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Developing Core Capabilities for Local Health Departments to Engage in Land Use and Transportation Decision Making for Active Transportation

Lemon, Stephenie C. PhD; Goins, Karin Valentine MPH; Sreedhara, Meera MPH; Arcaya, Mariana ScD; Aytur, Semra A. PhD; Heinrich, Katie PhD; Kerner, Bridget MS; Lyn, Rodney PhD; Maddock, Jay E. PhD; Riessman, Robin MPH; Schmid, Thomas L. PhD

Journal of Public Health Management and Practice: January 08, 2019 - Volume Publish Ahead of Print - Issue - p
doi: 10.1097/PHH.0000000000000948
Research Full Report: PDF Only

Objective: To develop a core set of capabilities and tasks for local health departments (LHDs) to engage in land use and transportation policy processes that promote active transportation.

Design: We conducted a 3-phase modified Delphi study from 2015 to 2017.

Setting: We recruited a multidisciplinary national expert panel for key informant interviews by telephone and completion of a 2-step online validation process.

Participants: The panel consisted of 58 individuals with expertise in local transportation and policy processes, as well as experience in cross-sector collaboration with public health. Participants represented the disciplines of land use planning, transportation/public works, public health, municipal administration, and active transportation advocacy at the state and local levels.

Main Outcome Measures: Key informant interviews elicited initial capabilities and tasks. An online survey solicited rankings of impact and feasibility for capabilities and ratings of importance for associated tasks. Feasibility rankings were used to categorize capabilities according to required resources. Results were presented via second online survey for final input.

Results: Ten capabilities were categorized according to required resources. Fewest resources were as follows: (1) collaborate with public officials; (2) serve on land use or transportation board; and (3) review plans, policies, and projects. Moderate resources were as follows: (4) outreach to the community; (5) educate policy makers; (6) participate in plan and policy development; and (7) participate in project development and design review. Most resources were as follows: (8) participate in data and assessment activities; (9) fund dedicated staffing; and (10) provide funding support.

Conclusions: These actionable capabilities can guide planning efforts for LHDs of all resource levels.

This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

UMass Worcester Prevention Research Center, University of Massachusetts Medical School, Worcester, Massachusetts (Dr Lemon and Mss Goins and Sreedhara); Department of Urban Studies and Planning, Massachusetts Institute of Technology, Cambridge, Massachusetts (Dr Arcaya); Department of Health Management and Policy, University of New Hampshire, Durham, New Hampshire (Dr Aytur); Department of Kinesiology, Kansas State University, Manhattan, Kansas (Dr Heinrich); National Association of County and City Health Officials, Washington, District of Columbia (Ms Kerner); Division of Health Management and Policy, Georgia State University, Atlanta, Georgia (Dr Lyn); School of Public Health, Texas A&M University, College Station, Texas (Dr Maddock); UMass Transportation Center, University of Massachusetts Amherst, Amherst, Massachusetts (Ms Riessman); and Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, Georgia (Dr Schmid).

Correspondence: Stephenie C. Lemon, PhD, Division of Preventive and Behavioral Medicine, UMass Worcester Prevention Research Center, University of Massachusetts Medical School, 368 Plantation St, Worcester, MA 01605 (

This work was funded by cooperative agreement number U48DP005031 from the Centers for Disease Control and Prevention to Stephenie Lemon and (Principal Investigator) Karin Valentine Goins. Bridget Kerner, and Robin Riessman were paid consultants. Meera Sreedhara's work was supported by funding from UMass Center for Clinical and Translational Science (UMCCTS), TL1 grant #UL1TR001453.

The findings and conclusions from this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

The authors declare no conflicts of interest.

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