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Measuring and monitoring progress towards achieving healthy, equitable and sustainable cities is a priority for planners, policymakers and researchers in diverse contexts globally. Yet data collection, analysis, visualisation and reporting on policy and spatial indicators involve specialised knowledge, skills, and collaboration across disciplines. Integrated open-source tools for calculating and communicating urban indicators for diverse urban contexts are needed, which provide the multiple streams of evidence required to influence policy agendas and enable local changes towards healthier and more sustainable cities. This paper reports on the development of open-source software for planning, analysis and generation of data, maps and reports on policy and spatial indicators of urban design and transport features for healthy and sustainable cities. We engaged a collaborative network of researchers and practitioners from diverse geographic contexts through an online survey and workshops, to understand and progressively meet their requirements for policy and spatial indicators. We outline our framework for action research-informed open-source software development and discuss benefits and challenges of this approach. The resulting Global Healthy and Sustainable City Indicators software is designed to meet the needs of researchers, planners, policy makers and community advocates in diverse settings for planning, calculating and disseminating policy and spatial urban indicators.

Creating healthy and sustainable cities should be a global priority. Some cities prioritize 15-minute cities as a planning approach with co-benefits for health, climate change mitigation, equity, and economic recovery from COVID-19. Yet, as our recent Lancet Global Health series on “Urban Design, Transport, and Health” showed, many cities have a long way to go to achieve this vision. This policy guideline summarizes the main findings of the series, which assessed health and sustainability indicators for 25 cities in 19 countries. We then outline steps governments can take to strengthen policy frameworks and deliver more healthy, equitable, and sustainable built environments.The Lancet Global Health series provided clear evidence that cities need to transform urban governance to enable integrated planning for health and sustainability and commit to policy implementation. Evidence-informed indicators should be used to benchmark and monitor progress. Cities need policy frameworks that are comprehensive and consistent with evidence, with measurable policy targets to support implementation and accountability. The series provided evidence-informed thresholds for some key urban design and transport features, which can be embedded as policy targets. Policies and interventions must prioritize identifying and reducing inequities in access to health-supportive environments. Governments should also invest in open data and promote citizen-science programmes, to support indicator development and research for public benefit. We provide tools to replicate our indicators and an invitation to join our 1000 Cities Challenge via the Global Observatory of Healthy and Sustainable Cities.

BackgroundNational, regional and global scientific production and research capacity for physical activity - PA may contribute to improving public health PA policies and programs. There is an uneven distribution of research productivity by region and country income group, where countries with the highest burden of non-communicable diseases attributable to physical inactivity having low research productivity. A first step towards improving global research capacity is to objectively quantify patterns, trends, and gaps in PA research. This study describes national, regional and global trends and patterns of PA research from 1950 to 2019.MethodsA systematic review using searches in PubMed, SCOPUS and ISI Web of Knowledge databases was conducted in August 2017 and updated between January and May 2020. The review was registered at the PROSPERO database number CRD42017070153. PA publications per 100,000 inhabitants per country was the main variable of interest. Descriptive and time-trend analyses were conducted in STATA version 16.0.ResultsThe search retrieved 555,468 articles of which 75,756 were duplicates, leaving 479,712 eligible articles. After reviewing inclusion and exclusion criteria, 23,860 were eligible for data extraction. Eighty-one percent of countries (n = 176) had at least one PA publication. The overall worldwide publication rate in the PA field was 0.46 articles per 100,000 inhabitants. Europe had the highest rate (1.44 articles per 100,000 inhabitants) and South East Asia had the lowest (0.04 articles per 100,000 inhabitants). A more than a 50-fold difference in publications per 100,000 inhabitants was identified between high and low-income countries. The least productive and poorest regions have rates resembling previous decades of the most productive and the richest.ConclusionThis study showed an increasing number of publications over the last 60 years with a growing number of disciplines and research methods over time. However, striking inequities were revealed and the knowledge gap across geographic regions and by country income groups was substantial over time. The need for regular global surveillance of PA research, particularly in countries with the largest data gaps is clear. A focus on the public health impact and global equity of research will be an important contribution to making the world more active.

Background: Population-level physical activity increases are improbable without intersectoral collaboration across government levels and sectors to develop and implement physical activity promotion policies. This study aims to provide information about the development of the Interaction between National and Local Government Levels in Development and Implementation of Physical Activity Policies Tool (INTEGRATE PA-Pol). A framework was created to examine the development and implementation of national and subnational physical activity policies and the (mis)alignment between government levels. Methods: The work was conducted in 3 phases: (1) a scoping review was carried out to identify local government physical activity promotion policies and instruments for assessing them, (2) an expert group designed 6 questionnaires, and (3) cognitive response testing was employed for validity testing and item modification with a panel of research and policy experts. Results: The INTEGRATE PA-Pol Tool consists of 6 questionnaires assessing how national and subnational governments collaborate to develop and implement physical activity promotion policies. Conclusion: This tool can assist in better understanding the development and implementation of a public policy monitoring system that will allow for benchmarking and priority setting to comprehend how physical activity promotion policies are designed and executed. [ABSTRACT FROM AUTHOR]

Background: National physical activity (PA) policy processes are only beginning to be studied in Latin America, and little attention has focused at the subnational level. This study examined national–subnational relations in the policy process (agenda setting, policy formulation, adoption, implementation, and evaluation) in selected Latin American countries. Methods: The Global Observatory for Physical Activity's (GoPA!) INTEGRATE-PA-Pol tool was applied in Colombia, Costa Rica, Ecuador, and Mexico. Data were collected in matched pairs of the capital plus one noncapital city among national and subnational policymakers (n = 27), previously identified by the GoPA! Country Contacts. PA policy development and implementation were assessed using descriptive statistics. Results: Twenty-three (response rate = 85.2%) informants provided data, mainly from the health sector (52.2%), followed by the sport (26.1%), transport (13.0%), and education (8.7%) sectors. Most informants reported that their countries had a current PA policy embedded within noncommunicable diseases prevention plans (46.2%), other plans (46.2%), or obesity prevention/management/control plans (7.7%). Respondents at the subnational level rated PA promotion as central (64.3%), while the national-level role was important but not central (75.0%). National and subnational policymakers indicated low-to-little involvement in the other level's PA policy processes across the 5 policy stages. Conclusions: This study demonstrated that collecting national and subnational PA policy data across countries with the active collaboration of the GoPA! network was feasible. We also successfully identified governmental interactions throughout the PA policy process, suggesting suboptimal engagement between national and subnational levels. [ABSTRACT FROM AUTHOR]

By providing spaces for recreation, physical activity, social gatherings, and time in nature, urban parks offer physical, mental, and social benefits to users. However, many urban residents face barriers to park use. The COVID-19 pandemic introduced new potential barriers to urban park access and use, including changes to daily life and employment, closure of park amenities and restrictions to public movement, and risk from the coronavirus itself. The mixed-methods PARCS study measured use and perceptions of a large urban park in St. Louis, Missouri before, during, and after local COVID-19 contingency measures and restrictions. We examine data from 1,157 direct observation assessments of park usership, an online survey of park users (n=561), interviews with key stakeholders (n=27), four focus groups (n=30), and a community-based participatory research sub-study (n=66) to comprehensively characterize the effects of the COVID-19 pandemic on park use. Park users who felt unsafe from the coronavirus experienced 2.65 higher odds of reducing park use. However, estimated park visits during COVID-19 contingency measures (n=5,023,759) were twice as high as post-contingency (n=2,277,496). Participants reported using the park for physical activity, recreation, time in nature, and socializing during the contingency period. Black, Hispanic/Latino, and young people were less likely to visit the park than others, suggesting an additional, disproportionate impact of the pandemic on minoritized and socioeconomically disadvantaged communities. This study highlights the role of public spaces like parks as resources for health and sites where urban health inequities can be alleviated in times of public crisis. [ABSTRACT FROM AUTHOR]

Access to and use of parks is associated with physical activity participation. Our Voice is a systematic method blending community-based participatory research (CBPR) and citizen science. As part of a comprehensive, mixed-methods study in St. Louis, Missouri (PARCS), we tested the feasibility of the Our Voice method for gathering community input on the barriers to and facilitators of accessibility and use of large metropolitan parks, by describing the implementation of the Our Voice method among recreational and commuter users of a large metropolitan park in St. Louis, MO. Due to challenges posed by COVID-19, the Our Voice methodology was adapted for remote participation. Twenty-three citizen scientists (14 recreational park users and 9 commuters) collected and analyzed geolocated route, photo, and audio or text data on facilitators and barriers to park use and access. They identified 6 priority themes and 12 solution ideas, and presented them to stakeholders. In contrast to previous Our Voice studies, separate user groups (recreation and commuter users) independently prioritized many of the same themes. Adaptation of the Our Voice protocol to virtual practices during COVID-19 revealed positive implications for cost, reach, and scale of studies grounded in CBPR and citizen science. We provide a set of recommended practices for using Our Voice as a method to evaluate and promote equity of access and use of metropolitan parks., Competing Interests: Conflict of interest statement: We have no conflicts of interest to disclose., (© JHEAL, 2021.)