title: Identifying mechanisms for facilitating knowledge to action strategies targeting the built environment.
abstract: In recent years, obesity-related diseases have been on the rise globally resulting in major challenges for health systems and society as a whole. Emerging research in population health suggests that interventions targeting the built environment may help reduce the burden of obesity and type 2 diabetes. However, translation of the evidence on the built environment into effective policy and planning changes requires engagement and collaboration between multiple sectors and government agencies for designing neighborhoods that are more conducive to healthy and active living. In this study, we identified knowledge gaps and other barriers to evidence-based decision-making and policy development related to the built environment; as well as the infrastructure, processes, and mechanisms needed to drive policy changes in this area.
  
  
  
  We conducted a qualitative thematic analysis of data collected through consultations with a broad group of stakeholders (N = 42) from Southern Ontario, Canada, within various sectors (public health, urban planning, and transportation) and levels of government (federal, provincial, and municipalities). Relevant themes were classified based on the specific phase of the knowledge-to-action cycle (research, translation, and implementation) in which they were most closely aligned.
  
  
  
  We identified 5 themes including: 1) the need for policy-informed and actionable research (e.g. health economic analyses and policy evaluations); 2) impactful messaging that targets all relevant sectors to create the political will necessary to drive policy change; 3) common measures and tools to increase capacity for monitoring and surveillance of built environment changes; (4) intersectoral collaboration and alignment within and between levels of government to enable collective actions and provide mechanisms for sharing of resources and expertise, (5) aligning public and private sector priorities to generate public demand and support for community action; and, (6) solution-focused implementation of research that will be tailored to meet the needs of policymakers and planners. Additional research priorities and key policy and planning actions were also noted.
  
  
  
  Our research highlights the necessity of involving stakeholders in identifying inter-sectoral solutions to develop and translate actionable research on the built environment into effective policy and planning initiatives.
authors.affiliation: Centre for Urban Health Solutions, The Keenan Research Centre, Li Ka Shing Knowledge Institute, St. Michael's Hospital, 209 Victoria Street, M5B 1T8, Toronto, ON, Canada. fazlig@smh.ca.|Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada. fazlig@smh.ca.
authors.forename: Ghazal S
authors.initials: GS
authors.lastname: Fazli
authors.affiliation: Centre for Urban Health Solutions, The Keenan Research Centre, Li Ka Shing Knowledge Institute, St. Michael's Hospital, 209 Victoria Street, M5B 1T8, Toronto, ON, Canada.
authors.forename: Maria I
authors.initials: MI
authors.lastname: Creatore
authors.affiliation: Centre for Urban Health Solutions, The Keenan Research Centre, Li Ka Shing Knowledge Institute, St. Michael's Hospital, 209 Victoria Street, M5B 1T8, Toronto, ON, Canada.|Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.|Institute for Clinical Evaluative Sciences, Toronto, ON, Canada.
authors.forename: Flora I
authors.initials: FI
authors.lastname: Matheson
authors.affiliation: Centre for Urban Health Solutions, The Keenan Research Centre, Li Ka Shing Knowledge Institute, St. Michael's Hospital, 209 Victoria Street, M5B 1T8, Toronto, ON, Canada.|Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada.|Institute for Clinical Evaluative Sciences, Toronto, ON, Canada.
authors.forename: Sara
authors.initials: S
authors.lastname: Guilcher
authors.affiliation: Centre for Urban Health Solutions, The Keenan Research Centre, Li Ka Shing Knowledge Institute, St. Michael's Hospital, 209 Victoria Street, M5B 1T8, Toronto, ON, Canada.|Department of Nutrition, Faculty of Health Sciences, Ariel University, Ariel, Israel.
authors.forename: Vered
authors.initials: V
authors.lastname: Kaufman-Shriqui
authors.affiliation: Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.|Public Health Ontario, Toronto, ON, Canada.
authors.forename: Heather
authors.initials: H
authors.lastname: Manson
authors.affiliation: Centre for Urban Health Solutions, The Keenan Research Centre, Li Ka Shing Knowledge Institute, St. Michael's Hospital, 209 Victoria Street, M5B 1T8, Toronto, ON, Canada.
authors.forename: Ashley
authors.initials: A
authors.lastname: Johns
authors.affiliation: Centre for Urban Health Solutions, The Keenan Research Centre, Li Ka Shing Knowledge Institute, St. Michael's Hospital, 209 Victoria Street, M5B 1T8, Toronto, ON, Canada.|Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.|Institute for Clinical Evaluative Sciences, Toronto, ON, Canada.
authors.forename: Gillian L
authors.initials: GL
authors.lastname: Booth
mesh_terms: D002947:Cities; D002958:City Planning; D003924:Diabetes Mellitus, Type 2 / Q000517:prevention & control*; D004779:Environment Design / Q000706:statistics & numerical data; D006302:Health Services Research; D006801:Humans; D009864:Ontario; D011050:Policy Making; D017149:Private Sector; D011634:Public Health; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D014186:Transportation
keywords: Built environment; Chronic diseases; Knowledge to action; Planning; Population health; Stakeholder engagement; Transportation; Urban health