Developing and utilising the physical activity environment policy index: a tool to advance the implementation of physical activity policy in Ireland.

Physical activity is one of the most impactful health behaviours in terms of preventing premature mortality. Supplementing the impact on mortality is the effect that PA has on morbidity and potentially on other beneficial societal outcomes. Unfortunately, the vision of communities and societies which enjoy the full benefits of widespread physical activity participation is not one that is being substantively realised. Research, and action, is required to ameliorate this problem.

Theory suggests that public policy can support the achievement of health sustaining levels of physical activity by the general population. However, it is not clear which policies best support physical activity outcomes. Further, audits of existing national level physical activity policies suggest that policy is often poorly implemented. My research contributes to the development of Physical Activity Environment Policy Index (PA-EPI), a new policy research tool that enables the assessment of policy implementation by researchers and the benchmarking and comparison of policy implementation across polities.

To provide scientific evidence for the PA-EPI’s development, a systematic review protocol was developed. This protocol outlines the methodology for a series of systematic reviews which identify the evidence behind policies and their effectiveness in supporting physical activity outcomes.

Guided by this protocol, four systematic reviews were conducted. The systematic reviews recommended various policy actions as effective in promoting physical activity in Sport, Education, Transport and Mass Media settings.

The findings of these reviews informed the development of the PA-EPI. This evidence was synthesized with other forms of evidence in an iterative four-step process culminating in the final PA-EPI framework and monitoring tool and an associated eight-step process for using the tool.

The PA-EPI tool was then utilised to perform a policy implementation assessment in Ireland. This identified implementation gaps in the domains of Transport, Urban Design, Healthcare and Health-in-all-policies. Based on these findings a list of recommended implementation actions was formulated and dissemination to a panel of national stakeholders.

This project has contributed to the development of a tool which supports physical activity policy implementation research. The PA-EPI is not merely a tool for research, however, but also for physical activity advocacy. The success of the PA-EPI project depends on fostering partnerships with national physical activity stakeholders and policymakers and, over the long term, adoption by the international physical activity research and advocacy community. Future research using the PA-EPI should integrate these insights and investigate promoting health equity within the process and learning from the process how to improve PA policy in the future.