The U.S. Community Guide to Preventive Services strongly recommends changes in urban design, land use and accessibility to increase physical activity. To achieve these goals, policy change is often needed. This study assessed attitudes of decision
makers in Hawaii to determine if physical activity related issues are among their priorities.
Methods: State and county officials (n =179) were mailed surveys. Respondents listed
the three most important problems (openended) in Hawaii and rated the importance of
23 specified problems, of which six directly related to physical activity. Results: The survey
was completed by 126 (70.4%) respondents. The most frequently mentioned categories for the open-ended questions were affordable housing, environment/sustainability, sprawl/
traffic/population growth, and healthcare. Among the closed-ended physical activity
related items, increasing traffic was ranked highest (43.9%) and fourth overall. Less than
12% of decision makers rated other physical activity issues as important. Conclusions:
Future work is needed to increase the visibility and importance of physical activity related
issues among policymakers.