Online Program

Understanding the implementation and feasibility of physical activity promotion strategies among local health departments

Wednesday, November 4, 2015 : 1:30 p.m. - 1:50 p.m.

Marissa Zwald, MPH, Brown School of Social Work, Washington University in St. Louis, St. Louis, MO
Lindsay Elliott, BA, Brown School, Washington University in St. Louis, Saint Louis, MO
Ross C. Brownson, PhD, The Brown School & Prevention Research Center of St. Louis, Washington University in St. Louis, St. Louis, MO

Local health departments (LHDs) are instrumental in implementing physical activity (PA) evidence-based policies and programs (EBPPs). With a shift from individual-level behavior change strategies towards policy and environmental approaches, more information is needed on which PA-EBPPs LHDs implement, and feasibility, barriers, and facilitators to PA-EBPP implementation.


Guided by recommendations in the Community Guide (widely-used systematic review), an online survey was developed and administered in January 2015 to all Missouri LHDs. Questions included: (1) implementation of 9 possible PA-EBPPs; (2) perceived feasibility of non-implemented PA-EBPPs, and (3) barriers and facilitators to EBPP implementation.


100 LHDs participated (89% response rate). LHDs frequently implemented PA community-wide campaigns (66% implemented), individual health behavior programs (60%), and PA social support interventions (59%). PA-EBPPs least implemented were policies/programs that make streets safer (e.g., crosswalks, Complete Streets) (36%), enhanced school-based physical education (26%), and stair prompts (15%).

PA-EBPPs rated most feasible to implement included PA community-wide campaigns (65% perceived feasible), PA social support interventions (58%), and individual health behavior programs (50%). EBPP implementation barriers were limited funding (17%), staff capacity (16%), and time (12%). Incentives for implementing EBPPs were access to data resources (52%), training workshops (47%), and grant-writing assistance (39%).

Chi-square analyses revealed differences in EBPP implementation by LHD characteristics, where LHDs with more employees was associated with increased EBPP use (p<.05) and LHDs further in the accreditation process was associated with increased EBPP use (p<.05).


PA-EBPPs frequently implemented and identified as feasible by LHDs demonstrate potential leverage points for PA strategies for other LHDs.

Learning Areas:

Chronic disease management and prevention
Implementation of health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs
Public health or related public policy
Public health or related research

Learning Objectives:
Identify at least one physical activity evidence-based policy or program a local health department can implement. Describe physical activity promotion policies or programs that are perceived as most feasible to implement by local health departments. Describe barriers and facilitators to the implementation of physical activity promotion policies or programs by local health departments.

Keyword(s): Practice-Based Research, Physical Activity

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Marissa Zwald is a doctoral student at the Brown School at Washington University in St. Louis and the Prevention Research Center of St. Louis. Her research focuses on physical activity policy.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.