From National to local physical activity policy

Background: The interaction between actors involved in the physical activity policy processes in Latin America remains understudied. Purpose: This study examined national-subnational alignment in the policy process (agenda setting, policy development, adoption, implementation, and evaluation) in four Latin American countries. Methods: The INTEGRATE-PA-Pol tool from the Global Observatory for Physical Activity (GoPA!) was pilot tested in Colombia, Costa Rica, Ecuador, and Mexico. Data were collected in matched pairs of the capital and a non-capital city, engaging national and subnational informants (n=27) identified by GoPA! Country Contacts. Cross-level perspective on the (mis)alignment was considered as (dis)similar perceptions regarding the engagement of national-subnational government levels throughout the policy process and the extent of the engagement (low/medium/high). The tool’s scoring guide was used to evaluate (mis)alignment (aligned/moderate misalignment/strong misalignment). Results: Twenty-three informants (response rate=85.2%) from health (52.2%), sport (26.1%), transport (13.0%), and education (8.7%) sectors participated. A third of policies focused exclusively on physical activity, with over half integrating it into other policies. In Ecuador and Mexico, informants perceived medium national and low subnational engagement in the policy process of national policies, showing a moderate misalignment. Colombia was aligned with perceived medium national and medium subnational engagement, while Costa Rica was aligned with high national and medium subnational engagement. In terms of subnational policies, national and subnational informants from Colombia, Costa Rica, Ecuador, and Mexico were aligned with engagements from low to medium at both levels. Conclusions: This study demonstrates the feasibility of collecting cross-level physical activity policy data collaborating with GoPA!’s network. Results revealed opportunities for improving alignment across-levels. Practical implications: Our results can contribute to understanding national-subnational government interactions during the policy processes in Latin America. Funding: Universidad de los Andes, Colombia; University of California San Diego, USA; Universidade Federal de Pelotas, Brazil; Centers for Disease Control and Prevention (U48DP006395).

Background: Population-level physical activity increases are only possible with intersectoral collaboration across government levels and sectors to develop and implement physical activity promotion policies. Purpose: This study aims to provide information about developing the “Interaction between National and Local Government Levels in Development and Implementation of Physical Activity Policies Tool” (INTEGRATE-PA-Pol). Methods: A framework was created to examine the development and implementation of national and subnational physical activity promotion policies and the (mis)alignment between government levels. Three phases were conducted: 1) a scoping review to identify local government physical activity promotion policies and instruments for assessing them, 2) questionnaire development, and 3) cognitive response testing (validity testing and item modification) with experts. Results: The search identified 89 articles, with 23 meeting the eligibility criteria for data extraction. These studies informed the development of the INTEGRATE-PA-Pol Tool, which is comprised of six questionnaires. It evaluates (1) the political system, governance, and internal structure of countries and cities of interest; (2) the main sectors involved in national/subnational physical activity policy development; and (3) the involvement of actors in five stages of the policy development cycle. The tool provided a scoring and analysis guide for generating quantitative summaries. This study produced a strong face, content validity, and feasibility tool for low- to medium-income Latin American countries to assess national/subnational physical activity policies and the (mis)alignment between government levels. Conclusion: This tool can assist in better understanding the (mis)alignments between government levels and sectors during the policy process, uncovering policy gaps, and improving national/subnational policy translation. Practical implications: Our tool will contribute to developing and implementing a global public policy monitoring system to enable benchmarking and priority setting for physical activity promotion policies. Funding: Universidad de los Andes, Colombia; University of California San Diego, USA; Universidade Federal de Pelotas, Brazil; CDC (U48DP006395).

Background: The Dutch government aims for 75% of the Dutch population to comply with the Physical Activity Guidelines by 2040. In 2023, only 44.3% did comply. With new policies, different approaches and clear knowledge needs, the Netherlands is tackling the ‘physical activity crisis’ on a national and local level. In short: physical activity should become as normal as brushing your teeth.

Program Delivery: The new national policy (2022) is committed to integral policymaking with other ministries, to make physical activity part of healthcare, education, living environment and work. This is done in a system approach by knowledge institutions, a national programme that focuses on scaling up great initiatives (Beweegalliantie) and many regional and local parties. The Knowledge Centre for Sports & Physical Activity NL will elaborate on the new policy and provide inspiring examples of knowledge transfer to practitioners as well, like the co-design of the PA Guidelines Cycle together with ambassadors for plain language.

Evaluation:
Half of the Dutch have annual contact with a healthcare professional about a health question. In many cases, practicing physical activity is part of the solution. There have been evaluations in the care setting, which show that a different set-up in terms of referral leads to more PA among people (Beweeghuis Maastricht). But are we getting closer to the 75% target? The first evaluation of the national policy will be available in 2024.

Conclusions: Long-term sports policy and learning approach is needed to ensure that people actually practice PA more.

Practical implications:
During our presentation, we can elaborate which steps we have taken to integrate policies aimed at more physical activity. Which are working, and what we still need to learn from others? We also learn from the Policy Dialogues, organised by the WHO.

Funding: Funding comes from the government, municipalities and local organisations.

Background: All 21st Century Olympic Game host cities have incorporated some kind of inferred or explicit commitment in their Olympic bids to increase community participation in sports and/or physical activity (Reis et al., 2017). The ongoing commitment of Olympic host cities to develop and implement PA policies is in spite of evidence suggesting that the initiatives are not yet translating to increased population levels of PA (Bauman et al., 2021). An important public health opportunity exists to examine the motivations of political leaders and other key policy actors, to prioritise PA policy development as part of hosting large international sporting events such as the Olympic Games. Purpose: The current investigation aimed to examine if and why key actors such as political leaders and senior bureaucrats incorporated PA policy development as part of their 2032 Brisbane Olympic legacy preparations. Methods: The research project was divided into two components, Part A: an analysis of Brisbane 2032 Olympic Submission documents, Queensland (sub national) PA policies and PA policy instruments (eg lead agency implementation plans, annual reports and departmental budgets). Part B: interviews with relevant elected leaders and key decision makers regarding motivations to incorporate PA policy components within Olympic submission documents and subsequent policy development. Results: Documentary evidence confirmed 2032 Brisbane Olympic Legacy documents include ambitions to increase community levels of participation in sport and/or PA including PA policy development. Interviews with key decision makers identified common motivational themes for incorporating PA considerations within Olympic Legacy planning. Conclusions: Initial results found politicians and key decision makers view increased community participation in sport and PA as a potential community benefit emerging from hosting the games. Practical implications: Hosting Olympic Games provide a significant opportunity to engage key decision makers to consider and develop PA policies. Funding: None

Background: The US National Physical Activity Plan (NPAP) was first released in 2010 to provide actionable direction toward meeting the Physical Activity (PA) Guidelines for Americans and further facilitate PA for all. The evidence-informed strategies and tactics informed eight societal sectors on promoting PA throughout the population. A priority of the NPAP is to stimulate states to develop relevant state-level plans that consider contextual variables, including cultural, environmental, and socioeconomic factors, with input from stakeholders that represent all population sectors. To date, there are only two state plans modeled after the NPAP – Texas and West Virginia (WV). Program Delivery or Policy Components: The WV Physical Activity Plan (WVPAP) has first released in 2012, and most recently in May, 2024. The development teams comprised of over 100 stakeholders across all 10 societal sectors have successfully generated a guide to encourage all sectors to accept their role in promoting PA, and in facilitating sustainable changes in policy and practice that will allow all people to have opportunities to be PA. The WVPAP also focuses on multi-sector collaboration that can provide support for PA regardless of inequalities. Evaluation. Tracking dissemination and implementation is critical to assessing the Plan. Online surveys, statewide symposiums, and state health data have also provided assessment data. It is critical to have continuous communication and support between the WVPAP team and the cross-sector partners to evaluate the Plan. Conclusions: Partnerships are critical to the development, dissemination, implementation, and evaluation of the WVPAP. Partnerships at the local levels also consider the local contexts. Practical implications: The WVPAP gives our state decision-makers, leaders, and practitioners the guide they need to make PA a priority locally, and state-wide. The WVPAP is also well-positioned to serve as a model for other states and regions using the NPAP framework. Funding: WVBPH, NACDD

Background: At the last ISPAH congress, we presented the results of applying physical activity measures of Fujisawa City to Global Action Plan on Physical Activity 2018-2030 (GAPPA). The co-benefits of the multi-sectoral measures that were previously unseen became apparent. In Japan, a new national health promotion plan (the third term of Healthy Japan 21) will go into effect in FY2024, and prefectural and municipal governments will formulate plans based on this plan. Progress since the last report will be presented. Program Delivery or Policy Components: Multiple divisions and related measures with co-benefits were added to the annual plan for FY 2023. These include the following: 1) City planning division: mobility management (GAPPA policy action 2.1), utilization of bicycles [ promotion of cycle plans] (2.2); 2) University: promotion of physical activity-related resource maps (3.2, 4.1, 4.2), medical coordination for physical activity (3.2), funding acquisition (4.5), and evaluation of plans (4.3); 3) Social welfare council: provide information on related issues on each other’s websites, etc. (1.2).; and 4) Senior citizens support division: provide information on physical activity promotion even at events held for other purposes (1.2, 1.3). The following health promotion plan in Fujisawa City from FY2025 is being formulated. The university has gathered the necessary know-how for physical activity promotion and collaborated with stakeholders, including companies, to create a platform (KEIO SPORTS SDGs) that can be implemented in other municipalities. Evaluation: The city added ten new co-benefit projects to the annual plan for 2023. Conclusions: The workshop’s findings based on GAPPA were considered helpful for the multi-sectoral collaboration measures. Practical implications: The findings are expected to be incorporated into and implemented in Fujisawa City’s next long-term health promotion plan and other divisions’ plans. They can also be applied in other districts.