Academic journal article Canadian Journal of Public Health

Pathways to Policy: Lessons Learned in Multisectoral Collaboration for Physical Activity and Built Environment Policy Development from the Coalitions Linking Action and Science for Prevention (CLASP) Initiative

Academic journal article Canadian Journal of Public Health

Pathways to Policy: Lessons Learned in Multisectoral Collaboration for Physical Activity and Built Environment Policy Development from the Coalitions Linking Action and Science for Prevention (CLASP) Initiative

Article excerpt

Coalitions Linking Action and Science for Prevention (CLASP) was an initiative of the Canadian Partnership Against Cancer (the Partnership) that aimed to reduce the risk of cancer and chronic disease in Canadians through the implementation of evidence-based program and policy interventions. Twelve projects were funded through CLASP in two phases: seven CLASP1 projects from 2009 to 2012, of which three were renewed for an additional two years, and five CLASP2 projects from 2013 to 2016. The projects addressed the spectrum of cancer and chronic disease risk factors in a variety of settings (e.g., municipalities, Indigenous communities, schools, workplaces, health care, etc.). CLASP brought together project coalitions that were multijurisdictional (partners from two or more provinces/territories) to scale up what had been demonstrated to work in one jurisdiction to others.1 The coalitions were also multidisciplinary (research, practice and policy partners) to facilitate the uptake of evidence into practice and policy.1

The development of new policies and policy change was pursued as a key outcome across the CLASP projects as a crucial mechanism for sustaining a population-level impact beyond the funding period. Both laws and regulations enacted by governments (i.e., "big P policies") and organizational rules, practices and decisions (i.e., "little p policies"),2 either newly developed or changed through CLASP, were considered policies impacted by CLASP. At the conclusion of the seven CLASP1 projects, 239 policies were tallied through the initiative's evaluation as newly created or changed through CLASP efforts (policies impacted by CLASP2 projects will be available at the conclusion of the CLASP initiative evaluation in December 2016). Of these, 163 pertained specifically to policies focused on creating healthier built environments and increasing physical activity and were the result of efforts from two CLASP1 projects: Children's Mobility, Health and Happiness (CMHH), led by Green Communities Canada, and Healthy Canada by Design (HCBD), led by the Heart and Stroke Foundation of Canada.

Physical inactivity is an important risk factor for chronic disease and cancer in particular. It is estimated that one third of cancers worldwide can be attributed to physical inactivity, diet and weight, and physical activity has been shown to reduce the risk of over a dozen cancers by 20% or more.3,4 The built environment has been directly implicated in levels of leisure-time and utilitarian physical activity. Communities where built environments have elements such as greater density and transportation network connectivity have higher levels of physical activity.5,6 The built environment has also been shown to impact health through effects on air quality,7-9 injury prevention,10,11 social connectivity,12,13 and exposure to the natural environment.14,15

Population-based health interventions aimed at changing environments, such as land use and transportation policies, must be implemented in non-health sectors.16 The successful development and implementation of policies outside of health therefore necessitates effective partnerships and collaboration across sectors.16 These same policies also provide benefits beyond health - for environmental sustainability, climate change17 costs of municipal infrastructure,18 and economic development. These are issues which have involved urban planners and their allies in the "Smart Growth" movement for many years. New York City's many innovative healthy public policies under Mayor Bloomberg's term (2002-2013), including a trans-fat ban, point-of-sale calorie labelling, complete streets and cycle lane expansion, and supermarket construction incentives, among others, are all attributed in part to a commitment to collaboration across sectors.19 While multisectoral collaboration to address health issues and catalyze policy development is increasingly understood, what makes a multisectoral partnership successful is less well defined. …

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