Identifying what works for local physical inactivity interventions

The case for getting everybody active every day could not be clearer. Inactivity is responsible for 1 in 6 deaths and wider health, social and economic costs for individuals, families and communities in England. However, it is less clear ‘what works’ to tackle inactivity, especially interventions that can be implemented with pace and scale.
A collaboration of the willing to address the rising tide of inactivity is developing across sectors, political parties and at community, local and national levels. Yet resources have never been tighter and the All Parliamentary Commission on Physical Activity reported that poor measurement and evaluation of interventions illustrates the “lack [of] a coherent picture of what ‘good’ looks like”.
In commissioning this work, we sought to explore the Commission’s concerns and test their hypotheses. It takes a rigorous, objective approach based on the Nesta standards of evidence and the Standard Evaluation Framework for Physical Activity. It doing so we test two things: 1) Can we identify ‘what works’ for roll-out across the country?; and 2) Are there issues to be addressed regarding measurement and evaluation of interventions? The answer to both is that we are making progress, but more work is needed.
In many ways this work exceeded expectations. The community came together to present over 950 projects and programmes for scrutiny, making it the largest study of its kind. A broad range of intervention models were represented , from those which change the physical infrastructure of the world we live in, to targeted programmes supporting specific individuals into activity. It is likely we will need a mix of such approaches.
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Everybody active, every day – the evidence
The Nesta standards illustrate a somewhat academic approach to evidence, and this highlights the disparity between academic research and programme-level evaluations. Few projects achieve the higher thresholds of Nesta, reflecting the gap in research investment into physical activity
and the limitations of current methodologies, particularly for infrastructure and ecological interventions. However, many initiatives aspire to build from routine data collection through structured internal and external evaluation before some move into the research space.
The project has highlighted the significant gap in routine collection of baseline data and evaluation. This is something that we have suspected for some time, so tangible evidence of the issue allows us to truly start to address the ‘elephant in the room’.
We recognise that across this spectrum there are different levels of evaluation which need to be appropriate to the scale and focus of the intervention; however commissioners should consider how they can resource this as part of responsible commissioning.
Public Health England intends to lead from the front. Commissioning this work was always the start, not the end of a process. We will continue to roll out training and support for the use of the Standard Evaluation Framework for physical activity to help projects evaluate their impact, including baseline and monitoring data in all interventions. A recently conducted mapping of the academic sector will form the basis of improve the academia-delivery interface on evaluation. We are also developing our own offering to support partners at both national and local level.
Throughout our recent engagement process, many people have remarked that it is an exciting time for physical activity and that it ‘feels’ different. Embedding systematic and standardised evaluation in national and local levels will ensure what is done ‘sticks’. PHE is committed to be there to lead and support you.
Dr Justin Varney
National Lead for Adult Health and Wellbeing