Perceptions of barriers and levers to health-enhancing physical activity policies in French cities

Abstract

Abstract Background Policy is one of the levers to initiate structural change to foster the promotion of Health-Enhancing Physical Activity (HEPA). To this end, policymakers have to deal with complex ecosystems embedded in specific contexts. However, limited research has been published on this topic at the local level. The purpose of this study was to identify the barriers and levers to develop HEPA policies from the point of view of municipals managers and elected officials in mid-size French cities. Methods This study was conducted following the concept mapping approach: a list of statements was submitted to 17 French mid-size cities. These statements completed the beginning of this sentence: “In a mid-size municipality context, to develop HEPA policies, it is necessary to...”. First, key informants in each city rated the importance of each statement without considering their local context according to a Likert scale, ranging from 1 (not at all important) to 6 (extremely important). Then, they had to rate the feasibility of each statement considering their local context according to a Likert scale ranging from 1 (not at all feasible) to 6 (extremely feasible). Results A total of 23 municipal managers and 10 elected officials from sport (n = 14), health (n = 10), and social (n = 9) sectors from 11 French mid-size cities participated in this study. Statements related to political commitment, shared governance and partnership appeared as potential levers to develop HEPA policies. Statements related to the economic model of the local HEPA promotion, mandate of the mayor, and land use planning appeared as potential barriers to develop HEPA policies. The results varied according to the position and the sector of the respondent. Conclusions The results suggest that some local contextual factors could affect the development of HEPA policies in mid-size French cities. This study contributes to a better understanding of the development of local HEPA policies in the French context. Key messages Local contextual factors should be considered when developing health-enhancing physical activity policies. The perceptions of these local contextual factors varied according to the position and the sector of the respondent.