健康设计的制度导向对中国的启示——以“设计下的积极生活”项目进展为例

Institutional-Oriented Design for Health and Its Enlightenment to China:“Active Living by Design”International Progress and Implications

缺乏运动导致的健康问题日益受到关注,积极生活将增加体力活动融入日常。"设计下的积极生活"("Active Living by Design",ALbD)项目应对健康问题被发起,从而更新项目理念与策略以适应新发展。本文首先梳理积极生活相关研究的发展脉络与实施评估,其次以时间为轴线例举不同层次的实践项目,包括计划初期、发展阶段和项目最新实践。研究成果、评估结果、实践经验都为ALbD模式更新提供了基础。本文最后重点分析ALbD新模式的理念、策略与发展变化,并结合案例提出设计需要兼顾合作与公平、可持续发展思想,同时要聚焦服务群体、调动民间资本、构建社会规制。本文通过解析设计的政策属性与制度导向,以期为我国的积极设计与研究提供借鉴。

Physical inactivity is one of the most important public health issues internationally.Public health advocates have increasingly highlighted the importance of implementing physical activity interventions.Active living is a way to incorporate physical activity into daily life which could provide health benefits.The"Active Living by Design,ALbD"project is a community grant program established to help communities create environments that support active living.But the research of active living in China is still limited with little comprehensive consideration of various factors promoting active living.This paper first reviews the literature on active living from three aspect,including policy,public support,and evaluation.Research has already found that active-living oriented zoning had a positive impact on physical activity.Policies,like guidelines,principles,laws,and regulations all could promote active living.Therefore,the renewal and reform of those policies is an effective way for policymakers to create a physically active community,and urban planning regulations are one of the most important parts of policy implementation.Furthermore,studies show that public support for policies is also related to physical activity,thus public education and media coverage addressing active-living issues can help shape a social environment in which facilitate active living.Additionally,evaluating the effectiveness of the implementation process and results of the project could figure out the existing limitations and strengthens of the ongoing project,which needs multiple evaluation methods depending on different situations.Secondly,we exemplify different levels of practical projects in time sequence,including the initial period of the ALbD,the developing stage and the practices after the new concept updated.The first level is the initial implementation of the 5P(preparation,promotions,programs,policy,and physical projects)strategy.We exhibit five representative cases selected from the initial 25 pilot areas.Then,the project of the second level covers several areas,including parks,recreational facilities,schools,pedestrian and bicycle infrastructure,gardens and workplaces.In the third level,Santa Ana,California,which is one of the initial pilot areas,is used as an application example of the new model of community action.Further,this paper focuses on the improvement of the new model’s concept,strategy and renovation,which is related to various community health goals.The new action model is concentrated from the initial 5P to the new 3P(partner,prepare,process)method.Through comparison of the case study during past years and the concept change,we could get deep into the developing process of active living projects.In the early stage,the implementation depicts a linear community change process.From pre-preparation and promotion to implementation and policymaking,showing how a community could engage individuals in physical activity through design.However,the new community action model weakens the order of execution but emphasizes the core concept of execution.The three concepts,including partner,prepare,and process,run through the whole project,no longer a single procedure.Accordingly,ALbD puts forward new practical content based on initial one.The practical strategy of the new model broadens the depth of the design content,which can be divided into two parts;focusing on equity and cooperation,including health interests,community participation,joint leadership and strategic communication;emphasizing the idea of sustainable development,like strategy of sustainable development and the construction of learning atmosphere.Finally,this paper provides references for active living related design in China.1)Shaping an active living norm through refined management.The concept of active living can permeate every link of the traditional urban design management system.2)Diversifying the foundation resources and promote multidisciplinary partnerships.Communities in a variety of settings could adjust measures according to local conditions to encourage multiple organizations to participate by publicizing the economic benefits brought by active living.3)Focusing on the micro-scale improvement of service groups.Renovation of micro-scale projects within the community can also improve lifestyles compared to traditional area planning.Combined with the administrative system of our country,we can divide the design-related work into every community by starting from serving smaller residential groups and encouraging community demonstration grant program.This study analyzes the renewal of the ALbD project concept and the development of practice projects,finding that the design needs to combine the concept of equity,cooperation,and sustainable development while using policy measures.The ALbD project starts with daily life and practically implements the concept to every potential aspect,therefore reduces the timeliness and implementation difficulty of macro-scale planning control.Different from the situation of European and American countries,domestic social projects are mostly led by the government.The mechanism of multidisciplinary participation is lacking,and the active lifestyle and other health concepts are not considered high priorities in community design.Therefore,we expect to offer references on integrating the design concept of active living into the policy implementation,management and institutional level,which could broadly address physical activity,built environments,social support,and community awareness.