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A Site-Specific Literature Review of Policy and Environmental Interventions That Promote Physical Activity and Nutrition for Cardiovascular Health: What Works?
Abstract
OBJECTIVE: To review the literature to determine whether policy and environmental interventions can increase people's physical activity or improve their nutrition. DATA SOURCES: The following databases were searched for relevant intervention studies: Medline, Chronic Disease Prevention File, PsychInfo, Health Star, Web of Science, ERIC, the U.S. Department of Transportation, and the U.S. Department of Agriculture. STUDY SELECTION: To be included in the review, studies must have (1) addressed policy or environmental interventions to promote physical activity and/or good nutrition; (2) been published from 1970 to October 2003; (3) provided a description of the intervention; and (4) reported behavioral, physiological, or organizational change outcomes. Studies that had inadequate intervention descriptions or that focused on determinants research, individual-level interventions only, the built environment, or media-only campaigns were excluded. DATA EXTRACTION: We extracted and summarized studies conducted before 1990 (n = 65) and during 1990-2003 (n = 64). DATA SYNTHESIS: Data were synthesized by topic (i.e., physical activity or nutrition), by type of intervention (i.e., point-of-purchase), and by setting (i.e., community, health care facility, school, worksite). Current studies published during 1990-2003 are described in more detail, including setting and location, sample size and characteristics, intervention, evaluation period, findings, and research design. Findings are also categorized by type of intervention to show the strength of the study designs and the associations of policy and environmental interventions with physical activity and nutrition. CONCLUSIONS: The results of our review suggest that policy and environmental strategies may promote physical activity and good nutrition. Based on the experimental and quasi-experimental studies in this review, the following interventions provide the strongest evidence for influencing these behaviors: prompts to increase stair use (N = 5); access to places and opportunities for physical activity (N = 6); school-based physical education (PE) with better-trained PE teachers, and increased length of time students are physically active (N = 7); comprehensive work-site approaches, including education, employee and peer support for physical activity, incentives, and access to exercise facilities (N = 5); the availability of nutritious foods (N = 33), point-of-purchase strategies (N = 29); and systematic officer reminders and training of health care providers to provide nutritional counseling (N = 4). Further research is needed to determine the long-term effectiveness of different policy and environmental interventions with various populations and to identify the steps necessary to successfully implement these types of interventions.
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“To determine the sustainable impact of interventions, studies with longer intervention and evaluation periods are needed [20].”
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Kremers, S., Reubsaet, A., Martens, M. K., Gerards, S. M. P. L., Jonkers, R., Candel, M. J. J. M., de Weerdt, I., & de Vries, N. K. (2009) · Obesity Reviews · doi:10.1111/j.1467-789x.2009.00598.x · Cited by 57
Social Determinants and Nutrition: Reflections on the Role of Communication
Viswanath, K., & Bond, K. (2007) · Journal of Nutrition Education and Behavior · doi:10.1016/j.jneb.2006.07.008 · Cited by 56
Kwak, L., Kremers, S., Werkman, A. M., Visscher, T. L. S., van Baak, M. A., & Brug, J. (2006) · Obesity Reviews · doi:10.1111/j.1467-789x.2006.00304.x · Cited by 54
“Point-of-decision prompts were also used as pointof-purchase information in worksite cafeterias and in the form of labelling of healthy food choices (94,123).”
BackgroundMethodRütten, A., Schow, D. C., Breda, J., Galea, G., Kahlmeier, S., Oppert, J., van der Ploeg, H. P., & van Mechelen, W. (2016) · International Journal of Public Health · doi:10.1007/s00038-016-0807-y · Cited by 53
“Doing so may help overcome conceptual hurdles in previously published literature, which often conflates ‘‘policy and environmental approaches’’ or deals with policy approaches as a type of (physical activity) intervention (Brownson et al. 2006; Matson-Koffman et al. 2005; Rychetnik et al. 2002; Sallis et al. 1998).”
Golaszewski, T., Allen, J. R., & Edington, D. (2008) · American Journal of Health Promotion · doi:10.4278/ajhp.22.4.tahp · Cited by 52
Warner, L. M., & French, D. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108677318.032 · Cited by 62
Population physical activity behaviour change: A review for the European College of Sport Science
Biddle, S., Brehm, W., Verheijden, M. W., & Hopman-Rock, M. (2011) · European Journal of Sport Science · doi:10.1080/17461391.2011.635700 · Cited by 50
Changing Behavior Using Ecological Models
Salmon, J., Hesketh, K. D., Arundell, L., Downing, K. L., & Biddle, S. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108677318.017 · Cited by 57
Worksite Policies and Environments Supporting Physical Activity in Midwestern Communities
Dodson, E. A., Lovegreen, S. L., Elliott, M., Haire-Joshu, D. L., & Brownson, R. C. (2008) · American Journal of Health Promotion · doi:10.4278/ajhp.07031626 · Cited by 48
“Recent, site-specific literature reviews support the association between a small number of worksite policies, similar to those reported here, and increased physical activity.(10,11) We extend this work to examine a broad array of policies and their combined effect.”
Olstad, D. L., Downs, S., Raine, K. D., Berry, T. R., & McCargar, L. J. (2011) · BMC Public Health · doi:10.1186/1471-2458-11-423 · Cited by 48
“School-based studies, by contrast, have shown that healthy food environments foster good dietary behaviours [4-7] and appropriate body weights among children [5,6] and as such, there is significant momentum across North America to improve school nutrition environments.”
BackgroundKwak, L., Kremers, S., van Baak, M. A., & Brug, J. (2005) · Health Promotion International · doi:10.1093/heapro/dai033 · Cited by 48
“All rights reserved. doi:10.1093/heapro/dai033 For Permissions, please email: journals.permissions@oxfordjournals.org Advance access publication 9 December 2005”
BackgroundInfluentialAllen, P. M., Sequeira, S. M., Jacob, R. R., Hino, A. A. F., Stamatakis, K. A., Harris, J. K., Elliott, L., Kerner, J. F., Jones, E., Dobbins, M., et al. (2013) · Implementation Science · doi:10.1186/1748-5908-8-141 · Cited by 47
“In the past two decades, environmental and policy approaches to prevent cancer and other chronic diseases have been identified that provide the potential to reach entire communities and populations statewide [14-18].”
BackgroundShemilt, I., Hollands, G. J., Marteau, T. M., Nakamura, R., Jebb, S. A., Kelly, M. P., Suhrcke, M., & Ogilvie, D. (2013) · PLoS ONE · doi:10.1371/journal.pone.0075070 · Cited by 50
A genetic perspective on the association between exercise and mental health
de Geus, E. J. C., & de Moor, M. H. M. (2008) · Mental health and physical activity · doi:10.1016/j.mhpa.2008.09.005 · Cited by 47
Saunders, R. P., Wilcox, S., Baruth, M., & Dowda, M. C. (2013) · Evaluation and Program Planning · doi:10.1016/j.evalprogplan.2013.11.003 · Cited by 46
“In turn, the Health-Promoting Church environment was expected to positively influence psychosocial variables and ultimately health behavior and health outcomes for congregants (Blankenship et al., 2006; Cohen et al., 2000; Matson-Koffman et al., 2005).”
BackgroundRamires, V. V., dos Santos, P. C., Filho, V. C. B., Bandeira, A. D. S., Tenório, M. C. M., de Camargo, É. M., Ravagnani, F. C. D. P., Sandreschi, P. F., de Oliveira, V. J. M., Hallal, P. C., et al. (2023) · Journal of Physical Activity and Health · doi:10.1123/jpah.2022-0395 · Cited by 74
Changing Behavior Using Self-Determination Theory
Hagger, M. S., Hankonen, N. E., Chatzisarantis, N. L. D., & Ryan, R. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108677318.008 · Cited by 67
Andersen, L. L., & Zebis, M. K. (2014) · International Journal of Rheumatology · doi:10.1155/2014/761363 · Cited by 43
Embodied Work: Insider Perspectives on the Work of HIV/AIDS Peer Counselors
Hilfinger Messias, D. K., Moneyham, L., Vyavaharkar, M., Murdaugh, C., & Phillips, K. D. (2009) · Health Care for Women International · doi:10.1080/07399330902928766 · Cited by 42
Cauchi, D., Glonti, K., Petticrew, M. P., & Knai, C. (2016) · Obesity Reviews · doi:10.1111/obr.12441 · Cited by 44
“Our methods led to the exclusion of a number of high quality SRs which implicitly or explicitly addressed environmental interventions, such as those by Matson-Koffman et al. 23 and Wang et al. 150 .”
MethodStankevitz, K., Dement, J. M., Schoenfisch, A. L., Joyner, J., Clancy, S. M., Stroo, M., & Østbye, T. (2017) · Journal of Occupational and Environmental Medicine · doi:10.1097/jom.0000000000001092 · Cited by 41
“One study found that reducing prices on healthy foods in vending machines can increase sales of these foods,(46) while increasing access to healthy foods can lead to increased fruit and vegetable consumption.(45)”
BackgroundStrong Hearts, Healthy Communities: A Community-Based Randomized Trial for Rural Women
Seguin, R. A., Paul, L., Folta, S., Nelson, M., Strogatz, D., Graham, M. L., Diffenderfer, A., Eldridge, G. D., & Parry, S. A. (2018) · Obesity · doi:10.1002/oby.22158 · Cited by 39
Economic incentives and nutritional behavior of children in the school setting: A systematic review
Jensen, J. D., Hartmann, H., de Mul, A., Schuit, A. J., & Brug, J. (2011) · Nutrition Reviews · doi:10.1111/j.1753-4887.2011.00422.x · Cited by 40
Planning and Implementation Intention Interventions
Rhodes, R. E., Grant, S. J., & de Bruijn, G. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108677318.039 · Cited by 46
Attitudes and Persuasive Communication Interventions
Hamilton, K., & Johnson, B. T. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108677318.031 · Cited by 44
Changing Behavior Using Habit Theory
Orbell, S., & Verplanken, B. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108677318.013 · Cited by 50
Metadata
- Authors
- Matson-Koffman, D. M., Brownstein, J. N., Neiner, J. A., & Greaney, M. L.
- Affiliations
- National Center for Chronic Disease Prevention and Health Promotion (US)
- ORCID
- Greaney, Mary L.
- Venue
- American Journal of Health Promotion
- Publisher
- SAGE Publications
- Published
- 2005-01
- Volume
- 19
- Issue
- 3
- Pages
- 167-193
- ISSN
- 0890-1171 (ISSN-L)
- 2168-6602
- OpenAlex
- W2179535556
- Cited by
- 315
- References
- 151
- Citations by year
- 2026: 4 · 2025: 1 · 2024: 1 · 2023: 4 · 2022: 7 · 2021: 5 · 2020: 55 · 2019: 12 · 2018: 17 · 2017: 9 · 2016: 11 · 2015: 12 · 2014: 7 · 2013: 16 · 2012: 14
- FWCI
- 2.56
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Health Promotion (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Centers for Disease Control and Prevention
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Physical Activity and Health
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Health Promotion and Cardiovascular Prevention
- Social Sciences › Transportation › Urban Transport and Accessibility
- Keywords
- physical activity promotion, nutrition promotion, health policy, environmental interventions, cardiovascular health, school-based physical education, workplace health, food availability, health professional counseling, community-based intervention, health promotion effectiveness, food marketing regulation
- MeSH terms
- Adult, Cardiovascular Diseases, Environment, Female, Health Promotion, Humans, Male, Middle Aged, Nutritional Physiological Phenomena, United States, Exercise
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