How healthy are our physical activity policy environments: learnings from two EU countries

Background: Public policies are an important upstream component of physical activity (PA) as they can influence whole populations. The systematic evaluation, benchmarking and monitoring of public policies that promote healthy environments is needed for accountability and assessment of impact.

Purpose: The Physical Activity Environment Policy Index (PA-EPI) is a tool developed to facilitate comparative PA policy research. This study presents the learnings of PA-EPI implementation in Ireland (IE) and the Netherlands (NL).

Methods: Implementation of PA-EPI comprised 8-steps. Steps 1-4 involved collecting evidence of policy implementation and its validation by government officials. Cross-sectoral coalitions of non-government experts rated the extent of implementation against best practice (steps 5-6). Based on expert ratings, a scorecard categorized indicators into high, medium, low or none/very little implementation. Step 7-8 identified future implementation actions.

Results: Government officials in IE (N=4) and NL (N=15) validated their respective PA-EPIs, yielding minor changes (steps 1-4). Experts in IE (N=16) and NL (n=14) rated the extent of policy implementation (step 5-6). IE obtained one none/very little, 25 low, 19 medium, and zero high implementation scores, whereas NL received zero none/very little, 10 low, 28 medium and 7 high implementation scores. Implementation gaps were identified in transport, urban design and healthcare policy domains for IE, and one indicator in the education, mass media, sport for all and workplace domains received a low score in NL. In infrastructure support, gaps for IE emerged in the Health in All Policies domain, leadership scored the lowest in NL.

Conclusions: Results show policy implementation as uneven, with important gaps in several domains. Prioritized recommendations provided a pathway for governments to take action and demonstrate progress over time.

Practical implications: Future cross-country comparisons of PA-EPI results will help establish benchmarks for governments at the forefront of creating and implementing policies to promote PA.

Funding: JPI