Walk Score® is a proprietary walkability metric that ranks locations by proximity to destinations, with emerging health promotion applications for increasing walking as physical activity. Currently, field validations of Walk Score® have only occurred in metropolitan regions of the United States; moreover, many studies employ an earlier Walk Score® version utilizing straight line distance. To address this gap, we conducted a field validation of the newest, network-based metric for three municipal types along a rural-urban continuum in Alberta, Canada. In 2015, using street-level systematic observations collected in Bonnyville, Medicine Hat, and North Central Edmonton in 2008 (part of the Community Health and the Built Environment (CHBE) project), we reverse engineered 2181 scores with the network Walk Score® algorithm. We computed means, 95% confidence intervals, and t-tests (α = 0.05) for both sets of scores. Applying the Clifford-Richardson adjustment for spatial autocorrelation, we calculated Spearman's Rank Correlation Coefficients (rho, rs) and adjusted p-values to measure the strength of association between the derived scores and original network scores provided by Walk Score®. Spearman's rho for scores were very high for Bonnyville (rs = 0.950, adjusted p < 0.001), and high for Medicine Hat (rs = 0.790, adjusted p < 0.001) and North Central Edmonton (rs = 0.763, adjusted p < 0.001). High to very high correlations between derived scores and Walk Scores® field validated this metric across small, medium, and large population centres in Alberta, Canada. However, we suggest caution in interpreting Walk Score® for planning and evaluating health promotion interventions, since the strength of association between destinations and walking may vary across different municipal types.
ObjectiveTo assess and compare the favourability of healthy public policy options to promote healthy eating from the perspective of members of the general public and policy influencers in two Canadian provinces.DesignThe Chronic Disease Prevention Survey, administered in 2016, required participants to rank their level of support for different evidence-based policy options to promote healthy eating at the population level. Pearson’s χ2 significance testing was used to compare support between groups for each policy option and results were interpreted using the Nuffield Council on Bioethics’ intervention ladder framework.SettingAlberta and Québec, Canada.ParticipantsMembers of the general public (n 2400) and policy influencers (n 302) in Alberta and Québec.ResultsGeneral public and policy influencer survey respondents were more supportive of healthy eating policies if they were less intrusive on individual autonomy. However, in comparing levels of support between groups, we found policy influencers indicated significantly stronger support overall for healthy eating policy options. We also found that policy influencers in Québec tended to show more support for more restrictive policy options than their counterparts from Alberta.ConclusionsThese results suggest that additional knowledge brokering may be required to increase support for more intrusive yet impactful evidence-based policy interventions; and that the overall lower levels of support among members of the public may impede policy influencers from taking action on policies to promote healthy eating.
Health in all policies can address chronic disease morbidity and mortality by increasing population-level physical activity and healthy eating, and reducing tobacco and alcohol use. Both governmental and nongovernmental policy influencers are instrumental for health policy that modifies political, economic, and social environments. Policy influencers are informed and persuaded by coalitions that support or oppose changing the status quo. Empirical research examining policy influencers' contact with coalitions, as a social psychological exposure with health policy outcomes, can benefit from application of health communication theories. Accordingly, we analyzed responses to the 2014 Chronic Disease Prevention Survey for 184 Canadian policy influencers employed in provincial governments, municipalities, large workplaces, school boards, and the media. In addition to contact levels with coalitions, respondents' jurisdiction, organization, and ideology were analyzed as potential moderators. Calculating authority score centrality using network analysis, we determined health policy supporters to be more central in policy influencer networks, and theorized their potential to impact health policy public agenda setting via priming and framing processes. We discuss the implications of our results as presenting opportunities to more effectively promote health policy through priming and framing by coordinating coalitions across risk behaviors to advance a societal imperative for chronic disease prevention.
Population ageing combined with physical inactivity has critical implications for the public health of communities in the twenty-first century. In the last decade, the World Health Organization launched the age-friendly cities agenda, aiming to address population ageing through whole-systems, rights-based, health equity-focused approaches. An important intervention for age-friendly communities is modifying built environments to support population-level physical activity. Physical activity can help mitigate impacts of chronic diseases and social isolation on older adults. Need for advocacy and action in this area raises questions of how to develop supportive environments for physical activity across age-friendly community types. In Canada, a substantial proportion of older adults live outside large urban municipalities, for which scant research exists on fostering age-friendly built environments. To this end, we conducted qualitative research involving semi-structured interviews with 21 municipal policy influencers in Alberta, Canada to gather perspectives on development and early implementation of an age-friendly policy framework in the small urban and rural context. Our findings are organised by three main themes providing key lessons for advocacy and action, namelypursuing comprehensive planning,promoting public engagementandprioritising the needs of older adults. This research informs advocacy and action priorities in promoting built environment modification for routine physical activity as part of an age-friendliness agenda for small urban and rural regions of Canada and other countries.
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