Start small, dream big: Experiences of physical activity in public spaces in Colombia.

Multi-sectoral strategies to promote active recreation and physical activity in public spaces are crucial to building a "culture of health". However, studies on the sustainability and scalability of these strategies are limited. This paper identifies the factors related to the sustainability and scaling up of two community-based programs offering physical activity classes in public spaces in Colombia: Bogotá's Recreovía and Colombia's "Healthy Habits and Lifestyles Program-HEVS". Both programs have been sustained for more than 10years, and have benefited 1455 communities. We used a mixed-methods approach including semi-structured interviews, document review and an analysis of data regarding the programs' history, characteristics, funding, capacity building and challenges. Interviews were conducted between May-October 2015. Based on the sustainability frameworks of Shediac-Rizkallah and Bone and Scheirer, we developed categories to independently code each interview. All information was independently analyzed by four of the authors and cross-compared between programs. Findings showed that these programs underwent adaptation processes to address the challenges that threatened their continuation and growth. The primary strategies included flexibility/adaptability, investing in the working conditions and training of instructors, allocating public funds and requesting accountability, diversifying resources, having community support and champions at different levels and positions, and carrying out continuous advocacy to include physical activity in public policies. Recreovía and HEVS illustrate sustainability as an incremental, multi-level process at different levels. Lessons learned for similar initiatives include the importance of individual actions and small events, a willingness to start small while dreaming big, being flexible, and prioritizing the human factor.