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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. Community-Based Social Support for Physical Activity

Approach. Shared-use agreements between communities and organizations for physical activity areas

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Overview. Community-based social support interventions combine physical activity opportunities with social support to build, strengthen, and maintain networks that encourage positive behavior change. These interventions may include education, group or individual counseling, and plans tailored to individual needs. Successful examples include walking groups, exercise 'buddy' systems, and the creation of contracts or physical activity goals with others (Hanson 2015, Cleland 2012).

Evidence. Scientifically Rigorous Evidence. Strategies based on scientifically rigorous evidence are proven effective across multiple robust studies. While success is highly likely, local impact may vary. Monitor outcomes and use data to tailor these strategies to the community's unique needs.

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:

  • Shared-use agreement inventory and characteristics databases
  • Community capacity building and technical assistance logs
  • Community perception and satisfaction surveys

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 shared-use agreements established between communities and organizations to increase access to physical activity areas. (Measures the implementation and reach of the intervention)
  • Number of physical activity areas (e.g., school gyms, parks, community centers) made available through shared-use agreements. (Quantifies the expansion of physical activity spaces)

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

  • Percent of shared-use agreements that include provisions for access, safety, and maintenance of physical activity areas. (Assesses the quality and comprehensiveness of the agreements)
  • Percent of shared-use physical activity spaces that are promoted through responsive and relevant outreach strategies. (Measures the responsiveness of the intervention)

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

  • Number of community-wide policies for resolutions passed to support and sustain shared-use agreements for physical activity. (Measures the institutionalization of the practice through policy)
  • Number of community organizations and champions trained to negotiate and implement effective shared-use agreements. (Assesses the capacity-building and leadership development aspect of the intervention)
  • Number of community partnerships and coalitions formed to support and maintain shared-use agreements over time. (Shows the long-term collaboration and sustainability of the intervention)
  • Number of communities that implement shared-use agreements as part of a comprehensive, multi-sector physical activity promotion strategy. (Assesses the integration and collective impact of the intervention)

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

  • Percent of shared-use agreements that prioritize access for communities facing challenges to physical activity resources. (Measures the focus on reach and access)
  • Percent of leadership and decision-making roles in shared-use agreement initiatives held by community members. (Measures the power-sharing and authentic engagement)
  • Percent reduction in gaps in physical activity levels between communities with differing levels of access to resources, following implementation of shared-use spaces. (Measures the impact on increasing access)
  • Percent increase in positive perceptions and social norms related to physical activity across all segments of the community exposed to shared-use agreements. (Assesses the normative shift towards valuing and supporting active living for all)

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.

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.