Philip Bors

Neighborhood environment, access to places for activity, and leisure-time physical activity in a diverse North Carolina population

Purpose. To examine associations between perceived neighborhood characteristics, access to places for activity, and leisure-time physical activity. Design. Cross-sectional telephone survey. Setting. Cabarrus, Henderson, Pitt, Robeson, Surry, and Wake counties in North Carolina. Subjects. Population-based sample of 1796 adults at least 18 years of age residing in the six counties. Measures. The 133-item questionnaire assessed self-reported leisure-time physical activity and perceptions of neighborhood characteristics (sidewalks, trails, heavy traffic, streetlights, unattended dogs, and safety from crime) and general access to places for physical activity. Results. Trails, streetlights, and access to places were positively associated with engaging in any leisure activity: unadjusted odds ratio (OR) (95% confidence interval [CI]); 1.62 (1.09–2.41), 1.57 (1.14–2.17), and 2.94 (1.91–4.52), respectively. Trails and access to places were positively associated with engaging in the recommended amount of leisure activity: 1.49 (1.00–2.22), and 2.28 (1.30–4.00), respectively). In multivariable logistic regression modeling including environmental factors and demographics, access to places was associated with any activity (2.23 [1.44–3.44]) and recommended activity (2.15 [1.23–3.77]), and trails were associated with recommended activity (1.51 [1.00–2.28]). Conclusion. Certain neighborhood characteristics, particularly trails, and access to places for physical activity may be associated with leisure activity levels. In this study, perceived neighborhood environmental factors and access to places for physical activity were strongly associated with race, education, and income.

The Active Living by Design national program: community initiatives and lessons learned.

Public health advocates have increasingly highlighted the importance of implementing comprehensive physical activity interventions that use an ecologic framework. Such a framework can broadly address physical activity barriers, such as the lack of opportunities, social support, policies, built environments, and community awareness. The Active Living by Design (ALbD) was a community grant program of the Robert Wood Johnson Foundation (RWJF), which was established to help 25 communities create environments that support active living. Each funded site established a multidisciplinary community partnership and implemented the 5P strategies: preparation, promotions, programs, policy, and physical projects. The community partnerships worked within neighborhoods, schools, worksites, and other organizations to increase physical and social supports for physical activity. Ten community examples illustrate the 5Ps. Throughout the 5-year grant, the ALbD national program office provided community partnerships with group and individualized learning opportunities. Technical assistance and peer-to-peer learning was facilitated by ALbD project officers, who also coached each community partnership via site visits, regular phone calls, and electronic communications. The ALbD grant program provided valuable lessons for communities, technical assistance organizations, and funders. Community partnerships experienced success in a variety of settings and their collaborative approaches encouraged multiple organizations, including funders, to participate in improving conditions for active living. Strong local leadership was a key to success and community partnerships benefited considerably from peer-to-peer learning. The 5P model, while challenging to implement comprehensively, proved to be a useful model for community change.

Assessment for Active Living Harnessing the Power of Data-Driven Planning and Action

BACKGROUND Robert Wood Johnson Foundations Active Living by Design (ALbD) grant program funded 25 communities across the U.S. The ALbD National Program Office (NPO) supported grantee community partnerships with technical assistance for assessment, planning, and implementation activities intended to increase population levels of physical activity. PURPOSE This paper analyzes and summarizes the range of assessments conducted to identify local barriers and opportunities for active living as important elements of a thorough intervention planning process. METHODS Evaluation of the partnerships focused on documenting community changes and strategies used to produce those changes. With support from NPO staff and external evaluators, partnerships tracked and summarized their community assessment approaches as well as strengths and challenges in conducting assessments. RESULTS The partnerships documented a range of assessment strategies and methods. Partnerships used several qualitative methods, including focus groups, individual and group interviews, and public meetings. Quantitative methods included surveys, audits, observations, and analysis of existing data, among others. The environmental audit was the most common assessment method used by the partnerships. Assessment processes and findings were used for not only intervention planning but also community engagement and direct advocacy. Assessment data collectors varied from professional staff to community volunteers. CONCLUSIONS Assessments were essential to the identification of local barriers and assets related to active living, which in turn helped ALbD partnerships prioritize and refine their action strategies. Assessment processes were also valuable in building relationships with new partners, community members, and local officials.

Change in the prevalence of leisure activity with the number of activities recalled

PURPOSE The purpose of this study was to examine how the estimated prevalence of leisure activity changed when respondents self-reported up to four activities, compared with using information only from the respondents one, two, and three most commonly performed leisure activities. METHODS Information on leisure activities, sociodemographics, and body mass index (BMI) categories was collected in the year 2000 during a telephone interview of 1813 randomly selected adults living in six North Carolina counties. Recommended activity was defined as moderate leisure activity > or =5x wk(-1) for > or =30 min per session or vigorous leisure activity > or =3x wk(-1) for > or =20 min per session. RESULTS Among respondents, 32.1% reported participation in no leisure activity, 41.7% reported one activity, 21.5% reported two activities, 3.8% reported three activities, and 0.9% reported four activities during the past month. The largest change in prevalence occurred when using two activities compared with one activity for recommended activity, overall and by sociodemographic and BMI categories. The prevalence of recommended activity determined by using 1, 2, 3, or 4 activities was 21.0%, 26.0%, 26.5%, and 26.7%, respectively. CONCLUSION In this study, collecting information on two leisure activities was the most efficient balance for population specific accuracy of recommended activity.

HKHC Community Dashboard: design, development, and function of a Web-based performance monitoring system.

BACKGROUND As part of Robert Wood Johnson Foundations Healthy Kids, Healthy Communities (HKHC) national grant program, a technical assistance team designed the HKHC Community Dashboard, an online progress documentation and networking system. The Dashboard was central to HKHCs multimethod program evaluation and became a communication interface for grantees and technical assistance providers. METHODS The Dashboard was designed through an iterative process of identifying needs and priorities; designing the user experience, technical development, and usability testing; and applying visual design. The system was created with an open-source content management system and support for building an online community of users. The site developer trained technical assistance providers at the national program office and evaluators, who subsequently trained all 49 grantees. Evaluators provided support for Dashboard users and populated the site with the bulk of its uploaded tools and resource documents. The system tracked progress through an interactive work plan template, regular documentation by local staff and partners, and data coding and analysis by the evaluation team. Other features included the ability to broadcast information to Dashboard users via e-mail, event calendars, discussion forums, private messaging, a resource clearinghouse, a technical assistance diary, and real-time progress reports. RESULTS The average number of Dashboard posts was 694 per grantee during the grant period. Technical assistance providers and grantees uploaded a total of 1304 resource documents. The Dashboard functions with the highest grantee satisfaction were its interfaces for sharing and progress documentation. A majority of Dashboard users (69%) indicated a preference for continued access to the Dashboards uploaded resource documents. CONCLUSIONS The Dashboard was a useful and innovative tool for participatory evaluation of a large national grant program. While progress documentation added some burden to local project staff, the system proved to be a useful resource-sharing technology.