Laura Brennan - Academia.edu (original) (raw)

Papers by Laura Brennan

American Journal of Preventive Medicine, Nov 1, 2012

Background-From 2003 to 2008, 25 cross-sector, multidisciplinary community partnerships funded th... more Background-From 2003 to 2008, 25 cross-sector, multidisciplinary community partnerships funded through the Active Living by Design (ALbD) national program designed, planned, and implemented policy and environmental changes, with complementary programs and promotions. This paper describes the use of concept-mapping methods to gain insights into promising active living intervention strategies based on the collective experience of community representatives implementing ALbD initiatives. Methods-Using Concept Systems software, community representatives (n=43) anonymously generated actions and changes in their communities to support active living (183 original statements, 79 condensed statements). Next, respondents (n=26, from 23 partnerships) sorted the 79 statements into self-created categories, or active living intervention approaches. Respondents then rated statements based on their perceptions of the most important strategies for creating community changes (n=25, from 22 partnerships) and increasing community rates of physical activity (n=23, from 20 partnerships). Cluster analysis and multidimensional scaling were used to describe data patterns. Results-ALbD community partnerships identified three active living intervention approaches with the greatest perceived importance to create community change and increase population levels of physical activity: changes to the built and natural environment, partnership and collaboration efforts, and land-use and transportation policies. The relative importance of intervention approaches varied according to subgroups of partnerships working with different populations.

American Journal of Preventive Medicine, Jul 1, 1997

Obesity Reviews, Sep 5, 2014

Exposure to physical and policy environments that limit availability, affordability and appeal of... more Exposure to physical and policy environments that limit availability, affordability and appeal of healthy eating and active living options is higher for U.S. blacks than whites. This may contribute to high risk of obesity in black communities and limit effectiveness of preventive interventions. Here, we assess applicability to black Americans of findings from a prior evidence review system designed to accelerate the discovery and application of policy and environmental strategies for childhood obesity prevention and assess external validity. The database included 600 peer-reviewed articles reporting data from 396 sets of studies (study groupings) published from January 2000 through May 2009 and pertained to 24 types of policy and environmental strategies. Only 33 study groupings (∼8%) included ≥50% black Americans or reported subgroup analyses. Of 10 evaluation studies for interventions rated as effective for all populations in the primary review, 8 suggested effectiveness of child-focused interventions in school or child care settings for obesity-or physical activity-related outcomes in black Americans. Overall findings highlight the need for rigorous evaluations of interventions that reach black children in community or institutional settings, and conceptual frameworks and research designs geared to identifying ethnic or ethnicity-income group differences in intervention effects.

Evaluation and Program Planning, 2006

There are few studies evaluating changes made to enhance the activity friendliness of a community... more There are few studies evaluating changes made to enhance the activity friendliness of a community. The purpose of this paper is to review approaches that practitioners can use to evaluate interventions at the community level. Interventions at the community level address indicators across the physical, socio-cultural, institutional/organizational and political/economic environments. Evaluation approaches can include a variety of perceived and objective measures, including self-report surveys, in-depth interviews, environmental audits and use of existing data. The purpose of each approach, along with examples, is presented first, followed by a discussion of how and when each approach should be used and other considerations when evaluating interventions. In addition, this paper reviews special considerations for policy evaluation, while highlighting the need for such work. The paper concludes with a section discussing overarching challenges and lessons learned, including the use of multiple sources of data, participatory approaches and reliable and valid measurement tools.

American Journal of Preventive Medicine, 2012

Background-From 2003 to 2008, 25 cross-sector, multidisciplinary community partnerships funded th... more Background-From 2003 to 2008, 25 cross-sector, multidisciplinary community partnerships funded through the Active Living by Design (ALbD) national program designed, planned, and implemented policy and environmental changes, with complementary programs and promotions. This paper describes the use of concept-mapping methods to gain insights into promising active living intervention strategies based on the collective experience of community representatives implementing ALbD initiatives. Methods-Using Concept Systems software, community representatives (n=43) anonymously generated actions and changes in their communities to support active living (183 original statements, 79 condensed statements). Next, respondents (n=26, from 23 partnerships) sorted the 79 statements into self-created categories, or active living intervention approaches. Respondents then rated statements based on their perceptions of the most important strategies for creating community changes (n=25, from 22 partnerships) and increasing community rates of physical activity (n=23, from 20 partnerships). Cluster analysis and multidimensional scaling were used to describe data patterns. Results-ALbD community partnerships identified three active living intervention approaches with the greatest perceived importance to create community change and increase population levels of physical activity: changes to the built and natural environment, partnership and collaboration efforts, and land-use and transportation policies. The relative importance of intervention approaches varied according to subgroups of partnerships working with different populations.

Document Design, 2003

Many people are trying to be smarter every day. How's about you? There are many ways to evoke... more Many people are trying to be smarter every day. How's about you? There are many ways to evoke this case you can find knowledge and lesson everywhere you want. However, it will involve you to get what call as the preferred thing. When you need this kind of sources, the following book can be a great choice. tailoring health messages customizing communication with computer technology is the PDF of the book.

Http Dx Doi Org 10 1080 02701367 2000 11082798, Feb 13, 2015

Http Dx Doi Org 10 1300 J013v29n02_08, Oct 21, 2008

This study examined the rates and factors associated with physical activity in women of various a... more This study examined the rates and factors associated with physical activity in women of various ages. Adult women (n = 653) from four community-based family medicine clinics completed a self-administered behavioral and health questionnaire while waiting to see their physician. Findings suggested variation in physical activity over the life span, with older women performing less physical activity than younger women. Family characteristics (e.g., having children) were strongly associated with performing less structured, less intense physical activities of daily living among women 49 years and younger. Younger women reported having high self-efficacy for physical activity, but also reported the greatest numbers of barriers. Women in the oldest age category reported health as the most common motivator for physical activity, but were also least likely to perform physical activity. Interventions designed to meet the unique needs of women at different stages in their lives will potentially reduce the rate of inactivity among women. Creative, flexible strategies that incorporate physical activity into the daily routine should be used in the program development.

Journal of public health management and practice : JPHMP

Women & Health, 1999

This study examined the rates and factors associated with physical activity in women of various a... more This study examined the rates and factors associated with physical activity in women of various ages. Adult women (n = 653) from four community-based family medicine clinics completed a self-administered behavioral and health questionnaire while waiting to see their physician. Findings suggested variation in physical activity over the life span, with older women performing less physical activity than younger women. Family characteristics (e.g., having children) were strongly associated with performing less structured, less intense physical activities of daily living among women 49 years and younger. Younger women reported having high self-efficacy for physical activity, but also reported the greatest numbers of barriers. Women in the oldest age category reported health as the most common motivator for physical activity, but were also least likely to perform physical activity. Interventions designed to meet the unique needs of women at different stages in their lives will potentially reduce the rate of inactivity among women. Creative, flexible strategies that incorporate physical activity into the daily routine should be used in the program development.

Health Education & Behavior, 2003

Although the relationship of psychosocial factors to physical activity has been explored, there i... more Although the relationship of psychosocial factors to physical activity has been explored, there is increased interest in how perceptions of the community environment influence behavior. However, few methodological studies have incorporated perceptions of the social and community environment (protective social factors) or addressed key measurement issues. Computer-assisted telephone interviews were administered to a national sample of 1,818 U.S. adults. Unadjusted and multivariate-adjusted odds ratios were calculated to compare active and inactive participants by Protective Social Factors (PSF) scores and selected sociodemographics. Confirmatory factor analysis and reliability analysis suggested strong PSF scale psychometric properties (alpha = .92). After adjustment for potential confounders, a 10-point rise in the PSF score resulted in a 12% increased likelihood of meeting Centers for Disease Control and Prevention/American College of Sports Medicine recommendations. Additional analyses indicated that greater perceived PSFs were associated with meeting these recommendations among Whites but not among African Americans.

Health Education, 2002

A randomized field trial compared the effectiveness of three types of printed educational materia... more A randomized field trial compared the effectiveness of three types of printed educational materials designed to increase nutrition label reading. Adult primary care patients (n=915) from four health centers in Missouri were recruited from the lobby while waiting to see a doctor. Participants completed a baseline assessment and were randomly assigned to one of three intervention groups or to a

Annual Review of Public Health, 2011

The childhood obesity epidemic has stimulated the emergence of many policy and environmental stra... more The childhood obesity epidemic has stimulated the emergence of many policy and environmental strategies to increase healthy eating and active living, with relatively few research recommendations identifying the most effective and generalizable strategies. Yet, local, state, and national decision makers have an urgent need to take action, particularly with respect to lower-income and racial and ethnic populations at greatest risk. With the surge of promising and emerging policy and environmental strategies, this review provides a framework, criteria, and process modeled from existing expert classification systems to assess the strength of evidence for these strategies. Likewise, this review highlights evidence gaps and ways to increase the types and amount of evidence available to inform policy and environmental strategies. These priorities include documenting independent and interdependent effects, determining applicability to different populations and settings, assessing implementation fidelity and feasibility, identifying cumulative benefits and costs, ascertaining impacts on health equity, and tracking sustainability.

American Journal of Preventive Medicine, 2012

Twenty-five cross-sector, multidisciplinary community partnerships received funding through the A... more Twenty-five cross-sector, multidisciplinary community partnerships received funding through the Active Living by Design (ALbD) national program to design, plan, and implement innovative initiatives to support active living. This paper examines implementation patterns across ALbD community partnerships related to community characteristics; preparation efforts; and policy, environmental, programmatic, and promotional strategies. Investigators used a mixed-methods, participatory evaluation design, triangulating multiple qualitative and quantitative data sources collected from 2007 to 2009. Configural frequency analysis facilitated detection of variables as well as configurations of variables occurring more (types) or less (anti-types) frequently than patterns expected by chance alone. Overall, community partnerships with more preparation activities (assessment, sustainability) implemented a larger number of active living promotions, programs, policy influences, and physical projects, cumulatively (type). Yet, community partnerships working in communities with >40% of the population from a non-Caucasian racial and ethnic background and >40% of the population in poverty implemented fewer active living promotions, programs, policy influences, and physical projects, cumulatively (type). The resulting types and anti-types provide insight into patterns across communities that may be ascribed to varying configurations of community contexts, resources, and strategies implemented. Rigorous, systematic examination of the underlying causal structures related to the configurations of community characteristics, preparation efforts, and implementation strategies is needed.

American Journal of Preventive Medicine, 2012

Beginning in 2003, Active Living by Design (ALbD) established innovative approaches across 25 com... more Beginning in 2003, Active Living by Design (ALbD) established innovative approaches across 25 communities to increase physical activity through community design, public policies, programming, and communication strategies. The complexity of the ALbD projects called for a mixed-methods evaluation to understand implementation as well as perceived and actual impacts of these efforts. Six primary evaluation methods addressed three primary aims: (1) to assess impacts of physical projects and policy changes on community environments; (2) to document intervention strategies implemented, as well as intended and unintended consequences; and (3) to identify strengths and challenges in planning, developing, and implementing interventions. The ALbD evaluation included cross-site comparisons and more in-depth case studies. This article describes the methods used to address the three aims. Analysis of the strengths and challenges associated with the different methods, including partnership capacity surveys, Concept Mapping, an online progress reporting system, key informant interviews, focus groups, and photos and videos. Additional methods, including environmental audits and direct observation, were explored to specifically assess environmental changes. Several important challenges included the lack of baseline data, difficulty in evaluating natural experiments, the need for ongoing policy surveillance, and the need to capture longer-term endpoints. The mixed-methods evaluation of ALbD advances implementation and evaluation science related to community-based efforts for promoting active living through identification of methods and measures to capture multicomponent and complex interventions as well as translation of a range of approaches to create community change across a variety of populations and settings.

American Journal of Preventive Medicine, 2012

Between 2003 and 2008, a total of 25 partnerships funded through the Active Living by Design (ALb... more Between 2003 and 2008, a total of 25 partnerships funded through the Active Living by Design (ALbD) program worked to change built environments and policies in communities to help citizens be active in their daily routines. This paper systematically summarized the scope of ALbD physical projects and policy changes, described resources generated by the partnerships, and highlighted supports and barriers to the process. Using a mixed-methods approach, multiple data sources, including key informant interviews, focus groups, and a web-based tracking system, were used to collect data during project implementation. Qualitative results were analyzed using systematic coding procedures to identify themes, ideas, and concepts derived from the data. Data analysis occurred in 2008-2010. Most of the 25 partnerships documented physical projects and policy changes in each of the following sectors: urban planning (n=16); active transportation (n=23); trails/parks/recreation/open space (n=22); communities (n=22); and schools (n=18). ALbD community partnerships were successful at generating ≈ $256 million in resources beyond their initial grant, mostly through policy changes. Challenges included creating and sustaining political will and community support as well as securing technical expertise and resources. Planning and relationship building were critical to success in changing policy and implementing projects. Although there is more to understand about how these change processes affect physical activity and health across populations and settings, as well as how social, cultural, and psychosocial factors influence community responses to the policy changes and physical projects, findings from this initiative provide a foundation for subsequent research and practice.

American Journal of Preventive Medicine, 2012

Robert Wood Johnson Foundation&am... more Robert Wood Johnson Foundation's Active Living by Design (ALbD) grant program funded 25 communities across the U.S. The ALbD National Program Office (NPO) supported grantee community partnerships with technical assistance for assessment, planning, and implementation activities intended to increase population levels of physical activity. This paper analyzes and summarizes the range of assessments conducted to identify local barriers and opportunities for active living as important elements of a thorough intervention planning process. Evaluation of the partnerships focused on documenting community changes and strategies used to produce those changes. With support from NPO staff and external evaluators, partnerships tracked and summarized their community assessment approaches as well as strengths and challenges in conducting assessments. The partnerships documented a range of assessment strategies and methods. Partnerships used several qualitative methods, including focus groups, individual and group interviews, and public meetings. Quantitative methods included surveys, audits, observations, and analysis of existing data, among others. The environmental audit was the most common assessment method used by the partnerships. Assessment processes and findings were used for not only intervention planning but also community engagement and direct advocacy. Assessment data collectors varied from professional staff to community volunteers. Assessments were essential to the identification of local barriers and assets related to active living, which in turn helped ALbD partnerships prioritize and refine their action strategies. Assessment processes were also valuable in building relationships with new partners, community members, and local officials.

American Journal of Preventive Medicine, 2010

American Journal of Preventive Medicine, 2014

Investigators developed a review system to evaluate the growing literature on policy and environm... more Investigators developed a review system to evaluate the growing literature on policy and environmental strategies to prevent childhood obesity. More than 2000 documents published between January 2000 and May 2009 in the scientific and grey literature were identified (2008-2009) and systematically analyzed (2009-2012). These focused on policy or environmental strategies to reduce obesity/overweight, increase physical activity, and/or improve nutrition/diet among youth (aged 3-18 years). Guided by the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework, investigators abstracted studies of 24 intervention strategies and assessed evidence for their effectiveness (i.e., study design, intervention duration, and outcomes) and population impact (i.e., effectiveness and reach--participation or exposure, and representativeness) in 142 evaluation study groupings and 254 associational study groupings (n=396 groupings of 600 peer-reviewed studies). The 24 strategies yielded 25 classifications (school wellness policies yielded nutrition and physical activity classifications): 1st-tier effective (n=5); 2nd-tier effective (n=6); "promising" (n=5); or "emerging" (n=9). Evidence for intervention effectiveness was reported in 56% of the evaluation, and 77% of the associational, study groupings. Among the evaluation study groupings, only 49% reported sufficient data for population impact ratings, and only 22% qualified for a rating of high population impact. Effectiveness and impact ratings were summarized in graphic evidence maps, displaying effects/associations with behavioral and obesity/overweight outcomes. This paper describes the results and products of the review, with recommendations for policy research and practice.

American Journal of Preventive Medicine, Nov 1, 2012

Background-From 2003 to 2008, 25 cross-sector, multidisciplinary community partnerships funded th... more Background-From 2003 to 2008, 25 cross-sector, multidisciplinary community partnerships funded through the Active Living by Design (ALbD) national program designed, planned, and implemented policy and environmental changes, with complementary programs and promotions. This paper describes the use of concept-mapping methods to gain insights into promising active living intervention strategies based on the collective experience of community representatives implementing ALbD initiatives. Methods-Using Concept Systems software, community representatives (n=43) anonymously generated actions and changes in their communities to support active living (183 original statements, 79 condensed statements). Next, respondents (n=26, from 23 partnerships) sorted the 79 statements into self-created categories, or active living intervention approaches. Respondents then rated statements based on their perceptions of the most important strategies for creating community changes (n=25, from 22 partnerships) and increasing community rates of physical activity (n=23, from 20 partnerships). Cluster analysis and multidimensional scaling were used to describe data patterns. Results-ALbD community partnerships identified three active living intervention approaches with the greatest perceived importance to create community change and increase population levels of physical activity: changes to the built and natural environment, partnership and collaboration efforts, and land-use and transportation policies. The relative importance of intervention approaches varied according to subgroups of partnerships working with different populations.

American Journal of Preventive Medicine, Jul 1, 1997

Obesity Reviews, Sep 5, 2014

Exposure to physical and policy environments that limit availability, affordability and appeal of... more Exposure to physical and policy environments that limit availability, affordability and appeal of healthy eating and active living options is higher for U.S. blacks than whites. This may contribute to high risk of obesity in black communities and limit effectiveness of preventive interventions. Here, we assess applicability to black Americans of findings from a prior evidence review system designed to accelerate the discovery and application of policy and environmental strategies for childhood obesity prevention and assess external validity. The database included 600 peer-reviewed articles reporting data from 396 sets of studies (study groupings) published from January 2000 through May 2009 and pertained to 24 types of policy and environmental strategies. Only 33 study groupings (∼8%) included ≥50% black Americans or reported subgroup analyses. Of 10 evaluation studies for interventions rated as effective for all populations in the primary review, 8 suggested effectiveness of child-focused interventions in school or child care settings for obesity-or physical activity-related outcomes in black Americans. Overall findings highlight the need for rigorous evaluations of interventions that reach black children in community or institutional settings, and conceptual frameworks and research designs geared to identifying ethnic or ethnicity-income group differences in intervention effects.

Evaluation and Program Planning, 2006

There are few studies evaluating changes made to enhance the activity friendliness of a community... more There are few studies evaluating changes made to enhance the activity friendliness of a community. The purpose of this paper is to review approaches that practitioners can use to evaluate interventions at the community level. Interventions at the community level address indicators across the physical, socio-cultural, institutional/organizational and political/economic environments. Evaluation approaches can include a variety of perceived and objective measures, including self-report surveys, in-depth interviews, environmental audits and use of existing data. The purpose of each approach, along with examples, is presented first, followed by a discussion of how and when each approach should be used and other considerations when evaluating interventions. In addition, this paper reviews special considerations for policy evaluation, while highlighting the need for such work. The paper concludes with a section discussing overarching challenges and lessons learned, including the use of multiple sources of data, participatory approaches and reliable and valid measurement tools.

American Journal of Preventive Medicine, 2012

Background-From 2003 to 2008, 25 cross-sector, multidisciplinary community partnerships funded th... more Background-From 2003 to 2008, 25 cross-sector, multidisciplinary community partnerships funded through the Active Living by Design (ALbD) national program designed, planned, and implemented policy and environmental changes, with complementary programs and promotions. This paper describes the use of concept-mapping methods to gain insights into promising active living intervention strategies based on the collective experience of community representatives implementing ALbD initiatives. Methods-Using Concept Systems software, community representatives (n=43) anonymously generated actions and changes in their communities to support active living (183 original statements, 79 condensed statements). Next, respondents (n=26, from 23 partnerships) sorted the 79 statements into self-created categories, or active living intervention approaches. Respondents then rated statements based on their perceptions of the most important strategies for creating community changes (n=25, from 22 partnerships) and increasing community rates of physical activity (n=23, from 20 partnerships). Cluster analysis and multidimensional scaling were used to describe data patterns. Results-ALbD community partnerships identified three active living intervention approaches with the greatest perceived importance to create community change and increase population levels of physical activity: changes to the built and natural environment, partnership and collaboration efforts, and land-use and transportation policies. The relative importance of intervention approaches varied according to subgroups of partnerships working with different populations.

Document Design, 2003

Many people are trying to be smarter every day. How's about you? There are many ways to evoke... more Many people are trying to be smarter every day. How's about you? There are many ways to evoke this case you can find knowledge and lesson everywhere you want. However, it will involve you to get what call as the preferred thing. When you need this kind of sources, the following book can be a great choice. tailoring health messages customizing communication with computer technology is the PDF of the book.

Http Dx Doi Org 10 1080 02701367 2000 11082798, Feb 13, 2015

Http Dx Doi Org 10 1300 J013v29n02_08, Oct 21, 2008

This study examined the rates and factors associated with physical activity in women of various a... more This study examined the rates and factors associated with physical activity in women of various ages. Adult women (n = 653) from four community-based family medicine clinics completed a self-administered behavioral and health questionnaire while waiting to see their physician. Findings suggested variation in physical activity over the life span, with older women performing less physical activity than younger women. Family characteristics (e.g., having children) were strongly associated with performing less structured, less intense physical activities of daily living among women 49 years and younger. Younger women reported having high self-efficacy for physical activity, but also reported the greatest numbers of barriers. Women in the oldest age category reported health as the most common motivator for physical activity, but were also least likely to perform physical activity. Interventions designed to meet the unique needs of women at different stages in their lives will potentially reduce the rate of inactivity among women. Creative, flexible strategies that incorporate physical activity into the daily routine should be used in the program development.

Journal of public health management and practice : JPHMP

Women & Health, 1999

This study examined the rates and factors associated with physical activity in women of various a... more This study examined the rates and factors associated with physical activity in women of various ages. Adult women (n = 653) from four community-based family medicine clinics completed a self-administered behavioral and health questionnaire while waiting to see their physician. Findings suggested variation in physical activity over the life span, with older women performing less physical activity than younger women. Family characteristics (e.g., having children) were strongly associated with performing less structured, less intense physical activities of daily living among women 49 years and younger. Younger women reported having high self-efficacy for physical activity, but also reported the greatest numbers of barriers. Women in the oldest age category reported health as the most common motivator for physical activity, but were also least likely to perform physical activity. Interventions designed to meet the unique needs of women at different stages in their lives will potentially reduce the rate of inactivity among women. Creative, flexible strategies that incorporate physical activity into the daily routine should be used in the program development.

Health Education & Behavior, 2003

Although the relationship of psychosocial factors to physical activity has been explored, there i... more Although the relationship of psychosocial factors to physical activity has been explored, there is increased interest in how perceptions of the community environment influence behavior. However, few methodological studies have incorporated perceptions of the social and community environment (protective social factors) or addressed key measurement issues. Computer-assisted telephone interviews were administered to a national sample of 1,818 U.S. adults. Unadjusted and multivariate-adjusted odds ratios were calculated to compare active and inactive participants by Protective Social Factors (PSF) scores and selected sociodemographics. Confirmatory factor analysis and reliability analysis suggested strong PSF scale psychometric properties (alpha = .92). After adjustment for potential confounders, a 10-point rise in the PSF score resulted in a 12% increased likelihood of meeting Centers for Disease Control and Prevention/American College of Sports Medicine recommendations. Additional analyses indicated that greater perceived PSFs were associated with meeting these recommendations among Whites but not among African Americans.

Health Education, 2002

A randomized field trial compared the effectiveness of three types of printed educational materia... more A randomized field trial compared the effectiveness of three types of printed educational materials designed to increase nutrition label reading. Adult primary care patients (n=915) from four health centers in Missouri were recruited from the lobby while waiting to see a doctor. Participants completed a baseline assessment and were randomly assigned to one of three intervention groups or to a

Annual Review of Public Health, 2011

The childhood obesity epidemic has stimulated the emergence of many policy and environmental stra... more The childhood obesity epidemic has stimulated the emergence of many policy and environmental strategies to increase healthy eating and active living, with relatively few research recommendations identifying the most effective and generalizable strategies. Yet, local, state, and national decision makers have an urgent need to take action, particularly with respect to lower-income and racial and ethnic populations at greatest risk. With the surge of promising and emerging policy and environmental strategies, this review provides a framework, criteria, and process modeled from existing expert classification systems to assess the strength of evidence for these strategies. Likewise, this review highlights evidence gaps and ways to increase the types and amount of evidence available to inform policy and environmental strategies. These priorities include documenting independent and interdependent effects, determining applicability to different populations and settings, assessing implementation fidelity and feasibility, identifying cumulative benefits and costs, ascertaining impacts on health equity, and tracking sustainability.

American Journal of Preventive Medicine, 2012

Twenty-five cross-sector, multidisciplinary community partnerships received funding through the A... more Twenty-five cross-sector, multidisciplinary community partnerships received funding through the Active Living by Design (ALbD) national program to design, plan, and implement innovative initiatives to support active living. This paper examines implementation patterns across ALbD community partnerships related to community characteristics; preparation efforts; and policy, environmental, programmatic, and promotional strategies. Investigators used a mixed-methods, participatory evaluation design, triangulating multiple qualitative and quantitative data sources collected from 2007 to 2009. Configural frequency analysis facilitated detection of variables as well as configurations of variables occurring more (types) or less (anti-types) frequently than patterns expected by chance alone. Overall, community partnerships with more preparation activities (assessment, sustainability) implemented a larger number of active living promotions, programs, policy influences, and physical projects, cumulatively (type). Yet, community partnerships working in communities with >40% of the population from a non-Caucasian racial and ethnic background and >40% of the population in poverty implemented fewer active living promotions, programs, policy influences, and physical projects, cumulatively (type). The resulting types and anti-types provide insight into patterns across communities that may be ascribed to varying configurations of community contexts, resources, and strategies implemented. Rigorous, systematic examination of the underlying causal structures related to the configurations of community characteristics, preparation efforts, and implementation strategies is needed.

American Journal of Preventive Medicine, 2012

Beginning in 2003, Active Living by Design (ALbD) established innovative approaches across 25 com... more Beginning in 2003, Active Living by Design (ALbD) established innovative approaches across 25 communities to increase physical activity through community design, public policies, programming, and communication strategies. The complexity of the ALbD projects called for a mixed-methods evaluation to understand implementation as well as perceived and actual impacts of these efforts. Six primary evaluation methods addressed three primary aims: (1) to assess impacts of physical projects and policy changes on community environments; (2) to document intervention strategies implemented, as well as intended and unintended consequences; and (3) to identify strengths and challenges in planning, developing, and implementing interventions. The ALbD evaluation included cross-site comparisons and more in-depth case studies. This article describes the methods used to address the three aims. Analysis of the strengths and challenges associated with the different methods, including partnership capacity surveys, Concept Mapping, an online progress reporting system, key informant interviews, focus groups, and photos and videos. Additional methods, including environmental audits and direct observation, were explored to specifically assess environmental changes. Several important challenges included the lack of baseline data, difficulty in evaluating natural experiments, the need for ongoing policy surveillance, and the need to capture longer-term endpoints. The mixed-methods evaluation of ALbD advances implementation and evaluation science related to community-based efforts for promoting active living through identification of methods and measures to capture multicomponent and complex interventions as well as translation of a range of approaches to create community change across a variety of populations and settings.

American Journal of Preventive Medicine, 2012

Between 2003 and 2008, a total of 25 partnerships funded through the Active Living by Design (ALb... more Between 2003 and 2008, a total of 25 partnerships funded through the Active Living by Design (ALbD) program worked to change built environments and policies in communities to help citizens be active in their daily routines. This paper systematically summarized the scope of ALbD physical projects and policy changes, described resources generated by the partnerships, and highlighted supports and barriers to the process. Using a mixed-methods approach, multiple data sources, including key informant interviews, focus groups, and a web-based tracking system, were used to collect data during project implementation. Qualitative results were analyzed using systematic coding procedures to identify themes, ideas, and concepts derived from the data. Data analysis occurred in 2008-2010. Most of the 25 partnerships documented physical projects and policy changes in each of the following sectors: urban planning (n=16); active transportation (n=23); trails/parks/recreation/open space (n=22); communities (n=22); and schools (n=18). ALbD community partnerships were successful at generating ≈ $256 million in resources beyond their initial grant, mostly through policy changes. Challenges included creating and sustaining political will and community support as well as securing technical expertise and resources. Planning and relationship building were critical to success in changing policy and implementing projects. Although there is more to understand about how these change processes affect physical activity and health across populations and settings, as well as how social, cultural, and psychosocial factors influence community responses to the policy changes and physical projects, findings from this initiative provide a foundation for subsequent research and practice.

American Journal of Preventive Medicine, 2012

Robert Wood Johnson Foundation&am... more Robert Wood Johnson Foundation's Active Living by Design (ALbD) grant program funded 25 communities across the U.S. The ALbD National Program Office (NPO) supported grantee community partnerships with technical assistance for assessment, planning, and implementation activities intended to increase population levels of physical activity. This paper analyzes and summarizes the range of assessments conducted to identify local barriers and opportunities for active living as important elements of a thorough intervention planning process. Evaluation of the partnerships focused on documenting community changes and strategies used to produce those changes. With support from NPO staff and external evaluators, partnerships tracked and summarized their community assessment approaches as well as strengths and challenges in conducting assessments. The partnerships documented a range of assessment strategies and methods. Partnerships used several qualitative methods, including focus groups, individual and group interviews, and public meetings. Quantitative methods included surveys, audits, observations, and analysis of existing data, among others. The environmental audit was the most common assessment method used by the partnerships. Assessment processes and findings were used for not only intervention planning but also community engagement and direct advocacy. Assessment data collectors varied from professional staff to community volunteers. Assessments were essential to the identification of local barriers and assets related to active living, which in turn helped ALbD partnerships prioritize and refine their action strategies. Assessment processes were also valuable in building relationships with new partners, community members, and local officials.

American Journal of Preventive Medicine, 2010

American Journal of Preventive Medicine, 2014

Investigators developed a review system to evaluate the growing literature on policy and environm... more Investigators developed a review system to evaluate the growing literature on policy and environmental strategies to prevent childhood obesity. More than 2000 documents published between January 2000 and May 2009 in the scientific and grey literature were identified (2008-2009) and systematically analyzed (2009-2012). These focused on policy or environmental strategies to reduce obesity/overweight, increase physical activity, and/or improve nutrition/diet among youth (aged 3-18 years). Guided by the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework, investigators abstracted studies of 24 intervention strategies and assessed evidence for their effectiveness (i.e., study design, intervention duration, and outcomes) and population impact (i.e., effectiveness and reach--participation or exposure, and representativeness) in 142 evaluation study groupings and 254 associational study groupings (n=396 groupings of 600 peer-reviewed studies). The 24 strategies yielded 25 classifications (school wellness policies yielded nutrition and physical activity classifications): 1st-tier effective (n=5); 2nd-tier effective (n=6); "promising" (n=5); or "emerging" (n=9). Evidence for intervention effectiveness was reported in 56% of the evaluation, and 77% of the associational, study groupings. Among the evaluation study groupings, only 49% reported sufficient data for population impact ratings, and only 22% qualified for a rating of high population impact. Effectiveness and impact ratings were summarized in graphic evidence maps, displaying effects/associations with behavioral and obesity/overweight outcomes. This paper describes the results and products of the review, with recommendations for policy research and practice.