Bike, walk, and wheel: a way of life in Columbia, Missouri.

BACKGROUND: With funding support from the Robert Wood Johnson Foundation, the Active Living Partnership of Columbia, Missouri, sought to make routine physical activity more commonplace in the community through behavioral and environmental change strategies.

INTERVENTION: The Active Living by Design 5P model (partnerships, promotions, programs, policy changes, and physical projects) was modified to create two mutually reinforcing components. Programs and promotions (e.g., Walking School Bus) were implemented to influence individual behaviors and generate public policy advocates. Policy changes, such as activity-friendly street design standards, created safe and attractive places for physical activity programs. A strong, diverse community partnership supported all efforts.

RESULTS: Key project successes were a citywide social marketing program; the Walking School Bus program, which grew rapidly; and policy campaigns resulting in improved street design standards and a voter-approved $3.5 million sales tax for sidewalks around schools. Notable challenges included programs targeting teenagers and efforts to increase physical activity through self-reported activity logging.

LESSONS LEARNED: The most important lesson was to implement multiple strategies because programs can leverage policy successes, and new policies often lead to more funding for infrastructure. Other lessons learned were to build early successes by reaching first for the "low-hanging fruit" (e.g., elementary-age children rather than teenagers) and to have a flexible plan to take advantage of unexpected opportunities (e.g., a new, influential partner with a specific interest).

CONCLUSIONS: A modified 5P model was tested and found to be an effective framework for achieving behavioral and environmental changes that promote healthy, active lifestyles in the community.