AssessmentAssurance Evaluation Policy development 1 2 3 4 Public Health Action Cycle

Assessment Assurance

Evaluation

Policydevelopment

1

2

3

4

Public Health Action Cycle

Causal Model from Formulation of a Policy to Health Outcomes

Policy Determinants

Policy

Environment

Physical Activity

Health

A

C

D

E

B

Level

Physical Activity Policy Framework

Outcomes of Policy

Develop and Implement Policy

Determinants of Policy

Identify Policy

Local RegionalState National

School

Worksite

TransportationParks/Public Spaces

HealthScale

Policy

Sector

B1 – Offers

B2 – Strategies in politics and organisation

B3 – Community potential and committment

B4 – Individual competences

C1 – Material environment

C2 – Social environment

C3 – Personal resources and behavioural patterns

A1Development of offers

A2Lobbying/Collaboration with organisations

A3Mobilisation of communities

A4Development of individual competences

InfrastructureServices

LegislationAdministrationOrganisationNetworks

GroupsCommunitiesPopulation

Individuals

Influencing factors DeterminantsMeasuresOutcome levels Pro

mo

tion

of P

hysical A

ctivity and

Sp

orts

Adapted from “Anleitung zum Ergebnismodell von Gesundheitsförderung Schweiz, 2004 „

Outcome Model of Health Promotion Switzerland Adapted for the Promotion of Physical Activity and Sports

Framework for Physical Activity PromotionHEPA Promotion

Policy Process

Physical ActivityBehaviour

Physical ActivityDeterminants

Programmes &Activities

Health

LeisureTransportWork/SchoolDomestic

Intensity

Duration Frequency

Context

…

Intensity

Duration Frequency

Context

Specific activity

Dimensions of physical activity

Intensity

Duration Frequency

Context

Specific activity

Intensity

Duration Frequency

Context

Overall

Modes of physical activity

Intensity

Duration Frequency

Context

Transport

Intensity

Duration Frequency

Context

Domestic

Intensity

Duration Frequency

Context

Work/School

Intensity

Duration Frequency

Context

Leisure

Framework for Physical Activity PromotionHEPA Promotion

Policy Process

Physical ActivityBehaviour

Physical ActivityDeterminants

Programmes &Activities

Health

IntrapersonalPhysical environment

Social environment

Modifiable Determinants of Physical Activity

Intrapersonal

Social environmentPhysical environment

Knowledge, attitudes and values

Skills and capabilitiesPositive expectations

Organised sport & exercise

Wider socialenvironement

Family environment

Home & work environment

Transport infrastructure

Leisure time &sports infrastructure

PhysicalActivity

Non-modifiable determinants

Physical environment

Social environment

Determinants of Physical Activity

Framework for Physical Activity Promotion

Policy Process

Physical ActivityBehaviour

Physical ActivityDeterminants

Programmes &Activities

Health

Development of offers

Mobilisation of communities

Training & education

PR campaignsConstruction work

Industrial activities

etc.

Dimensions of programmes and activitiesadapted from Schmid et al., 2006 and Cloetta et al, 2005

Local/subnational

NationalInternational

EducationIndustry/economy

TransportLand use/housing

Health

Scale

Elements of programmes and activites

Sector

Sport

Multi-sectoral approach

Development of offers

Mobilisation of communities

Training & education

PR campaingsConstruction work

Industrial activities

etc.

Uni-sectoral approach

Environment

Framework for Physical Activity Promotion

Policy Process

Physical ActivityBehaviour

Physical ActivityDeterminants

Programmes &Activities

Health

Legislation

Recommendations and guidelines

Policy and strategy documents

Leadership & strategic planning

Networking & committment

Dimensions of the policy processadapted from Schmid et al., 2006

Policy outcomesPolicy

determinants

Local/subnational

NationalInternational

Scale

Policy elements

Sector

Leadership & strategic planning

Networking &committment

Knowledge base

Legislation

Recommendations & guidelines

Policy & strategy documents

17.02.2006

Government level

Uni-sectoral approach

Multi-sectoral approach

Social climate

EducationIndustry/economy

TransportLand use/housing

HealthSport

Environment

Physical ActivityBehaviour

Health

Physical ActivityDeterminants

Programmes &ActivitiesPolicy Process

Framework for Physical Activity PromotionOther Influencing Factors

Framework for Physical Activity Promotion

Policy Process

Physical ActivityBehaviour

Physical ActivityDeterminants

Programmes &Activities

HealthKnowledge

Base

Framework for Physical Activity PromotionMonitoring and Evaluation

Policy Process

Physical ActivityBehaviour

Physical ActivityDeterminants

Programmes &Activities

HealthKnowledge

Base

Framework for Physical Activity Promotion Evidence Based HEPA Promotion

Policy Process

Physical ActivityBehaviour

Physical ActivityDeterminants

Programmes &Activities

HealthKnowledge

Base

Physical ActivityBehaviour

Health

Physical ActivityDeterminants

Programmes &ActivitiesPolicy Process

Framework for Physical Activity Promotion Evidence Based HEPA Promotion

KnowledgeBase

Policy Process

Physical ActivityBehaviour Determinants

Programmes &Activities

KnowledgeBase

Policy Process

Physical ActivityBehaviour Determinants

Programmes &Activities

KnowledgeBase

Policy Process

Physical ActivityBehaviour Determinants

Programmes &Activities

KnowledgeBase

Framework for Physical Activity Promotionwithin a Multi-Dimensional Health Policy

Diet

Smoking……

Health

Policy Process

Physical ActivityBehaviour

Physical ActivityDeterminants

Programmes &Activities

KnowledgeBase

Physical Activity

Policy Process

Physical ActivityDeterminants

Programmes &Activities

KnowledgeBase

.....

Policy Process

Physical ActivityDeterminants

Programmes &Activities

KnowledgeBase

Education

Policy Process

Physical ActivityDeterminants

Programmes &Activities

KnowledgeBase

Urban Planning

Policy Process

Physical ActivityDeterminants

Programmes &Activities

KnowledgeBase

Transport

Policy Process

Physical ActivityDeterminants

Programmes &Activities

KnowledgeBase

Sports

Framework for Physical Activity PromotionMulti-Sectoral Approaches

Policy Process

Physical ActivityDeterminants

Programmes &Activities

KnowledgeBase

HealthPhysicalActivity

Other Outcomes

Type I evidence

Disease risk factor (e.g. physical inactivity)

“Why should something be done?”

Type II evidence

Intervention prevalence of risk factor

“What should be done?”

Types of evidence for Public Health

Cavill et al 2005, adapted from Brownson et al 1999

Framework for Physical Activity PromotionType 1 Evidence

Policy Process

Physical ActivityBehaviour

Physical ActivityDeterminants

Programmes &Activities

HealthKnowledge

Base

„Why should something be done?“

Framework for Physical Activity PromotionType 2 Evidence

Policy Process

Physical ActivityBehaviour

Physical ActivityDeterminants

Programmes &Activities

HealthKnowledge

Base

„What should be done?“

Framework for Physical Activity PromotionPolicy research

Policy Process

Physical ActivityBehaviour

Physical ActivityDeterminants

Programmes &Activities

HealthKnowledge

Base

„How can be donewhat should be done?“

Slides 28 to 35 have not been used directly in the discussion paper,

but could be useful for presentations

Framework for Physical Activity PromotionHEPA Promotion

Policy Process

Physical ActivityBehaviour

Physical ActivityDeterminants

Programmes &Activities

Health

Framework for Physical Activity PromotionHEPA Promotion

Policy Process

Physical ActivityBehaviour

Physical ActivityDeterminants

Programmes &Activities

Health

Policy Process

Physical ActivityBehaviour

Physical ActivityDeterminants

Programmes &Activities

Health

Framework for Physical Activity PromotionHEPA Promotion

Policy Process

Physical ActivityBehaviour

Physical ActivityDeterminants

Programmes &Activities

Health

Framework for Physical Activity PromotionHEPA Promotion

PhysicalActivity

Health

HEPA

HEPA

Non-modifiable determinants

Physical environment

Social environment

Model for HEPA Determinants

Physical ActivityBehaviour

Health

Physical ActivityDeterminants

Programmes &ActivitiesPolicy Process

Framework for Physical Activity PromotionOther Influencing Factors

Physical ActivityBehaviour

Health

Physical ActivityDeterminants

Programmes &ActivitiesPolicy Process

Framework for Physical Activity Promotion Evidence Based HEPA Promotion

KnowledgeBase