Decision-making for active living infrastructure in new communities: a qualitative study in England.

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BACKGROUND: Urban design can influence population levels of physical activity and subsequent health impacts. This qualitative study investigates local level decision-making for 'active living' infrastructure (ALI)-walking and cycling infrastructure and open spaces in new communities. METHODS: Thirty-five semi-structured interviews with stakeholders, and limited ethnographic observations, were conducted with local government and private sector stakeholders including urban and transport planners, public health practitioners, elected councillors and developers. Interview transcripts were coded and analysed thematically. RESULTS: Public health practitioners in local government could act as knowledge brokers and leaders to motivate non-health stakeholders such as urban and transport planners to consider health when designing and building new communities. They needed to engage at the earliest stages and be adequately resourced to build relationships across sectors, supporting non-health outcomes such as tackling congestion, which often had greater political traction. 'Evidence' for decision-making identified problems (going beyond health), informed solutions, and also justified decisions post hoc, although case study examples were not always convincing if not considered contextually relevant. CONCLUSION: We have developed a conceptual model with three factors needed to bridge the gap between evidence and ALI being built: influential public health practitioners; supportive policies in non-health sectors; and adequate resources.

management and policy, physical activity, places, England, Local Government, Private Sector, Public Health, Qualitative Research
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J Public Health (Oxf)
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Oxford University Press (OUP)
All rights reserved
Medical Research Council (MR/K023187/1)
Medical Research Council (MC_UU_12015/6)
Wellcome Trust (087636/Z/08/Z)
Economic and Social Research Council (ES/G007462/1)
MRC (MC_UU_00006/7)
National Institute for Health and Care Research (16/137/34)
This work was supported by the British Heart Foundation, Cancer Research UK, Economic and Social Research Council, Medical Research Council, the National Institute for Health Research, and the Wellcome Trust, under the auspices of the UK Clinical Research Collaboration [grant numbers 087636/Z/08/Z, ES/G007462/1, MR/K023187/1 to ALG and DO]; and the National Institute for Health Research [grant number 16/137/34 to LF]. ALG and DO are supported by the Medical Research Council (MC_UU_12015/6) and Centre for Diet and Activity Research (CEDAR), a UKCRC Public Health Research Centre of Excellence. LF is supported by the NIHR Global Health Research Group and Network on Diet and Activity. No funder had any role in the study design; data collection, analysis, or interpretation; in the writing of the report; or in the decision to submit the article for publication.