Evidence-based interventions to promote physical activity: what contributes to dissemination by state health departments

Abstract

Background: Evidence-based guidelines for promoting physical activity have been produced, yet sparse information exists on the dissemination of effective interventions. The purpose of this study was to better understand the dissemination of physical activity interventions across the United States, focusing particularly on evidence-based guidelines.

Design: A cross-sectional study was conducted in the U.S. that was organized around a modified version of the diffusion of innovations theory.

Setting/participants: Respondents (n=49) were the physical activity contact person (e.g., program administrator, health educator) in each state or territorial health department.

Main outcome measures: Seven specific programs and policies relating to physical activity intervention were examined as dependent variables. Five additional domains--organizational climate, awareness, adoption, implementation, and maintenance--framed a set of independent variables.

Results: The most important factor related to decision making was the availability of adequate resources. Most respondents (89.8%) were aware of evidence-based guidelines to promote physical activity. However, less than half of the respondents (41%) had the authority to implement evidence-based programs and policies. A minority of respondents reported having support from their state governor (35.4%) or from most of their state legislators (21.3%). Several key factors were associated with the adoption of evidence-based interventions, including the presence of state funding for physical activity, whether the respondent participated in moderate physical activity, presence of adequate staffing, and presence of a supportive state legislature.

Conclusions: Awareness of the importance of promoting physical activity is relatively high in state and territorial health departments; however, the levels of internal support within the health department appear to outweigh any outside support from elected officials.