Whole System Approach to Increasing Physical Activity


Physical inactivity is a global public health problem. It is a leading risk factor for premature death from noncommunicable diseases. Conversely, regular physical activity is associated with reduced risks of heart disease, stroke, diabetes, breast and colon cancer, and with improved mental health and quality of life. Worldwide 23% of adults and 81% of adolescents (aged 11–17 years) do not meet the global recommendations for physical activity. The prevalence of inactivity varies considerably within and between countries. Unfortunately, physical inactivity increases with economic development, owing to the influence of changing patterns of transportation, use of technology, urbanisation and cultural values[1]. Therefore, the whole systems approach locally and globally is recommended in order to increase physical activity.

World Health Organisation (WHO) makes policies and strategies for promoting physical activity worldwide [2]. The latest draft for global action plan on physical activity for 2018-2030 contains four main strategic objects: create an active society, create active environments, create active people and create active systems [1].

Create an active society – social norms and attitudes

It is important to raise awareness of the multiple health benefits of physical activity and less sedentary behaviour for individual, family and community well-being. Implementation of community-based campaigns and regular mass-participation initiatives in public spaces are also beneficial. Strengthen pre- and in-service training of professionals, within and outside the health sector, including but not limited to, the transport, urban planning, education, tourism and recreation, sports and fitness sectors, as well as in grassroots community groups and civil society organisations, to increase knowledge and skills related to their roles and contributions in creating inclusive, equitable opportunities for an active society[1] .

Create active environments – spaces and places

Transforming public spaces to promote physical activity is a key contributor to achieving the Sustainable Development Goals[3]. Creating active environments would give rights to all people of all ages to have equitable access to safe places and spaces, in their cities and communities, in which to engage in regular physical activity, according to ability. It is important to strengthen the integration of urban and transport planning policies involving the use of wheelchairs and public transport. Improvement of walking and cycling infrastructure to enable and promote walking, cycling and other forms of mobility would help to increase physical activity. Finally the policy strengthening is needed in order to promote public amenities, schools, health care, sports and recreation facilities[1].For example ensuring that school playgrounds are designed to encourage varied, physically active play[4]

Create active people – programmes and opportunities

Creating and promoting access to opportunities and programmes, across multiple settings, would help people of all ages and abilities engage in regular physical activity as individuals, families and communities. This could be achieved by strengthening provision of good-quality physical education and more positive experiences and opportunities for active recreation, sports and play for girls and boys, applying the principles of the whole-of-school approach in all pre-primary, primary, secondary and tertiary educational institutions, so as to establish and reinforce lifelong health and physical literacy, and promote the enjoyment of, and participation in physical activity, according to ability. Enhancing provision of, and opportunities for, more physical activity programmes and promotion in private and public workplaces, community centres, recreation and sports facilities, faith-based centres, nature and other public spaces and places, to support participation in physical activity, by all people of diverse abilities[1].

Create active systems – governance and policy enablers

Creation of leadership, governance, multi-sectoral partnerships, workforce capabilities, advocacy and information systems across sectors to achieve excellence in resource mobilisation and implementation of coordinated international, national and subnational action to increase physical activity and reduce sedentary behaviour.

Creating data systems and capabilities at national and, where appropriate, subnational level, to support monitoring and accountability and ensure regular population surveillance of physical activity and sedentary behaviour, across all ages and multiple domains. The development and testing of new digital technologies to strengthen surveillance systems by including wider sociocultural and environmental determinants and regular multi-sectoral reporting on implementation to inform policy and practice. Moreover, strengthening of the national and institutional research and evaluation capacity and stimulation the application of digital technologies and innovation to accelerate the development. Strengthen financing mechanisms to secure sustained implementation of national and subnational action and the development of the enabling systems that support the development and implementation of policies aimed at increasing physical activity and reducing sedentary behaviour[1].

Move More plan, Sheffield UK

The Move More plan is a value-based, whole systems approach aiming to create a culture of physical activity resulting in Sheffield becoming the most active city in the UK by 2020. Taking into consideration the socio-ecological model for physical activity promotion, the approach has six outcomes: Empowered Communities, Active Environments, Active People & Families, Physical activity as Medicine, Active Schools and Active pupils, Active Workplaces and an Active Workforce . These outcomes will be assessed using routinely collected data[5].

Promoting long-term adherence to physical activity should be targeted through addressing the needs of and promoting activity for children, families, adults and older adults in specific contexts (e.g. workplaces, schools, communities, green spaces). Making the physically active choice the easy choice can be possible by designing Sheffield's spaces to promote opportunities for physical activity and to reduce sedentary behaviour. Moreover, the plan is based on principles such as reducing inequality in physical activity participation, making exercise enjoyable, communicating consistently with the public to raise awareness, ensuring interventions are evidence-based and promoting partnership with numerous organizations across a broad range of sectors.


  1. 1.0 1.1 1.2 1.3 1.4 1.5 http://apps.who.int/gb/ebwha/pdf_files/EB142/B142_18-en.pdf ( Accessed 6 May).
  2. http://www.who.int/topics/physical_activity/en/ (Accessed 6 May).
  3. http://www.euro.who.int/__data/assets/pdf_file/0018/353043/2017_WHO_Report_FINAL_WEB.pdf?ua=1 (Accessed 6 May).
  4. https://www.nice.org.uk/guidance/ng90/chapter/Recommendations#strategies-policies-and-plans-to-increase-physical-activity-in-the-local-environment (Accessed 6 May).
  5. https://www.movemoresheffield.com/Media/Default/Documents/move-more-plan.pdf