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BACKGROUND: The Physical Activity Research Center developed a research agenda that addresses youth physical activity (PA) and healthy weight, and aligns with the Robert Wood Johnson Foundation's Culture of Health. This paper summarizes prioritized research studies with a focus on youth at higher risk for inactive lifestyles and childhood obesity in urban and rural communities. METHODS: Systematic literature reviews, a survey, and discussions with practitioners and researchers provided guidance on research questions to build evidence and inform effective strategies to promote healthy weight and PA in youth across race, cultural, and economic groups. RESULTS: The research team developed a matrix of potential research questions, identified priority questions, and designed targeted studies to address some of the priority questions and inform advocacy efforts. The studies selected examine strategies advocating for activity-friendly communities, Play Streets, park use, and PA of youth in the summer. A broader set of research priorities for youth PA is proposed. CONCLUSION: Establishing the Physical Activity Research Center research agenda identified important initial and future research studies to promote and ensure healthy weight and healthy levels of PA for at-risk youth. Results will be disseminated with the goal of promoting equitable access to PA for youth.

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OBJECTIVE: The prevalence of obesity has increased significantly since the 1950s. Currently, more than one-third of adults are obese. This study includes the review of 611 bills that were introduced over the past 10 years for the purpose of reducing obesity. DESIGN: Bills were obtained from state legislature Web sites and Centers for Disease Control and Prevention's (CDC's) Division of Nutrition, Physical Activity, and Obesity legislative database. Full text of bills was read and summed by year and the following categories: (a) Taskforce, (b) School, (c) Community, and (d) Health care. Bills were then coded according to strategies outlined in the Institute of Medicine publication, Accelerating Progress in Obesity Prevention. RESULTS: Of the 611 obesity-specific bills proposed over the last decade, 93 (15.2%) passed and represented 30 states. The largest number of bills ("n") introduced was in the School category (n = 276), followed by Community (n = 126), Health care (n = 117), and Taskforce (n = 92). Percentages of bills passed were as follows: Taskforce (28%), Health care (16%), Schools (14%), and Community (7%). Institute of Medicine strategies were identified in most state legislations. CONCLUSION: Overall, 15% of obesity bills passed from 2001 to 2010. Legislation can be an important first step to change society and institutional norms to encourage and support people to develop healthier behaviors. Public health practitioners may find the Institute of Medicine guidance and the legislative database useful resources to further efforts in obesity prevention.

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BACKGROUND: The health benefits of physical activity are well documented in scientific literature. Bicycling for transportation is a modality of physical activity that people can incorporate easily into their daily lives. METHODS: A qualitative study using 11 semi-structured individual interviews and 5 focus groups was conducted among 31 male and 13 female adult residents of Bogotá, Colombia in 2006, to explore barriers and facilitators of bicycle use for transportation purposes. People were selected based on socioeconomic status, age, and gender. Thematic analysis complemented with thematic network analysis was used to analyze the data. RESULTS: Six main themes emerged from the study: 1) general acknowledgment of individual and collective benefits of bicycle use, 2) built environment conditions were linked with bicycle use, 3) some social factors affect bicycling negatively, 4) people perceived conflicts over public space related to the use of bike-paths, 5) general negative public perception of bicyclists, and 6) gender differences influence patterns of bicycle use. CONCLUSION: The findings from this qualitative study show that various social and physical barriers must be addressed to increase bicycle use as a means of transportation in Bogotá.

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BACKGROUND: Parks are important venues that can encourage population-level physical activity, and policy legislation can facilitate or discourage physical activity and other park uses, depending on the type and level of support. This study aims to summarize the status and content of state-level park-related legislation. METHODS: We searched for eligible legislation from 2001-2007 in two data sources, CDC's Nutrition, Physical Activity and Obesity Legislative Database and Lexis-Nexis, using the key words conservation, growth management/land use, parks, recreation, preservation, path, green space, or open space. State legislation was categorized into seven broad topic areas and analyzed by number introduced and passed (enacted as law), by state and category. RESULTS: States varied in the number and type of park-related legislation introduced and passed. Common categories of introduced park-related state legislation were preservation or conservation (n = 26, 9 passed), funding (n = 43, 10 passed), creation or acquisition of park land (n = 53, 9 passed), safety and liability (n = 34, 5 passed), accessibility (n = 20, 2 passed), outreach (n = 15, 2 passed), and outdoor activities (n = 13, 2 passed). CONCLUSION: During 2001 to 2007, 19% of park-related state legislation was enacted. Research on legislative policy is an emerging field, and more information on the content of park-related legislation could assist states in their efforts to promote physical activity in park venues.

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A rapid increase in economic well-being and urbanization in Kuwait have been accompanied by profound changes in lifestyle, including low levels of physical activity in all population groups. These changes have contributed to a high prevalence of overweight and obesity and to the escalation of the non-communicable disease rates, particularly coronary heart disease, stroke, hypertension and diabetes. The evolution of physical activity promotion, internationally, and a series of related meetings in Kuwait and neighboring countries, have started to generate an awareness among health authorities of the importance of physical activity in health promotion and disease prevention. A National Physical Activity Committee has been formed to design and implement a National Physical Activity Plan, which could also serve as a model for other countries. The authors describe the background and principles behind the development of the National Plan, summarize a template based upon the Kuwait experience and share the lessons learned from these efforts.

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With increasing evidence of the detrimental effects of physical inactivity, there is interest in enhancing research on policies that may influence physical activity in communities. Given the potential policy impact, a framework that organized and conceptualized policy interventions and priorities for public health efforts to promote physical activity was developed. In addition, the Physical Activity Policy Research Network (PAPRN) was formed as a way to operationalize the contents of the framework. Recommendations for future work in this area include enhancing transdisciplinary collaborations, raising the priority of policy evaluation, studying policies at all levels, and emphasizing dissemination of findings.

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From a public health perspective, a cost-benefit analysis of using bike/pedestrian trails in Lincoln, Nebraska, to reduce health care costs associated with inactivity was conducted. Data was obtained from the city's 1998 Recreational Trails Census Report and the literature. Per capita annual cost of using the trails was 209.28 U.S. dollars (59.28 U.S. dollars construction and maintenance, 150 U.S. dollars of equipment and travel). Per capita annual direct medical benefit of using the trails was 564.41 U.S. dollars. The cost-benefit ratio was 2.94, which means that every 1 U.S. dollar investment in trails for physical activity led to 2.94 U.S. dollars in direct medical benefit. The sensitivity analyses indicated the ratios ranged from 1.65 to 13.40. Therefore, building trails is cost beneficial from a public health perspective. The most sensitive parameter affecting the cost-benefit ratios were equipment and travel costs; however, even for the highest cost, every 1 U.S. dollar investment in trails resulted in a greater return in direct medical benefit.

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PURPOSE: Compare walking and bicycling for transportation and recreation with the percentage of the community devoted to parklands. METHODS: Behavioral Risk Factor Surveillance System (N = 206,992), Nationwide Personal Transportation Survey (N = 409,025), and Trust for Public Land (N = 55) data were used to estimate recreational walking and bicycling, utilitarian walking and bicycling, and parkland as a percentage of city acreage. Data were linked at the metropolitan statistical area or city level (N = 34). Pearson correlation coefficients were used to assess the associations among recreational and utilitarian walking and bicycling and parkland acreage. RESULTS: Utilitarian walking and bicycling and parkland acreage were significantly correlated (r = .62, p < .0001). No significant relationships were observed for leisure time walking or bicycling. DISCUSSION: Communities with more parks had significantly higher levels of walking and bicycling for transportation. Urban design features associated with leisure time physical activity might differ from those associated with transportation-related physical activity. Further studies are needed to articulate the relationships among community attributes and purposes of physical activity.

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We estimated the annual cost of bike and pedestrian trails in Lincoln, Neb, using construction and maintenance costs provided by the Department of Parks and Recreation of Nebraska. We obtained the number of users of 5 trails from a 1998 census report. The annual construction cost of each trail was calculated by using 3%, 5%, and 10% discount rates for a period of useful life of 10, 30, and 50 years. The average cost per mile and per user was calculated. Trail length averaged 3.6 miles (range = 1.6-4.6 miles). Annual cost in 2002 dollars ranged from 25,762 to 248,479 (mean = 124,927; median = 171,064). The cost per mile ranged from 5735 to 54,017 (mean = 35,355; median = 37,994). The annual cost per user was 235 (range = 83-592), whereas per capita annual medical cost of inactivity was 622. Construction of trails fits a wide range of budgets and may be a viable health amenity for most communities. To increase trail cost-effectiveness, efforts to decrease cost and increase the number of users should be considered.

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BACKGROUND: A persistently low population level of physical activity is a challenge for public health. Data on cost effectiveness of environmental interventions are needed to inform the development and implementing of such interventions. OBJECTIVE: To conduct cost-effectiveness analysis of bicycle/pedestrian trails. DESIGN: The costs of trail development and number of users of four trails in Lincoln, NE, were obtained. The costs were adjusted to 2003 dollars. The physical activity-related outcomes/items are number of users who were more physically active since they began using the trails, number of users who were physically active for general health, and number of users who were physically active for weight loss. Cost-effectiveness measures were derived. Sensitivity analysis was performed. RESULTS: The annual trail development cost US$289,035, 73% of which was construction cost. Of the 3,986 trail users, 88% were active at least 3 days a week. The average annual cost for persons becoming more physically active was US$98 (range US$65-253); the cost was US$142 (range US$95-366) for persons who are active for general health, and US$884 (range US$590-2,287) for persons who are active for weight loss. CONCLUSION: This analysis provides basic cost-effectiveness measures of bicycle/pedestrian trails. Policymakers can use this information in making resource allocation decisions.

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PURPOSE: To determine the relationship between urban sprawl, health, and health-related behaviors. DESIGN: Cross-sectional analysis using hierarchical modeling to relate characteristics of individuals and places to levels of physical activity, obesity, body mass index (BMI), hypertension, diabetes, and coronary heart disease. SETTING: U.S. counties (448) and metropolitan areas (83). SUBJECTS: Adults (n = 206,992) from pooled 1998, 1999, and 2000 Behavioral Risk Factor Surveillance System (BRFSS). MEASURES: Sprawl indices, derived with principal components analysis from census and other data, served as independent variables. Self-reported behavior and health status from BRFSS served as dependent variables. RESULTS: After controlling for demographic and behavioral covariates, the county sprawl index had small but significant associations with minutes walked (p = .004), obesity (p < .001), BMI (p = .005), and hypertension (p = .018). Residents of sprawling counties were likely to walk less during leisure time, weigh more, and have greater prevalence of hypertension than residents of compact counties. At the metropolitan level, sprawl was similarly associated with minutes walked (p = .04) but not with the other variables. CONCLUSION: This ecologic study reveals that urban form could be significantly associated with some forms of physical activity and some health outcomes. More research is needed to refine measures of urban form, improve measures of physical activity, and control for other individual and environmental influences on physical activity, obesity, and related health outcomes.

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