Physical Activity-Friendly Policies and Community Design Features in the US, 2014 and 2021.

INTRODUCTION: The 2014 Community-Based Survey of Supports for Healthy Eating and Active Living documented the prevalence of US municipal policy and community design supports for physical activity. The survey was repeated in 2021. Our study examined change in the prevalence of supports from 2014 to 2021, overall and by municipality characteristic. METHODS: Municipalities were sampled independently each survey year. We calculated prevalence in 2014 and 2021 and the prevalence ratio (PR) for 15 supports covering zoning codes, park policies and budgets, design standards, Complete Streets policies, and shared use agreements. We used a Bonferroni-corrected Breslow-Day test to test for interaction by municipality characteristic. RESULTS: In 2014 (2,009 municipalities) compared with 2021 (1,882 municipalities), prevalence increased for several zoning codes: block sizes of walkable distances (PR = 1.46), minimum sidewalk width (PR = 1.19), pedestrian amenities along streets (PR = 1.15), continuous sidewalk coverage (PR = 1.14), and building orientation to pedestrian scale (PR = 1.08). Prevalence also increased for design standards requiring dedicated bicycle infrastructure for roadway expansion projects or street retrofits (PR = 1.19). Prevalence declined for shared use agreements (PR = 0.87). The prevalence gap widened between the most and least populous municipalities for Complete Streets policies (from a gap of 33.6 percentage points [PP] in 2014 to 54.0 PP in 2021) and for zoning codes requiring block sizes that were walkable distances (from 11.8 PP to 41.4 PP). CONCLUSION: To continue progress, more communities could consider adopting physical activity-friendly policies and design features.

The High Obesity Program: Overview of the Centers for Disease Control and Prevention and Cooperative Extension Services Efforts to Address Obesity.

The burden of obesity and other chronic diseases negatively affects the nation's health, businesses, economy, and military readiness. The prevalence is higher in certain geographic locations. Beginning in 2014, the Centers for Disease Control and Prevention's Division of Nutrition, Physical Activity, and Obesity awarded funding to 11 land-grant universities through the High Obesity Program. This program implemented evidence- and practice-based strategies with a goal to increase access to nutritious foods and places to be physically active in counties in which the prevalence of obesity among adults was more than 40%. In these counties, funded land-grant universities developed partnerships and collaborations to work with community organizations, public health agencies, and other stakeholders to promote policy and environmental changes that address obesity. Data were collected by the Cooperative Extension Service in each selected county with technical assistance from land-grand universities and the Centers for Disease Control and Prevention. More than 2 million people were reached by the nutrition and physical activity policy, systems, and environmental interventions implemented.

State-Level Farmers Market Activities: A Review of CDC-Funded State Public Health Actions That Support Farmers Markets.

CONTEXT: Introducing farmers markets to underserved areas, or supporting existing farmers markets, can increase access and availability of fruits and vegetables and encourage healthy eating. Since 2003, the Centers for Disease Control and Prevention (CDC)'s Division of Nutrition, Physical Activity, and Obesity (DNPAO) has provided guidance and funding to state health departments (SHDs) to support the implementation of interventions, including activities around farmers markets, to address healthy eating, and improve the access to and availability of fruits and vegetables at state and community levels. OBJECTIVE: For this project, we identified state-level farmers market activities completed with CDC's DNPAO funding from 2003 to 2013. State-level was defined as actions taken by the state health department that influence or support farmers market work across the state. DESIGN AND PARTICIPANTS: We completed an analysis of SHD farmers market activities of 3 DNPAO cooperative agreements from 2003 to 2013: State Nutrition and Physical Activity Programs to Prevent Obesity and Other Chronic Diseases; Nutrition, Physical Activity and Obesity Program; and Communities Putting Prevention to Work. To identify state farmers market activities, data sources for each cooperative agreement were searched using the key words "farm," "market," "produce market," and "produce stand." State data with at least one state-level farmers market action present were then coded for the presence of itemized activities. RESULTS: Across all cooperative agreements, the most common activities identified through analysis included the following: working on existing markets and nutrition assistance benefit programs, supporting community action, and providing training and technical assistance. Common partners were nutrition assistance benefit program offices and state or regional Department of Agriculture or agricultural extension offices. IMPLICATIONS FOR POLICY & PRACTICE: Common farmers market practices and evidence-based activities, such as nutrition assistance benefits programs and land-use policies, can be adopted as methods for farmers market policy and practice work. CONCLUSION: The activities identified in this study can inform future planning at the state and federal levels on environment, policy, and systems approaches that improve the food environment through farmers markets.

Applying the School Health Index to a nationally representative sample of schools: update for 2006.

BACKGROUND: The School Health Index (SHI) is a tool designed to help schools assess the extent to which they are implementing practices included in the research-based guidelines and strategies for school health and safety programs developed by the Centers for Disease Control and Prevention (CDC). CDC previously analyzed data from the 2000 School Health Policies and Programs Study (SHPPS) to determine the percentage of US schools meeting the recommendations in the SHI. A new edition of the SHI (2005) and the availability of 2006 SHPPS data made it necessary to update and repeat the analysis. METHODS: SHPPS 2006 data were collected through computer-assisted personal interviews with faculty and staff in a nationally representative sample of schools. The data were then matched to SHI items to calculate the percentage of schools meeting the recommendations in 4 areas: school health and safety policies and environment, health education, physical education and other physical activity programs, and nutrition services. RESULTS: In accordance with the earlier findings, the present analysis indicated that schools nationwide were focusing their efforts on a few policies and programs rather than addressing the entire set of recommendations in the SHI. The percentage of items related to nutrition that schools met remained high, and an increase occurred in the percentage of items that schools met related to school health and safety policies and environment. CONCLUSIONS: More work needs to be done to assist schools in implementing school health policies and practices; this analysis helps identify specific areas where improvement is needed.

Applying the School Health Index to a nationally representative sample of schools.

The School Health Index (SHI) is a self-assessment and planning tool that helps individual schools identify the strengths and weaknesses of their health policies and programs. To determine the percentage of US schools meeting the recommendations in the SHI, the present study analyzed data from the School Health Policies and Programs Study (SHPPS) 2000. The SHPPS 2000 data were collected through computer-assisted personal interviews with faculty and staff in a nationally representative sample of schools. The SHPPS 2000 questions were then matched to SHI items to calculate the percentage of schools meeting the recommendations in 4 areas: school health and safety policies and environment, health education, physical education and other physical activity programs, and nutrition services. Although schools nationwide are meeting a few SHI items in each of these areas, few schools are addressing the entire breadth of items. A more coordinated approach to school health would help schools reinforce health messages.