Perceptions of the built environment influence support for local physical activity policies

The built environment has been shown to be an important factor that influences physical activity levels and lifestyles of individuals in various settings. Support for policies that result in a health-promoting built environment may be influenced by individuals' perceptions of their local built environment. A random-digit-dialed, telephone interview (n=1208) was conducted in US counties selected for either high (HIGH) or low (LOW) prevalence of obesity and physical inactivity from the Behavioral Risk Factor Surveillance System. Scales were created representing support for policies in schools, worksites and the community. Scales were created to capture respondent's' perceptions of their neighborhood built and food environments. Mean scores were determined for each scale. Regression models examined the influence of the built environment scales on support for policies. All analyses were stratified by HIGH and LOW county status. Individuals in LOW counties had higher mean scores in perceptions of their local food environment (p<0.001), neighborhood aesthetics (p<0.001) and destinations and facilities (p<0.001). Inverse associations were found between perceptions and support for policies with individuals from HIGH counties and LOW counties. More significant associations were found for individuals from LOW counties. Perceptions of environment differed by county obesity and inactivity prevalence. Policy support varied by perceptions of the built environment. Individuals in counties with lower prevalence of obesity and physical inactivity were less likely to support policies to improve the built environment. These findings have implications for policy change in schools, worksites and the community.