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.
Scenario planning is a method for anticipating possible alternative futures. Used widely in business applications, it allows planners to anticipate problems, reevaluate assumptions, and reflect on consequences of those alternative futures. In this article, scenario planning is applied to public health, specifically to illustrate the four steps in scenario planning for public health using a health department's desire to address chronic disease prevention and control. An unhealthy diet and physical inactivity are considered to be key risk factors. The scenarios are presented in table format and are for illustration purposes only. Many other plausible scenarios could be constructed. Scenario planning allows stake-holders to define a desired, shared vision of the future, but more important, they can better prepare public health professionals to be successful in a constantly changing environment.
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