Rural communities in Utah have high rates of obesity and low rates of physical activity (Utah Department of Health, 2016). All local health districts are considered rural or frontier except for four counties: Davis County, Salt Lake County, Utah County, and Weber-Morgan County. One of the major contributing factors to inadequate physical activity is the lack of bicycle and pedestrian infrastructures in rural communities.
PSE Change Solution
Offer mini-grants to three rural municipalities to support the implementation of bicycle and pedestrian infrastructure efforts.
Utah’s comprehensive cancer control coalition worked to implement and evaluate the PSE change through the following actions.
To maximize impact for rural communities, the project:
Identified and utilized existing partnerships (Step 1: Engage)
Retrieved data addressing obesity and physical activity from the Indicator-Based Information System for Public Health (Step 3: Assess)
Utilized resources and mini-grants (Step 4: Review)
The initial funding base increased between six and 22 times the amount of the original $3,000 grant with support from additional project sponsors who were engaged as partners and subsequently became stakeholders
Project outputs included:
Increased support for bike- and pedestrian-friendly infrastructure efforts in the communities where the Road Respect Communities (RRC) program was implemented
Community assessments of existing conditions for implementing an active transportation plans; and adoption and implementation of community-wide active transportation plans
Success Factors and Key Questions Addressed
Utah’s RRC was an existing program that functioned as the active transportation arm of the Utah Department of Transportation (UDOT) and provided local governments with support for their bicycle planning efforts by providing guidance for more bicycle-friendly environments (RRC, n.d.). Because the RRC program only focused on improving bike transportation and not pedestrian transportation, the Utah Cancer Control Program (UCCP) decided to partner with the DP 13-1305 grant program at the Department of Health to integrate promotion of walkability into the RRC program. Since many communities were already familiar with the RRC program, the UCCP decided to use UDOT’s knowledge of communities that would be most prepared and willing to work on an active transportation project, and offer them funds to put toward improving active transportation infrastructure for all modes of transport.
What difference(s) did the PSE change make in the short-term?
Because the bicycle component of the RRC program predates the walking component, the short-term changes relate to UDOT’s bike planning efforts. The RRC program is set up for communities to work toward achieving one of three levels of RRC status depending on the community’s existing active transportation conditions and readiness to develop or adopt a community active transportation plan. The focus of the first level, “Activate”, is to get the community organized to begin active transportation planning. The second level, “Ascend”, helps communities begin to develop an active transportation plan and increase community interest. The third level, “Peak”, adopts and implements the plan.
For process evaluation, communities were measured on the completion of activities to achieve the different levels of RRC status. As an additional part of process evaluation, the partners completed a questionnaire that will be discussed later in this case study.
The short-term outcome during the funding period was that one of the communities completed the requirements for all three levels and was designated a “Road Respect Community,” which provided statewide recognition. They continued to work with their countywide partners and multiple community champions to expand the RRC program to three additional neighboring communities during fiscal year 2015. After all three additional communities received RRC “Activate” or “Ascend” level status during the year, the communities worked together again with county partners to receive permission from UDOT to have the first county-wide RRC designation for fiscal year 2016. At the end of fiscal year 2016, all communities in the county had received at least the “Activate” status level, and so the county received the first countywide RRC status designation in Utah.
The other two communities continue to work toward full RRC recognition. They continue to meet regularly with community champions and partners, they have identified gaps in active transportation infrastructure that need to be prioritized, and they have begun development of an active transportation plan or developed the plan and have started to implement the plan. These efforts have included new, safer walking and biking routes between popular community destinations.
In addition, walking and other forms of active transportation are being added to the RRC program. UDOT is finalizing this change to the RRC designation level requirements and will begin implementing this change July 1, 2017. The new program change will also align with other national designations that communities like to work toward such as the “bike friendly city” designation from the League of American Cyclists.
What difference(s) did the PSE change make in the long-term?
The long-term impact of the initiative is still being measured.
Were there barriers to implementing the PSE change? If so, what were the lessons learned?
The staff identified champions by acknowledging that the project’s success largely depended on having elected officials on board, especially mayors (Step 4: Review). Rather than funding local health department or planning organizations, the UCCP learned that funds made a greater impact when given directly to city or county governments. Direct funding made it much more likely that elected officials would champion the project and remain involved. The Program then required the city or county to work with a planning organization if staff did not have the necessary planning expertise. They also were required to work with local health departments for their expertise in setting up baseline measures. These would be used in an eventual health impact assessment after the entire active transportation plan was fully implemented (potentially years down the road).
How did you measure/document the impact of the PSE change intervention?
As mentioned previously, the coalition created an evaluation questionnaire to be completed by all partners. The results revealed that community support was an essential element to the success of the process. The questionnaire served as project process evaluation, so it was also important to develop initial baseline criteria for the health impact assessment in order to evaluate the long-term outcomes and ultimate impact of the PSE change initiative.