S09-4 The development of the Physical Activity Environment Policy Index (PA-EPI): a tool for monitoring and benchmarking government policies and actions to improve physical activity

Abstract Background Insufficient physical activity (PA) is a global issue for health. A multifaceted response, including government action, is essential to improve population levels of PA. The purpose of this study was to develop the ‘Physical Activity Environment Policy Index’ (PA-EPI) monitoring framework to assess government policies and actions for creating a healthy PA environment. Methods An iterative process was undertaken. This involved a review of policy documents from authoritative organisations, a policy audit of four European countries, and systematic reviews of scientific literature. This was followed by an online consultation with academic experts (N = 101; 20 countries, 72% response rate), and policymakers (N = 40, 4 EU countries). During this process, consensus workshops where quantitative and qualitative data alongside theoretical and pragmatic considerations were used to inform PA-EPI development. Results The PA-EPI is conceptualised as a two-component ‘policy’ and ‘infrastructure support’ framework. The two components comprise eight policy and seven infrastructure support domains. The policy domains are education, transport, urban design, healthcare, public education (including mass media), sport-for-all, workplaces and community. The infrastructure support domains are leadership, governance, monitoring and intelligence, funding and resources, platforms for interaction, workforce development, and health-in-all-policies. Forty-five ‘good practice statements’ (GPS) or indicators of ideal good practice within each domain concludes the PA-EPI. A potential eight-step process for conducting the PA-EPI is described. Conclusions Once pre-tested and piloted in several countries of various sizes and income levels, the PA-EPI GPS will evolve into benchmarks established by governments at the forefront of creating and implementing policies to address inactivity.


Background
Insufficient physical activity (PA) is a global issue for health.A multifaceted response, including government action, is essential to improve population levels of PA.The purpose of this study was to develop the 'Physical Activity Environment Policy Index' (PA-EPI) monitoring framework to assess government policies and actions for creating a healthy PA environment.Methods An iterative process was undertaken.This involved a review of policy documents from authoritative organisations, a policy audit of four European countries, and systematic reviews of scientific literature.This was followed by an online consultation with academic experts (N = 101; 20 countries, 72% response rate), and policymakers (N = 40, 4 EU countries).
During this process, consensus workshops where quantitative and qualitative data alongside theoretical and pragmatic considerations were used to inform PA-EPI development.

Results
The PA-EPI is conceptualised as a two-component 'policy' and 'infrastructure support' framework.The two components comprise eight policy and seven infrastructure support domains.The policy domains are education, transport, urban design, healthcare, public education (including mass media), sport-for-all, workplaces and community.The infrastructure support domains are leadership, governance, monitoring and intelligence, funding and resources, platforms for interaction, workforce development, and health-in-all-policies.Forty-five 'good practice statements' (GPS) or indicators of ideal good practice within each domain concludes the PA-EPI.A potential eight-step process for conducting the PA-EPI is Goals Describe the progress of developing and monitoring global physical activity policy from the 1990s through the release and implementation of Global Action Plan for Physical Activity-GAPPA; Present findings of a systematic review of instruments for physical activity policy analysis; Describe the methods and progress after 1-year implementation of the Global Observatory for Physical Activity-GoPA! physical activity policy inventory; Present the preliminary findings and lessons learned after 1year implementation of the Global Observatory for Physical Activity-GoPA! physical activity policy inventory.Issue/problem Physical inactivity is one of the most important factors contributing to global morbidity and mortality, but despite both importance and the recent launch of a WHO action plan, public health policy around physical activity remains poorly developed and monitored.Description of the problem Physical inactivity accounts for as many as 5 million deaths per year globally but has yet to be addressed effectively by most governments or the World Health Organization(WHO).Many efforts led by WHO, national governments, networks, and academics from the 1990s to the present have tried to turn physical activity into a public health priority.Since its launch in 2015, the Global Observatory for Physical Activity-GoPA! has monitored the progress of national physical activity surveillance, policy and research.The GoPA! Policy Inventory created in 2017, contributes to physical activity policy monitoring and aims to collect data worldwide.

Results
In this symposium we will address several key questions about physical activity policy by examining different initiatives such as GAPPA and the experience of monitoring policy globally with the GoPA! policy inventory.We will examine whether it is feasible to track physical activity policy at the global and country levels, if the existence of ?good? physical activity policy is associated with less physical inactivity and how policy indicators may be used for advocacy and guidance in the coming years.Lessons Findings show that PA policy monitoring has and still varies substantially by geographic area and country income group.Effectiveness and implementation of PA policies remains challenging worldwide.PA policy indicators can enhance understanding of the links between policy and population levels of PA.

Main messages
GoPA! is committed to continue improving PA policy monitoring for informing and encouraging policy to address physical inactivity worldwide.Agenda and Presenters Introduction: Michael Pratt (10-minutes) Talk 1: Developing and monitoring physical activity policy: 1990 to today -Michael Pratt (15-minutes) Talk 2: Instruments for the analysis of national-level physical activity and sedentary behaviour policies: a systematic review -Z ˇeljko Pedis ˇic ´(15-minutes) Talk 3: The GoPA! Policy Inventory: Progress and methods -Andrea Ramirez (15-minutes)