Physical inactivity is a plague affecting the entire world today, not just the United States. The World Health Organization (WHO) recognizes this crisis and is committed to leading the world in a treatment plan. In a webinar, conducted by the ISBNPA and ISPAH, two international societies for physical activity and health, Dr. Fiona Bull (WHO) described their detailed plan of how to combat physical inactivity in the world called the Global Action Plan on Physical Activity (GAPPA).
The ultimate goal of GAPPA is to decrease insufficient physical activity (PA) by 10% relative to each country involved. The four thematic objectives in this plan are to create active societies, environments, people, and systems. The core part (Part 3) of the plan outlined how specific actions fit into each of these objectives. For example, an active environment is achieved by improving urban design, improving safety, and fast-tracking those methods through necessary political channels. The final part of the plan is the practical application of the theoretical ideas. While this section is currently under development, it will link GAPPA to the already established Global Physical Activity Toolkit in the hopes of providing countries with tangible resources to accomplish each objective.
During the second half of this webinar, Dr. Charlie Foster (ISPAH President) and Dr. Jo Salmon (ISBNPA Past-President) facilitated a discussion to address weaknesses or confusing areas of GAPPA. One topic that came up repeatedly was how countries begin to take action and how to evaluate their progress when each country has a different starting point. Dr. Bull emphasized a portion of the plan that discusses “best buys,” or successful interventions the WHO deemed most cost effective in their analysis. By far, the two best strategies were mass media efforts and physician-based care from primary care professionals. Another interesting point that came up during the discussion was the question of how to set the PA goals for each country in 2030. On the one hand, should it be “bigger and bolder” than the goal set for 2025, assuming that the basics have been set and have started working? Or should it be a more conservative goal that may be more realistic and within reach? There wasn’t enough time in this short session to come up with a convincing answer. Questions and dilemmas about GAPPA, including those just mentioned, are also questions of interest to public health researchers. Their work should continue to guide the work of WHO and similar organizations.
As someone new to the public health field, learning about the logic model in class was somewhat frustrating because it didn’t feel practical. Too often we read research that describes a perfectly realistic model but does not translate into palpable changes in PA or nutrition. GAPPA is a detailed, comprehensive logic model that details specific actions that will be used in implementation. It was perhaps the first time I fully understood the purpose of a logic model and how it can drive action to reach a goal.