Local assets and barriers to making active living supportive decisions: A qualitative study investigating city leaders' perspectives

Introduction: Municipal employees and elected officials play a central role in creating policies and environments that promote population physical activity; however, there has been minimal examination of the factors that influence their decisions. The purpose of this qualitative study was to identify factors that facilitate or hinder city design decisions that support active living.

Methods: Fifteen interviews were conducted in a large metropolitan southern United States city. Participants included 2 elected officials (Mayor, City Council Member) and 13 city employees including the Assistant City Manager, Planning Director, Parks Director, Public Works Director, Urban Redevelopment Manager, and Transit Manager. In-person interviews lasted 30-90 minutes, were audio recorded and transcribed. Transcripts were coded and analyzed for themes. Themes were identified as topics discussed by participants in 5 or more of the 15 interviews.

Results: Participants identified numerous barriers to making active living supportive decisions.  The most common were financial expense of changing the physical environment and poor existing infrastructure due to historical city planning decisions. Other barriers included: less supportive public attitudes, inadequate transit system, large geographical area, dependency on the automobile, and inefficient funding mechanisms.

Participants acknowledged city assets that supported active living efforts including political will and leadership, a political champion who advocates for change, growing citizen support, successful infrastructure projects, and public/private partnerships.

Conclusion: Qualitative methods can enhance understanding of factors influencing local city design. Public health implications include supporting active living champion(s), encouraging political leadership, increasing public education, and increasing involvement in city infrastructure projects promoting physical activity.