Environmental and Policy Strategies
Environmental and policy approaches tend to be broad in scope and affect underlying systems to provide opportunities, support, and cues to help people be more physically active. Based on the definitions of environmental and policy changes, at times they involve:
- The physical environment
- Social networks
- Organizational norms and policies
- Involvement of multiple sectors: public health, community organizations, policymaking bodies, departments of parks and recreation, transportation and planning agencies, business and industry, and the media
The U.S. Preventive Services Task Force is charged with reviewing all available evidence and issuing recommendations for interventions that have been proven effective on a community-wide scale. Their recommendations, published in the Community Guide, have included some specific to physical activity. While none are specific to adults with arthritis, they lay the scientific foundation for the strategies in this Guide.
This table lists interventions reviewed by the Community Guide, with Task Force findings for each (definitions of findings). The Community Guide includes systematic reviews of interventions in the following areas:
Click on an underlined intervention title for a summary of the review and relevant recommended approaches.
Linking these approaches—environmental and policy strategies with informational outreach and the availability of individual behavior/social change programs—is key to increasing reach. Some examples:
- Worksites build walking trails or provide walking maps to their employees (environmental/policy), disseminate Physical Activity. The Arthritis Pain Reliever materials to employees (campaigns/informational), and then have programs available that meet the needs of employees with arthritis such as the Arthritis Foundation’s group led Walk With Ease Program (behavioral/social)
- Health plan wellness programs provide “incentive points” for participation in evidence-based programs (environmental/policy), disseminate health communications materials (campaigns/informational) through member guides and email, and link health plan members to programs such as the Arthritis Foundation’s self-directed Walk With Ease program (behavioral/social).
To learn more
The Community Guide, Systematic Review Methods
The Community Guide, What are Research-tested Intervention Programs and why consider them?
The Community Guide, Increasing Physical Activity: Environmental and Policy Approaches
The Community Guide, Worksite Health Promotion
Arthritis Foundation, Centers for Disease Control and Prevention. A National Public Health Agenda for Osteoarthritis. Atlanta (GA): Centers for Disease Control and Prevention 2010.
Centers for Disease Control and Prevention. Arthritis as a potential barrier to physical activity among adults with obesity — United States, 2007 and 2009. MMWR Morb Mortal Wkly Rpt 2011a; 60(19);614-8.
Centers for Disease Control and Prevention. State-specific prevalence of no leisure-time physical activity among adults with and without doctor-diagnosed arthritis — United States, 2009. MMWR Morb Mortal Wkly Rep 2011b;60(48):1641-70.
Centers for Disease Control and Prevention. Prevalence of doctor-diagnosed arthritis and arthritis-attributable activity limitation --- United States, 2007-2009. MMWR Morb Mortal Wkly Rep 2010;59(39):1261-5.
Centers for Disease Control and Prevention. Arthritis as a potential barrier to physical activity among adults with heart disease — United States, 2005 and 2007. MMWR Morb Mortal Wkly Rpt 2009;58(7):165-169.
Centers for Disease Control and Prevention. Arthritis as a Potential Barrier to Physical Activity Among Adults with Diabetes — United States, 2005 and 2007. MMWR Morb Mortal Wkly Rpt 2008;57(18):486-489.
Rimmer JH, Riley B, Wang E, Rauworth A. Accessibility of health clubs for people with mobility disabilities and visual impairments. Am J Public Health 2005;95(11):2022-8.
Rimmer JH, Riley B, Wang E, Rauworth A, Jurkowski J. Physical activity participation among persons with disabilities: barriers and facilitators. Am J Prev Med 2004;26(5):419-25.
Wilcox S, Der Ananian C, Abbott J, et al. Perceived exercise barriers, enablers, and benefits among exercising and nonexercising adults with arthritis: results from a qualitative study. Arthritis Rheum 2006;55(4):616-27.
Zhang W, Nuki G, Moskowitz RW, et al. OARSI recommendations for the management of hip and knee osteoarthritis: part III: Changes in evidence following systematic cumulative update of research published through January 2009. Osteoarthritis Cartilage 2010;18(4):476-99.