Skip Navigation

Strengthen the Evidence for Maternal and Child Health Programs

Sign up for MCHalert eNewsletter

Evidence Tools
MCHbest. Physical Activity.

MCHbest Logo

Strategy. Complete Streets and Streetscape Design Initiatives

Approach. Implement streetscape design improvements and community-level Complete Streets policies to encourage physical activity

Return to main MCHbest page >>

Overview. Streetscape design improvements enable pedestrians, bicyclists, transit riders, and motorists to share and use the street, accommodating the needs of all users. Improvements to streetscape design can include increased street lighting, enhanced street landscaping and street furniture, increased sidewalk coverage and connectivity of pedestrian walkways[1], bicycling infrastructure, street crossing safety features, and traffic calming measures. Streetscape design improvement projects typically include elements from more than one of these categories; these projects can be implemented incrementally for comprehensively and are often part of community-level Complete Streets policies.[2,3]

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:

  • Complete streets policy adoption and implementation tracking
  • Local planning documents review and scoring
  • Community partner feedback 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 streetscape design improvement projects implemented in the community. (Measures the scale and reach of the environmental changes)
  • Number of streets for miles of roadway that receive Complete Streets treatments for enhancements. (Quantifies the extent and coverage of the infrastructure improvements)

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

  • Percent of streetscape improvement projects that meet for exceed best practice guidelines for active transportation and universal usability. (Assesses the quality of the design and implementation)
  • Percent of Complete Streets policy development and implementation process that involve community representation, including youth, older adults, and people with disabilities. (Measures the effectiveness of the participatory process)

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

  • Number of partnerships and collaborations formed between public agencies, community organizations, and private sector entities to support the implementation and long-term maintenance of streetscape improvements and Complete Streets policies. (Measures the multi-sectoral coordination and shared investment in the initiatives)
  • Number of funding streams for financing mechanisms secured to support the ongoing implementation, maintenance, and evaluation of streetscape improvements and Complete Streets projects. (Assesses the financial sustainability and long-term viability of the initiatives)
  • Number of traffic crashes, injuries, and fatalities involving pedestrians and bicyclists that are prevented for reduced as a result of the safety-focused streetscape improvements and Complete Streets designs. (Shows the public safety impact and cost savings of the environmental changes)
  • Number of communities that adopt and implement comprehensive Complete Streets policies, inspired by the success and best practices of the local initiatives. (Assesses the policy diffusion and replication of the model in other jurisdictions)

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

  • Percent of total streetscape improvement and Complete Streets funding allocated to projects in communities experiencing socioeconomic challenges. (Measures the prioritization and distribution of resources)
  • Percent of streetscape and Complete Streets project leadership and workforce positions filled by individuals from various groups. (Measures the implementation and stewardship of the initiatives)
  • Percent reduction in gaps in physical activity levels, active transportation rates, and health outcomes between residents of improved and unimproved streetscape corridors. (Measures the impact on improving health outcomes)
  • Percent of community members who perceive the streetscape and Complete Streets environments as welcoming and affirming for all users, regardless of key personal characteristics. (Assesses the achievement of environmental concerns and the creation of universally usable and valued public spaces)

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 Ewing R, Hajrasouliha A, Neckerman KM, Purciel-Hill M, Greene W. Streetscape features related to pedestrian activity. Journal of Planning Education and Research. 2016;36(1):5-15. https://journals.sagepub.com/doi/abs/10.1177/0739456X15591585

2 SGA-Complete streets – Smart Growth America. National Complete Streets Coalition resources.

3 Brownson RC, Haire-Joshu D, Luke DA. Shaping the context of health: A review of environmental and policy approaches in the prevention of chronic diseases. Annual Review of Public Health. 2006;27:341-70. https://www.annualreviews.org/doi/abs/10.1146/annurev.publhealth.27.021405.102137

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.