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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. Access to Places for Physical Activity

Approach. Support increased access to places for physical activity, and decreased financial costs of places for physical activity

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Overview. This multicomponent intervention is focused on increasing availability to places for physical activity by creating new community spaces and/or reducing costs at existing facilities. Oftentimes these strategies can include education or training for participants. Examples of studies with positive outcomes used a variety of efforts to increase availability to community space such as providing free passes to a local gym or YMCA.[1]

Evidence. Emerging Evidence. Strategies based on emerging evidence show promise but have not undergone extensive testing. While these approaches demonstrate potential, their effectiveness remains unconfirmed. Prioritize rigorous monitoring to ensure they achieve desired outcomes for all MCH populations.

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:

  • Partnership agreements and MOUs
  • Community resource directory updates and dissemination records
  • Qualitative data from partner interviews

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

  • 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).
  • Access to/Receipt of Care. This strategy increases the ability for individuals to obtain healthcare services when needed, including preventive, diagnostic, and treatment services.
  • Cost. This strategy helps to decrease the financial expenditure incurred by individuals, healthcare systems, and society in general for healthcare services.

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 community spaces designed and created by Title V for physical activity. (Assesses increase in physical activity resources)
  • Number of partnerships led by Title V formed with local facilities to provide free for reduced-cost access. (Evaluates community engagement)

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

  • Percent of new physical activity spaces designed with input from community members. (Measures comprehensive planning)
  • Percent of partnering facilities that offer relevant physical activity options. (Assesses appropriateness)

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

  • Number of local policies updated to support creation and maintenance of public physical activity spaces. (Shows policy-level changes)
  • Number of community programs led by Title V initiated to activate new for improved physical activity spaces. (Assesses programming to support usage)
  • Number of additional hours of physical activity reported by residents using new for improved spaces. (Quantifies behavior change)
  • Number of health improvements reported by regular users of new for subsidized physical activity spaces. (Assesses health impacts)

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

  • Percent of physical activity access resources allocated to neighborhoods with highest obesity rates. (Measures resource distribution)
  • Percent of new for improved spaces that are fully usable to people with disabilities. (Assesses design impact)
  • Percent increase in physical activity levels among residents, disaggregated by demographic factors. (Directly evaluates behavior change across subgroups)
  • Percent reduction in gaps in physical activity participation between different socioeconomic groups. (Measures improvements in health 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 Smith C, Clark AF, Wilk P, Tucker P, Gilliland JA. Assessing the effectiveness of a naturally occurring population-level physical activity intervention for children. Public Health. 2020;178:62-71.

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.