The National Physical Activity Plan is a multi-sectoral blueprint for creating a more robust culture of physical activity. It's appropriately aspirational, but grounded in practical objectives. Much like Healthy People 2020, it's great strength is its ability to unite powerful forces of change around common goals.

But the magnitude of the project - creating a cultural shift of national proportions - can feel overwhelming. So many changes need to be made in so many places. Real, measurable progress seems difficult to identify.

But like the journey of a thousand miles that begins with a single step, maybe cultural shifts of national proportions can begin with a single county.

And that county may be Greenville, South Carolina.

The folks of Greenville have created Livewell Greenville, a partnership of dozens of public and private organizations that aims to make Greenville County a healthier place to live, work, and play.

The approach of Livewell Greenville is to not only provide educational resources about healthy living, but also to create policies, systems and environments that make the healthy choice the easy choice.

The initiative focuses on seven societal buckets: at school, before and after school, at work, at the doctor, at mealtime, around town, and "for fun."

The following Livewell Greenville goals relate to physical activity:

• Provide tools to teachers to encourage physical activity during learning and throughout the day.
• Encourage more childcare providers to serve healthy meals and snacks and offer regular structured physical activity in licensed childcare centers.
• Encourage more after school providers to serve healthy meals and snacks and offer regular structured physical activity in non-licensed after school programs.
• Incentivize after school programs and childcare centers to adopt policies that support healthy eating and active living among children.
• Increase the number of work places that adopt policies and environments that support employees in staying physically active and eating healthy, nutritious food.
• Encourage health care providers to provide patients with practical referrals for healthy eating, active living, and treatment for obesity.
• Enable residents to run errands and commute on foot, by bike, or on Greenlink.
• Enable more Greenville County children to walk to school safely.
• Encourage neighborhood groups and residents to become more involved in the transportation planning process.
• Increase safety through Park Watch programs.
• Increase access to basic recreation facilities through the development of a model Complete Parks policy.
• Increase accessibility to local parks.
• Increase awareness of local facilities where residents can play and be active.

My hope is that Livewill Greenville will inspire thousands of similar community-based efforts around the country. Surely, duplicating the initiative would not be easy, and Livewelll Greenville benefits from the talents of dedicated community champions willing to invest significant time to make the initiative meaningful, but I'm willing to bet that every community has champions who are up for the challenge. Maybe every community won't succeed, but given what's at stake, it's certainly worth a try.

To follow the progress of Livewell Greenville and learn more about their inspirational community efforts, please visit livewellgreenville.org.

What are some examples of other communities dedicated to creating a healthier place to live, work, and play?

How do you measure something as far reaching as a national plan to get an entire population to be more physically active? Is the answer as simple as measuring physical activity across representative samples of the population to document how many Americans are or are not meeting federal Physical Activity Guidelines? Certainly the levels of physical activity among certain populations are logical outcomes to measure, and ones we are ultimately most interested in. But the answer is more complex - one that architects of the National Physical Activity Plan (NPAP) recognize as being critical to its overall success.

The NPAP was designed with the purpose of being actionable. From lawmaker or lobbyist to teacher or parent, the NPAP offers suggestions on how action can be taken to change the environments in which we work, live, learn, play, and commute, so they all offer easy access to physical activity. It may not be possible to evaluate the actions taken by every individual trying to advance the initiatives of the NPAP, but it is possible to measure outcomes that demonstrate the impact the NPAP is having, or not having, at national, state, and local levels. In order to determine the NPAP's impact, there is now a three-pronged evaluation effort underway.

1) At the national level, quarterly reports generated by sector-specific teams charged with implementing select recommendations from the NPAP's societal sectors will be collected to determine: Progress and barriers for each sector and for the NPAP overall; Products, programs, practice/policy changes, and media generated by the NPAP; and the level of collaboration between and among the different sectors of the NPAP.

2) Case studies of several states will be conducted to determine the extent to which the NPAP is impacting state physical activity plans, or related plans. Specifically, interviews will be conducted with key state-level representatives to determine awareness of gaps, barriers, and factors that contribute to knowledge transfer of the NPAP between national, state, and local levels, and to determine if and how the NPAP is being used within the state.

3) Additionally at state and local levels, members of the National Society of Physical Activity Practitioners in Public Health (NSPAPPH) are being surveyed to determine their opinions regarding the NPAP and motivations to use it, and changes to State plans as a result of the NPAP.

The NPAP evaluation effort is being spearheaded by the Physical Activity Policy Research Network within the Prevention Research Center at Washington University - St. Louis, with additional involvement from the Prevention Research Centers at UNC-Chapel Hill and the University of South Carolina.

How do you measure you or your organization measure your progress in improving health through physical activity?

The National Physical Activity Plan is an ambitious, comprehensive, and vital blueprint for creating a more active culture. It embodies the principles and best ideas formulated by folks steeped in the urgent effort to increase physical activity among all Americans. Already it is having an impact.

But there is a significant barrier. And it is one that must be overcome before the vision of the Plan can be fully realized.

It is the misconception that the ultimate goal of the National Physical Activity Plan is to promote physical activity. It isn't.

The ultimate goal of the National Physical Activity Plan is to save lives - millions of lives - and to improve the overall health and wellbeing of every American.

It is a goal worthy of the full attention of policymakers and thought leaders. And given the staggering cost of obesity and chronic diseases in this country - coupled with the dismal forecast for the life expectancy of America's current generation of children - it is a seriously urgent goal that requires immediate action.

Last month, the United Nations (UN) General Assembly held a high-level meeting to discuss the devastating impact that non-communicable diseases (NCDs) are having around the world. Not surprisingly, they reached the very conclusion that prompted the development of our country's own National Physical Activity Plan two years ago:

The resolution that resulted from the meeting recognized "the critical importance of reducing the level of expsoure of individuals and populations to the common modifiable risk factors for non-communicable diseases, namely, tobacco use, unhealthy diet, physical inactivity, and the harmful use of alcohol, and their determinants while at the same time strengthening the capacity of individuals and populations to make healthier choices and follow lifestyle patterns that foster good health."

In a recent editorial published by McClatchy Newspapers, Joe Moore, President and CEO of the International Health, Racquet & Sportsclub Association (IHRSA), connected the pressing nature of the UN resolution directly to the National Physical Activity Plan.

"As UN members formulate a coordinated strategy to prevent and control NCDs around the globe, we need to consider our own efforts," Moore wrote. "What can we do, as a united nation, to fight back the NCDs that we've let grow out of control in our own backyards?"

He continues, "Our country's first-ever National Physical Activity Plan lays out a vision that one day, all Americans will be physically active and will live, work, and play in environments that facilitate regular physical activity. Its ultimate purpose is to improve health, prevent disease and disability, and enhance quality of life."

In short, the National Physical Activity Plan is about making America strong again.

And that demands attention.

What are your ideas on what else we can do to emphasize the urgency of the National Physical Activity Plan? How do we get policymakers and opinion leaders to pay attention? What is your organization doing?