title: All health is local: state and local planning for physical activity promotion.
abstract: BACKGROUND
  Physical activity is a leading cause of death in the world. Although state and local public health planning is a useful strategy to address noncommunicable disease health concerns such as heart disease, diabetes, cancer, and obesity, physical activity frequently is subsumed in such disease-centric planning efforts. This strategy could dilute broader efforts to promote physical activity, create administrative silos that may be trying to accomplish similar goals, and weaken efforts to more collectively address a variety of noncommunicable diseases. Currently, few stand-alone state plans directed specifically at physical activity exist. The reasons and barriers for this situation are not understood.
  
  
  OBJECTIVE
  In 2011, we surveyed public health care practitioners to describe state and local efforts for physical activity planning.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Survey of physical activity practitioners in the United States.
  
  
  METHODS
  A total of 227 former or current members of the US National Society of Physical Activity Practitioners in Public Health who completed a survey.
  
  
  RESULTS
  Overall, 48.0% of respondents indicated that they were aware of public health plans for physical activity promotion in their state, whereas 36.6% indicated that they did not know. Respondents at the state level more frequently reported awareness of a plan (62.1%) than those with local-level (52.4%) or other job responsibilities (36.0%). A greater proportion of respondents reported that stand-alone physical activity plans existed in their state than actually did exist in the respective states. Integration with the National Physical Activity Plan was least often identified as a moderately or extremely relevant aspect of a state-level physical activity plan, although it was chosen at a high percentage (75.7%). Respondents identified financial support (88.0%) and political will and support (54.6%) most frequently as very or somewhat difficult barriers to moving forward with state-level physical activity plans.
  
  
  CONCLUSIONS
  These data suggest that despite efforts to increase development and use of stand-alone physical activity plans, most practitioners rely on existing chronic disease- or obesity-related plans to guide their efforts. Barriers to developing stand-alone physical activity plans must be addressed to develop such plans.
authors.affiliation: Division of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health, University of Texas Health Science Center-Houston, Austin, Texas 78701, USA. harold.w.kohl@uth.tmc.edu
authors.forename: Harold W
authors.initials: HW
authors.lastname: Kohl
authors.forename: Sara B
authors.initials: SB
authors.lastname: Satinsky
authors.forename: Geoffrey P
authors.initials: GP
authors.lastname: Whitfield
authors.forename: Kelly R
authors.initials: KR
authors.lastname: Evenson
mesh_terms: D003430:Cross-Sectional Studies; D015444:Exercise; D006285:Health Planning / Q000458:organization & administration / Q000706:statistics & numerical data; D006293:Health Promotion / Q000458:organization & administration* / Q000706:statistics & numerical data; D006801:Humans; D009111:Local Government; D009043:Motor Activity; D013219:State Government; D014481:United States