Abstract
BackgroundAlthough multi-sector policy is a promising strategy to create environments that stimulate physical activity among children, little is known about the feasibility of such a multi-sector policy approach. The aims of this study were: to identify a set of tangible (multi-sector) policy measures at the local level that address environmental characteristics related to physical activity among children; and to assess the feasibility of these measures, as perceived by local policy makers.MethodsIn four Dutch municipalities, a Delphi study was conducted among local policy makers of different policy sectors (public health, sports, youth and education, spatial planning/public space, traffic and transportation, and safety). In the first Delphi round, respondents generated a list of possible policy measures addressing three environmental correlates of physical activity among children (social cohesion, accessibility of facilities, and traffic safety). In the second Delphi round, policy makers weighted different feasibility aspects (political feasibility, cultural/community acceptability, technical feasibility, cost feasibility, and legal feasibility) and assessed the feasibility of the policy measures derived from the first round. The third Delphi round was aimed at reaching consensus by feedback of group results. Finally, one overall feasibility score was calculated for each policy measure.ResultsCultural/community acceptability, political feasibility, and cost feasibility were considered most important feasibility aspects. The Delphi studies yielded 16 feasible policy measures aimed at physical and social environmental correlates of physical activity among children. Less drastic policy measures were considered more feasible, whereas environmental policy measures were considered less feasible.ConclusionsThis study showed that the Delphi technique can be a useful tool in reaching consensus about feasible multi-sector policy measures. The study yielded several feasible policy measures aimed at physical and social environmental correlates of physical activity among children and can assist local policy makers in designing multi-sector policies aimed at an activity-friendly environment for children.
Highlights
Multi-sector policy is a promising strategy to create environments that stimulate physical activity among children, little is known about the feasibility of such a multi-sector policy approach
The political feasibility on its turn defines the financial resources that are reserved for certain policies and influences the cost feasibility
This study provided the respondents with information on which environmental characteristics could possibly affect children’s physical activity behavior during the first Delphi round, no detailed information was available on the effectiveness of the proposed policy measures
Summary
Multi-sector policy is a promising strategy to create environments that stimulate physical activity among children, little is known about the feasibility of such a multi-sector policy approach. Policy measures from policy sectors outside the public health domain–for example spatial planning, traffic and transportation, safety, and social affairs–are warranted to create activity-friendly environments for children [11,12,13,14]. Snowdon et al distinguish five different aspects of feasibility: political feasibility, cultural/community acceptability, technical feasibility, cost feasibility, and legal feasibility [19,20] These feasibility aspects largely correspond to the findings from the PorGrow project, which identifies six groups of criteria for assessing feasibility: societal benefits, additional health benefits, efficacy, economic cost to public sector, economic cost to individuals, economic costs to commercial sector, practical feasibility, and social acceptability [21]. Swinburn et al further mention the availability of a trained work force, the strength of the organizations, networks, systems and leaderships involved, and existing pilot or demonstration programs as possible factors in determining the feasibility of policy initiatives [16]
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