)
  • Percent of partnerships led by Title V formed with local organizations to implement physical activity policies. (Evaluates collaborative approach)

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

  • Number of training sessions conducted for staff on implementing physical activity policies that results in an increase in knowledge and/or skill. (Shows capacity building efforts)
  • Number of cross-sector collaborations led by Title V formed to support comprehensive physical activity policy implementation that report high levels of engagement. (Measures integrated approach)
  • Number of additional minutes of physical activity reported in settings with new policies supported by Title V. (Quantifies behavior change due to policies)
  • Number of policy-related improvements led by Title V in physical activity infrastructure for equipment. (Assesses tangible policy outcomes)

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

  • Percent of training sessions conducted for staff on implementing physical activity policies that results in an increase in knowledge and/or skill. (Shows capacity building efforts)
  • Percent of cross-sector collaborations led by Title V formed to support comprehensive physical activity policy implementation that report high levels of engagement. (Measures integrated approach)
  • Percent of additional minutes of physical activity reported in settings with new policies supported by Title V. (Quantifies behavior change due to policies)
  • Percent of policy-related improvements led by Title V in physical activity infrastructure for equipment. (Assesses tangible policy outcomes)

Note. When looking at your ESMs, SPMs, or other strategies:

  1. Move from measuring quantity to quality.
  2. Move from measuring effort to effect.
  3. Quadrant 1 strategies should be used sparingly, when no other data exists.
  4. The most effective measurement combines strategies in all levels, with most in Quadrants 2 and 4.

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

References

1 Szeszulski, J.; Walker, T.J.; McCurdy, S.A.; Hoelscher, D.M. Use of School Wellness Policy Templates in One Texas Public Health Region: A Mixed-Methods Analysis. J. Sch. Health 2021, 91, 562–573.

2 Francis, E.; Hivner, E.; Hoke, A.; Ricci, T.; Watach, A.; Kraschnewski, J. Quality of Local School Wellness Policies for Physical Activity and Resultant Implementation in Pennsylvania Schools. J. Sch. Health 2018, 40, 591–597.

3Kenney, E.L.; Barrett, J.L.; Bleich, S.N.; Ward, Z.J.; Cradock, A.L.; Gortmaker, S.L. Impact Of The Healthy, Hunger-Free Kids Act On Obesity Trends: Study Examines Impact of the Healthy, Hunger-Free Kids Act of 2010 on Childhood Obesity Trends. Health Aff. 2020, 39, 1122–1129.

4Au, L.E.; Crawford, P.B.; Woodward-Lopez, G.; Gurzo, K.; Kao, J.; Webb, K.L.; Ritchie, L.D. School Wellness Committees Are Associated With Lower Body Mass Index Z-Scores and Improved Dietary Intakes in US Children: The Healthy Communities Study. J. Sch. Health 2018, 88, 627–635.

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.