Implementation Resource Guide

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This Resource Guide includes potential steps to consider for planning and implementation. It includes implementation resources, Frequently Asked Questions (FAQs), and a “Multipurpose Resources” section for crosscutting material. For each content section, a small number of relevant resources were selected, prioritizing current, practical “how to” documents from federal agencies, national organizations, or CDC-funded partners whenever possible that are free and openly accessible to the public.

Who can use it?

State and local health departments, public health professionals, and community organizations working on ways to increase physical activity can use the resources in each section to guide their implementation process as they aim to build more activity-friendly communities.

How to find what you need:

Begin by using the resources for forming a cross-sector coalition, or skip ahead to the section that best describes your current stage of work. You will only need to reference the resources below that are relevant to the specific changes your community has selected.

Who should be part of my cross-sector coalition?

Include those who might be involved in implementing the action and/or those affected by the action. This could include representatives from public health, transportation, local business, and city planning, as well as elected officials and individuals from the community. People who use assistive devices or wheelchairs can offer valuable insight on facilitators and barriers to walking or rolling.

Partnership across agencies, departments, and sectors is important for implementing interventions outside the public health sphere and for gaining the perspectives of the populations most impacted by policies and projects. This may require a cultural shift away from working independently in silos, but it is helpful for determining shared goals, combining unique expertise, identifying funding sources, and understanding relevant laws or regulations when implementing community-wide changes.

Baseline assessment of current health conditions or behaviors and local capacity and readiness for implementing combined built environment approaches can be used to determine outcome goals and inform an action plan. It can also highlight areas of strength and areas with room for improvement, while providing a reference point for assessing any change or impact that occurs from an implementation.

There are many ways to implement this recommendation. In selecting an approach, you can consider many factors including existing and needed resources, feasibility, and competing community priorities. With limited resources, you may need to tackle one component at a time, but eventually activity-friendly routes and everyday destinations should combine or connect to increase physical activity.

Resources for Activity-Friendly Routes (i.e., Pedestrian, Bicycle, and Transit Transportation Systems)

Resources in this section provide guidance for creating activity-friendly routes that are a direct and convenient connection, offer physical protection from cars, or make it easier to cross the street.

Pedestrian Transportation Systems
  • Designing Sidewalks & Trails for Access Part 2 of 2: Review of Existing Guidelines & Practices Cdc-pdf[PDF-9.3MB]External
    This guidebook focuses on designing sidewalks and trails to provide access for all users, including people with disabilities. It provides planners, designers, and transportation engineers with information on how to develop sidewalks and trails to promote pedestrian access for all users. The chapters on Sidewalk Development lay out a methodical and detailed design process, including defining the needs and characteristics of users.
  • Improving the Pedestrian Environment Through Innovative Transportation DesignExternal
    This report contains a sample of ways transportation professionals and citizens have brought walking back into focus, not only in the capital budgets of government agencies, but also in the lives of citizens in communities large and small. The real-world case studies may be of particular value.
  • Local Policies and Practices That Support Safe Pedestrian EnvironmentsExternal
    This document contains tools and strategies to improve the safety, convenience, and accessibility of the pedestrian experience for a range of contexts (e.g., geography, community size, weather, demographics, and regulatory requirements) and development conditions (e.g., new and infill development, street reconstruction, and retrofitting). The Implementation Section of Chapter 2, the specific Case Studies in Chapter 3, and the summary of Implementation Challenges and Strategies in Chapter 4 may be of particular value.

Bicycle Transportation Systems

  • Getting the Wheels Rolling – A Guide to Using Policy to Create Bicycle Friendly Communities Cdc-pdf[PDF-5.31MB]External
    This guide provides a toolkit for decision-makers, government officials, community groups, and others interested in making all types of communities more bicycle friendly. It can help communities make changes that will allow residents to enjoy bicycling to work, to school, and around town. The 4-part breakdown of critical elements, with supporting examples, may be especially useful.
  • Separated Bike Lane Planning and Design GuideExternal
    This guide is a resource for project planners and designers who are considering, evaluating, and designing separated bike lanes as part of a complete streets approach. It also includes a Menu of Design Recommendations for several key components of safe, comfortable, and connected bike networks that can attract people of all ages and abilities to bicycling.
  • Urban Bikeway Design GuideExternal
    This Guide provides cities with state-of-the-practice solutions that can help create Complete Streets that are safe and enjoyable for bicyclists. The set of required, recommended, and optional elements listed in the Guide should provide useful input for communities to tailor their efforts to their specific conditions.

Public Transit Infrastructure and Access

  • Linking Transit Agencies & Land Use Decision Making – Guidebook for Transit AgenciesExternal
    This guide outlines the process for building a transit-supportive community and includes related case studies. It can help transit agencies better address connections among transit, land use planning, and development decisions. It addresses improved transit and land use by providing transit agencies with tools for communicating better at the decision-making table.
  • Planning for Transit-Supportive Development – A Practitioner’s GuideExternal
    This toolkit provides guidance for integrating transit planning with local land use planning that can help Metropolitan Planning Organizations (MPOs), regional planners, transit agencies, and local government elected officials, staff, land use planners, and transit planners. The best practices and success stories provide useful real-world examples for consideration and offer ideas for planners at every level on how to integrate transit-supportive development and investments.
  • Transit Street Design GuideExternal
    This document provides design guidance for developing transit facilities on city streets and designing and engineering streets to prioritize transit, improve transit service quality, and support other transitrelated goals. It also provides transportation departments, transit agencies, leaders, and practitioners with tools to prioritize transit. Case studies from a variety of communities are included.

Street Pattern Design and Connectivity

  • Building Healthy Corridors Cdc-pdf[PDF-5.0MB]External
    This report provides real-world examples of successfully creating healthy corridors including project profiles and lessons learned. It is a resource and reference for those undertaking corridor redevelopment efforts and highlighting the importance of health in decision-making processes.
  • Framework for Better Integrating Health into Transportation Corridor PlanningExternal
    This framework highlights specific activities that can inform transportation decisions at each step of the corridor planning process. These activities can help planners support healthy outcomes while improving the transportation system. The document includes realworld case examples from across the country.
  • Low-Stress Bicycling and Network Connectivity Cdc-pdf[PDF-1.76MB]External
    This report proposes a set of criteria for classifying road segments by levels of traffic stress. Stress classification and stress mapping can help communities target limited resources to areas in need of to the widest possible segment of the population with safe and direct routes between origins and destinations.
  • Urban Street Design GuideExternal
    The Guide outlines a clear vision for Complete Streets and guidance for their implementation. It includes a toolbox and tactics that cities can use to make streets safer and more accessible.

Resources for Everyday Destinations (i.e., Land Use and Environmental Design)

Parks and Recreational Facility Access

An action plan defines the approach and process a team will use to manage the implementation. It includes measurable objectives aligned with the key financial and human resources. After identifying a person to lead the plan’s execution, each step should align with specific tasks in the timeline.

Why do I have to evaluate if the CPSTF recommendation is already evidence-based?

It is important for communities to track implementation measures, such as changes in
public engagement or the quality of sidewalks, as outcomes along the way to guide their progress.
When resources permit, communities can also measure levels of physical activity before and after
making changes to the built environment, or they can compare levels of physical activity between
locations where changes did and did not occur. This allows a community to identify the types of changes that are most effective in improving their health.

Evaluating processes and outcomes can help communities improve their implementation and better understand the amount and specific type of changes that help their members become more physically active.

Sustainability is important because it creates and builds momentum to maintain community-wide change by organizing and maximizing community assets and resources. Coalitions and community stakeholders can be prepared to manage changes and challenges that arise during and after implementation to build foundations for long-term sustainability.

  • CDC Sustainability Planning Guide for Healthy Communities Cdc-pdf[PDF-2.81MB]
    This guide provides a process for sustaining policy strategies and related activities, introduces various approaches to sustainability, and demonstrates sustainability planning in action. It includes real-world examples of creating and building momentum to maintain community-wide change by organizing and maximizing community assets and resources. The synthesis of science- and practice-based evidence can help coalitions, public health professionals, and other community stakeholders develop, implement, and evaluate a long-term plan for sustaining change in systems and environments.
  • Expert Help from the Safe Routes to School National PartnershipExternal
    This section of the Safe Routes to School National Partnership website provides contact information for their consulting services and their individualized technical assistance to help rural or underserved neighborhoods overcome barriers to achieve long-term policy changes. The staff works to coach and assist communities across the country – large and small, urban and rural – to overcome obstacles and adopt policies that create healthy changes.

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Multipurpose Resources to Design Activity-Friendly Communities

The following list of resources addresses a combination of implementation approaches for both activity-friendly routes and everyday destinations. These materials also address integrating health into community design and transportation.

  • Built Environment Assessment Tool
    This manual explains the importance of understanding and measuring the built environment. It provides a tool for measuring the core features and qualities of the built environment that affect health, especially walking, biking, and other physical activity.
  • Creating Walkable and Bikeable Communities Cdc-pdf[PDF-62.5MB]External
    This resource provides tools, techniques, and samples for community leaders, elected officials, and others to consider while developing or improving bicycle and pedestrian facilities in their communities. It includes practical tools to implement a comprehensive community process, such as a self-assessment process, design recommendations, and implementation framework.
  • A Guide to Building Healthy StreetsExternal
    This guide discusses five key steps for putting a Complete Streets policy into action and highlights the unique roles public health staff can play. Each step includes model policy language, info on how to address equity, community examples, and key resources. It can help communities ensure that their Complete Streets policy creates real, on-the-ground change.
  • Partners for Public Health – A Guide to Creating Healthier Communities Cdc-pdf[PDF-1.78MB]External
    This guide provides information to public health department staff and advocates about public agencies that make policy decisions and implement projects related to the physical environment. Each section includes information about how agencies are structured, their decision-making processes, and accountability at four levels of authority: local, regional, state, and federal.
  • Pedestrian and Bicycle Transportation Along Existing Roads—ActiveTrans Priority Tool GuidebookExternal
    This guide presents a tool that may be used to help prioritize improvements to pedestrian and bicycle facilities, either separately or together as part of a “Complete Streets” evaluation approach.
  • A Resident’s Guide for Creating Safer Communities for Walking and Biking Cdc-pdf[PDF-2.53MB]External
    This guide includes information on identifying problems, taking action to address concerns, and finding solutions to improve safety for pedestrians and bicyclists. It also contains community success stories and tips for replicating efforts to help residents, parents, community association members, and others get involved in making communities safer.
  • Rethinking StreetsExternal
    This book shows actual examples of street re-designs from typical communities to show how they did what they did and see what resulted from the change. The book presents examples from a variety of completed street projects throughout the US.
  • Safe Routes to School Online GuideExternal
    This guide is a comprehensive online reference manual for developing Safe Routes to School (SRTS) programs. Users can choose specific topics based on their interests and needs, such as guidelines for adult school crossing guards, tools to create school route maps, and ways to include children with disabilities in SRTS initiatives. Guidance highlights what has worked in other communities, and the manual includes links to other SRTS publications and training resources.
  • Small Town and Rural Multimodal Networks Cdc-pdf[PDF-39.9MB]External
    This report is a resource and idea book for small towns and rural communities to support safe, accessible, comfortable, and active travel for people of all ages and abilities. It provides a bridge between existing guidance on bicycle/pedestrian design and rural practice. It encourages innovation when developing safe and appealing networks for bicycling and walking in small towns and rural areas, and it includes examples of project implementation in rural communities
  • Transportation and Health ToolExternal
    This tool provides easy access to data that practitioners can use to examine the health impacts of transportation systems. It includes data on a set of transportation and public health indicators for each U.S. state and metropolitan area that describe how the transportation environment affects safety, active transportation, air quality, and connectivity to destinations.

Additional Resources and Organizations

This section contains a list of web-based information hubs with resources to support implementing built environment changes that support connecting activity-friendly routes with everyday destinations.

  • The AARP Liveable Communities A-Z ArchivesExternal contains a searchable database of reports, action plans, studies, and articles about housing, transportation, Complete Streets, and walkability. Use the Search Box on the right side of the page to look for content by topic or subject of interest. Sections also address placemaking, economic benefits, age-friendliness, and social engagement in the context of designing activity-friendly communities for all.
  • The AARP Livability IndexExternal scores neighborhoods and communities for services and amenities. Users can search the Index by address, ZIP Code, or community to find an overall livability score, as well as a score for each of seven major livability categories: housing, neighborhood, transportation, environment, health, engagement, and opportunity. The website also provides resources to help consumers and policymakers use these livability scores to effect change in their communities.
  • The Urban Land Institute’s (ULI’s) Building Healthy Places Initiative Externalconnects ULI’s 40,000 members worldwide and their global networks with research and resources to provide leadership in the responsible use of land and in creating and sustaining thriving communities worldwide. Use the left navigation panel on the website to search content related to areas such as active transportation, healthy corridors, and creative placemaking.
  • ChangeLab SolutionsExternal works with neighborhoods, cities, and states to identify and leverage existing sources of funding and create new funding sources so communities can create places where the healthy choice is the easy choice. Their website includes model policies, how-to guides, fact sheets, and other policy tools and a downloadable catalog to help users start exploring.
  • The CDC’s Community Health Online Resource Center provides tools to support environmental changes that address obesity and tobacco use. These resources describe why environmental changes are at the heart of making healthy living easier and how to execute them. Tools include webinars, model policies, tool kits, databases, fact sheets, and other practical materials.
  • The National Center on Health, Physical Activity and Disability (NCHPAD)External is a public health resource center on health promotion for people with disability. NCHPAD works to create health equity by providing information, referral, and consultation services to caregivers, policymakers, and community members through web-based materials and health communication channels. Their website includes articles, research, and videos categorized by audience. Their How I WalkExternal campaign aims to promote walking as an inclusive physical activity.
  • The National Recreation and Parks AssociationExternal works with local park and recreation agencies to provide tools, resources, and technical assistance to improve access to healthy foods and increase opportunities for people to be physically active in their communities. Their areas of focus include ensuring that all people have safe access to high quality park and recreation facilities and programming; promoting healthy eating and physical activity standards; expanding access to evidence-based health prevention programs; connecting parks and the health community; and supporting programs and policies that eliminate health disparities.
  • The U.S. DOT Pedestrian and Bicycle Information Center (PBIC)External develops, synthesizes, promotes, and distributes accurate and current bicycling and walking information. The organization provides expert technical assistance to various audiences and produces a variety of reports, guides, and case studies. The PBIC mission is to improve the quality of life in communities by increasing safe walking and bicycling as a viable means of transportation and physical activity.
  • The APA’s Planning and Community Health CenterExternal provides tools and technical support to APA members so they can integrate health into planning practice at all levels. Areas of focus include active living, healthy eating, and health in all planning policies. The Center implements these aims through applied research, place-based investment, and education.
  • The Safe Routes to School National Partnership Resource CenterExternal shares best practices, develops resources, and provides coaching to individuals and communities seeking to advance Safe Routes to School, shared use agreements, and active transportation. It supports local, regional, and national efforts with a searchable library of resources and best practices. The National Partnership aims to advance safe walking and bicycling to and from schools; to improve the health and wellbeing of kids of all races, income levels and abilities; and to foster the creation of healthy communities for everyone.
  • The Smart Growth America Resource CenterExternal includes the National Complete Streets CoalitionExternal and helps communities plan for smarter, strategic growth as an investment for their future. It assists local leaders on the technical aspects of smart growth development and provides customized advice on how communities can use smart growth strategies to their advantage. The website includes a searchable database of resourcesExternal, including, transportation, Complete Streets, economic development, and rural development.

For inquiries or assistance, please contact DNPAOPolicy@cdc.gov.

The findings and conclusions in these resources are those of the author(s) and do not necessarily represent the official position of the Centers for Disease Control and Prevention. The presence of the CDC logo on this document is not intended as an endorsement of any commercial entity or product/service referenced herein.

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