An investigation into the implementation of system-based approaches to population-level physical activity promotion

Emergent evidence in recent decades suggests that the prevalence of non-communicable diseases, such as heart disease, diabetes and cancer are rising. One of the main risk factors identified that is driving this rise in non-communicable diseases is physical inactivity, which can be considered a complex issue due to the complexity of human behaviours. This complexity and the focus on addressing this important issue has given rise to a focus on system-based approaches in an attempt to consider different ways of tackling this. This research provides a critical exploration into the implementation of system-based approaches to promoting physical activity. The thesis explores the early implementation of the World Health Organisation’s Global Action Plan on Physical Activity around the world. The first study identified international early adopters of system-based approaches and appraised the common challenges and learning from these. The second study was an in-depth case study in Cardiff, Wales, evaluating the process of developing a system-based sport and physical activity strategy for the region. A mixed-methods approach was taken, using interviews, observation and surveys to investigate the implementation of system-based approaches to physical activity in practice. A number of key themes emerged, including the definition of a system-based approach, the process and outcomes of system mapping and approaches to engaging stakeholders. A range of common challenges also became apparent around managing the complexity of a system-based approach, building capacity across the system and overcoming resistance from stakeholders. Based on a discussion of the findings from these studies and against the current literature, a set of guidelines for best practice in system-based physical activity promotion were developed. These guidelines provide recommendations for academics, practitioners and policymakers seeking to facilitate a system-based approach.