Opportunities and Challenges

Historically, physical activity and fitness were integral to daily life and culture as a means of transportation, occupation, and maintaining a home.¹ During the 20th century, most physical activity was engineered out of daily living by the emergence of automobiles and labor-saving devices.^{14, 15} Thus, an active lifestyle for many people became one that included yard work and frequent trips to the gym during discretionary time. By the end of the century, physical inactivity was recognized as a risk factor for many chronic diseases and poor mental health, and active lifestyles were associated with overall health and well-being of individuals and communities. The restoration of physical activity to daily life increasingly has been considered by employers, school administrators, park and recreation managers, urban planners, transportation engineers, and public health practitioners. Intervention strategies are guided by recent science showing that multidisciplinary environmental interventions can improve physical activity levels and benefit local communities.²

Two Federal memorandums of understanding (MOUs) define future collaborations among Federal departments, including agencies within HHS. The Healthier Children and Youth MOU between HHS and the U.S. Departments of Agriculture (USDA) and Education synthesizes interagency activities in nutrition and physical activity that target young people. It provides an opportunity to widely shape the physical activity message to audiences, including school officials, parents, and children. The Public Health and Recreation MOU brings together the Federal land management agencies within USDA, the U.S. Departments of Interior and Transportation, the U.S. Army Corps of Engineers, and agencies in HHS. Together, they promote the use of public lands for public health and help ensure that all Americans understand the benefits of being physically active and the location of public spaces available to them for their active pursuits.

Also reflecting the role of public lands and recreational facilities in health promotion was a collaboration between the National Heart, Lung, and Blood Institute and the National Recreation and Park Association. Together, they developed Hearts N' Parks,¹⁶ a community-based initiative designed to encourage all Americans to maintain a healthy weight by improving nutrition and increasing physical activity. Local park and recreation departments were instrumental in implementing the 3-year program. The collaboration was successful in improving healthy eating and physical activity knowledge and behaviors among adults and children through community-based programs.

Opportunities for professional development, communication, and collaboration among physical activity practitioners in public health are increasing. Emerging public health organizations, programs, journals, and institutions, with a focus on physical activity in partnership with nongovernmental organizations, will continue to provide opportunities to collaborate, share ideas, and obtain technical assistance.¹⁷

The population-based interventions recommended in the Community Guide to Preventive Services provide public health professionals with approaches that are effective in influencing physical activity behavior.² Evidence-based activities or interventions include the following:

• Informational approaches: communitywide campaigns and point-of-decision prompts.
• Behavioral approaches: school-based physical education, individually adapted health behavior-change programs, and social support interventions in community settings.
• Environmental and policy approaches: access to places offering physical activity combined with informational outreach, street-scale and community-scale urban design and land-use policies and practices, and point-of-decision prompts.

The lack of evidence-based practices for physical activity programs targeting select populations continues to challenge public health practitioners trying to affect physical activity behaviors. Program planners need to strategically target select populations. REACH 2010 uses evidence-based strategies toward that end. In contrast, among people with disabilities, a variety of challenges diminish physical activity participation. These challenges include limited research and recommendations for physical activity programming that is appropriate for individuals with specific disabilities¹² and physical barriers (for example, lack of access to changing rooms in fitness facilities).¹³

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