Perceptions of barriers and levers of health-enhancing physical activity policies in mid-size French municipalities

A Noël Racine,A Vuillemin,B Massiera,J M Garbarino,F D’Arripe-Longueville,K Corrion

doi:10.1186/s12961-020-00575-z

Abstract

BackgroundPolicy is one of the levers for initiating structural change to foster the promotion of health-enhancing physical activity (HEPA). To this end, policy-makers have to deal with complex ecosystems embedded in specific contexts. However, limited research has been conducted on this topic at the local level. The purpose of this study was to identify the perceived barriers and levers of HEPA policies according to department heads and elected officials across various sectors in mid-size French municipalities.MethodsThis study used a mixed method primarily based on an adaptation of the concept mapping approach. A list of statements completing the sentence: ‘In a mid-size municipal context, to develop HEPA policies, it is necessary to …’ was submitted to key informants of 17 mid-sized French cities. Key informants in each municipality first rated the importance of each statement without considering their local context; they then rated the feasibility of each statement given their local context. In both cases, they used a Likert scale ranging from 1 to 6.ResultsA total of 23 municipal department heads and 10 elected officials from the sport (n = 14), health (n = 10) and social (n = 9) sectors in 11 mid-size French cities participated in this study. A list of 84 statements, sorted into 16 categories, was rated by participants according to their importance (M = 4.52, SD = 0.86) and their feasibility (M = 3.77, SD = 0.74). Potential barriers to (n = 10) and levers of (n = 38) HEPA policy development were identified. These results varied according to the position and sector of the participants.ConclusionsThe results suggest that local contextual factors can affect the development of HEPA policies in mid-size French municipalities. The different perceptions of the potential levers and barriers according to sector might affect intersectoral collaboration. This study contributes by enhancing understanding of how local HEPA policies are developed in the French context.

Highlights

Policy is one of the levers for initiating structural change to foster the promotion of health-enhancing physical activity (HEPA)
The statements were rated by 33 key informants from 11 municipalities, including department heads (n = 23) and elected officials (n = 10)
This study contributes to a better understanding of the development of local HEPA policies

Summary

Introduction

Policy is one of the levers for initiating structural change to foster the promotion of health-enhancing physical activity (HEPA). In France, the decentralisation process has included the transfer of some of the legal and ‘facultative’ competencies (optional according to the law) from the national government to local governments [19] This has meant that local governments can use their competencies to act on many health determinants such as urban, environmental, social, sport and health factors [4]. From these competencies, municipalities have the authority to influence the conditions and the environment where people live; it is a suitable level to promote an active and healthy lifestyle [20, 21].

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