Physical activity for health: framework

Achieving our vision

Physical activity is defined by the World Health Organization as any bodily movement produced by skeletal muscle that requires energy expenditure. The aim is for people to move more and there are many different ways we can all build more movement into our daily lives. Action to improve levels of physical activity is often seen as being related to efforts to increase participation in sport or gym exercise and it is certainly true that participation in formal sport and exercise is the route by which many people achieve recommended levels of physical activity. However, it is important to recognise the equal importance of recreational activity, particularly walking and wheeling, but also dance, active play and cycling as well as active travel, heavy housework or gardening.

This is recognised by The World Health Organization (WHO) in the Global Action Plan on Physical Activity 2018–2030 (GAPPA).^[16] The WHO Plan is firmly based on a systems-based approach to improving population levels of physical activity. The systems-based approach recognises that public health outcomes are influenced by a complex and adaptive system of interacting components, which will require the action of many partners to redesign the system to one that protects and promotes health.

This Framework applies the systems-based approach to physical activity. It outlines a wide range of actions across multiple sectors and settings, including schools, healthcare, transport, urban planning, sport, communities and workplaces. Progress across all of these sectors is essential if we are to achieve or vision.

Clear guidance on best practice has been provided by the World Health Organization in the and the International Society for Physical Activity For Health (ISPAH).^[17][18] While this international evidence and guidance forms a solid base to understand the broad approaches required to improve population levels of physical activity, we recognise that adaptation is required to ensure that specific actions reflect the Scottish context. Scotland is one of the first countries in the world to undertake this detailed adaptation of WHO and ISPAH guidance to a national context. This groundbreaking work was undertaken by Public Health Scotland (PHS) who developed a seven stage process to inform the national and local direction of physical activity in Scotland. The result is described in detail at A systems-based approach to physical activity in Scotland (publichealthscotland.scot). This crucial document has formed the basis of our approach in this Framework.

The PHS work identified 8 Strategic Delivery Outcomes which closely align to the 8 investments identified by the International Society for Physical Activity and Health (ISPAH) and are supported by strong evidence of effectiveness.^[19] If we can, collectively, achieve these outcomes, the result will be a transformational change in the health and wellbeing of the Scottish population.

The 8 Strategic Delivery Outcomes do not stand alone but must be seen in the context of the whole system. The Outcomes are not silos. Organisations and teams can and should identify where they can contribute across the 8 outcomes. This cross-sectoral partnership is key to success and the examples in this Framework were chosen to demonstrate where such partnerships are delivering outcomes.