The articles in this supplement focus on how to get active living design elements built in diverse community settings. This commentary explores the question of what needs to happen to ensure that, once built, these facilities will be effective in promoting physical activity.

While there is evidence that urban design and land-use policies and practices at both the street level (e.g., improved street lighting and traffic calming measures) and community level (e.g., mixed-use development) are effective in increasing physical activity, the specific characteristics of the built environment that best facilitate physical activity are not well-known. There is also a need to better understand what interventions work best in rural areas.

Key Findings:

• While local and state health departments play an important role, others (e.g., neighborhood coalitions, schools and planning agencies) may serve as the lead agency.
• It is important to fully engage community residents in ways that allow them to take ownership of project-related activities and tailor them to the unique needs of each community. (For example, safety can be a major barrier to physical activity.)
• The impacts of promotional campaigns and structured programs are likely to be amplified if done in concert with policy changes and physical projects that create more favorable environments for physical activity.

The ALbD initiative has been a powerful force in the growing public health movement to change the built environment in ways that promote physical activity and health more broadly. Successful projects recognize the need for broad partnerships, community engagement and locally tailored responses to address the unique circumstances of each community.