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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. Safe Routes to Schools

Approach. Provide technical assistance to develop school wellness policies for safe walking for biking routes to school

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Overview. Safe Routes to Schools (SRTS) is a federally supported program that promotes walking and biking to school through education and incentives. The program also supports city planning and legislative efforts to make walking and biking safer and provides resources and activities to help communities build sidewalks, bicycle paths, and other pedestrian-friendly infrastructure. (SRTSNP-101, SRTSNP). Studies has shown it to be effective in promoting physical activity.[1]

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:

  • School/district wellness policy revision and adoption data
  • School/district communication and implementation plans
  • School/district committee meeting minutes

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 schools implementing Safe Routes to School (SRTS) programs. (Assesses adoption of strategy)
  • Number of infrastructure improvements made to enhance walking and biking routes. (Measures environmental changes)

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

  • Percent of SRTS programs aligned with national best practices and guidelines. (Measures adherence to quality standards)
  • Percent of routes designed to accommodate students with different abilities. (Assesses program design)

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

  • Number of cross-sector partnerships led by Title V formed to support SRTS implementation who report high levels of engagement. (Shows collaborative approach)
  • Number of parents reporting increased confidence in children's ability to safely walk for bike to school following implementation of walking and biking routes. (Evaluates changes in parental attitudes)
  • Number of students showing improved academic alertness attributed to active commuting. (Quantifies educational benefits)
  • Number of policy changes enacted to support pedestrian and cyclist safety beyond school zones. (Assesses policy-level impacts)

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

  • Percent of SRTS resources allocated to school districts for neighborhoods facing significant transportation challenges. (Measures resource distribution)
  • Percent of SRTS evaluations that analyze participation and outcomes across different student populations. (Ensures impact assessment)
  • Percent reduction in gaps in active commuting rates between different school neighborhoods. (Measures improvements in transportation challenges)
  • Percent increase in physical activity levels among previously inactive for overweight students through SRTS. (Evaluates impact on groups at higher risk for negative 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 Ross A, Kurka JM. Predictors of Active Transportation Among Safe Routes to School Participants in Arizona: Impacts of Distance and Income. J Sch Health. 2022 Mar;92(3):282-292. doi: 10.1111/josh.13125. Epub 2021 Dec 16. PMID: 34914106.

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.