title: Local Health Department Engagement in Community Physical Activity Policy.
abstract: BACKGROUND
  This study assessed correlates of self-reported local health department (LHD) participation in community policy/advocacy activities that support physical activity.
  
  
  METHODS
  In 2014, cross-sectional data from the nationally representative 2013 National Profile of Local Health Departments study administered by the National Association of County and City Health Officials were analyzed. Outcomes were participation in policy/advocacy activities related to urban design/land use, active transportation, and access to recreational facilities. Independent variables included structural characteristics, performance improvement efforts, and collaboration. Multivariate logistic regression models were computed.
  
  
  RESULTS
  Representatives of 490 LHDs participated (79% response rate). Respondents reported similar participation in urban design/land use (25%); active transportation (16%); and recreational facility access (23%) policy/advocacy. LHDs with populations of ≥500,000 were more likely to report urban design/land use (p=0.004) as well as active transportation policy/advocacy participation (p=0.007) compared with those with populations of ≤50,000. LHDs with a community health improvement plan were more likely to participate in urban design/land use policy/advocacy (p=0.001). LHDs who regularly use the Community Guide were more likely to report policy/advocacy activity on active transportation (p=0.007) and expanding access to recreation facilities (p=0.009). LHDs engaged in a land use partnership were more likely to report urban design/land use (p<0.001) and active transportation (p=0.001) policy/advocacy participation.
  
  
  CONCLUSIONS
  Participation in community physical activity policy/advocacy among LHDs was low in this study and varied by LHD characteristics. Intervention opportunities include assisting smaller LHDs and promoting performance improvement efforts and evidence-based practice resources.
authors.affiliation: Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester, Massachusetts.
authors.forename: Karin V
authors.initials: KV
authors.lastname: Goins
authors.affiliation: National Association of County and City Health Officials, Washington, District of Columbia.
authors.forename: Jiali
authors.initials: J
authors.lastname: Ye
authors.affiliation: National Association of County and City Health Officials, Washington, District of Columbia.
authors.forename: Carolyn J
authors.initials: CJ
authors.lastname: Leep
authors.affiliation: National Association of County and City Health Officials, Washington, District of Columbia.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Robin
authors.affiliation: Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester, Massachusetts. Electronic address: stephenie.lemon@umassmed.edu.
authors.forename: Stephenie C
authors.initials: SC
authors.lastname: Lemon
mesh_terms: D002908:Chronic Disease / Q000517:prevention & control; D003299:Cooperative Behavior; D003430:Cross-Sectional Studies; D015444:Exercise; D005260:Female; D006266:Health Education; D006291:Health Policy; D006295:Health Resources; D006801:Humans; D009111:Local Government; D008297:Male; D009765:Obesity / Q000517:prevention & control; D011634:Public Health / Q000379:methods*; D011998:Recreation