Exploring Implementation Strategies in Evidence-Based Open Streets Programs for Promoting Physical Activity in the Americas: A Scoping Review

Raul David Gierbolini Rivera^1,2*Milena Franco Silva^1,2Fabiola Pineda^1,2Bryan Jeffrey Weiner³Byron J. Powell^1,4Ross Brownson^2,5,6Diana C Parra^1,2*

• ¹Brown School, Washington University in St. Louis, St. Louis, United States
• ²Washington University in St Louis Prevention Research Center, St. Louis, United States
• ³University of Washington Department of Health Systems and Population Health, Seattle, United States
• ⁴Center for Dissemination and Implementation in the Institute for Public Health, Washington University in St Louis, St. Louis, United States
• ⁵Siteman Cancer Center, St. Louis, United States
• ⁶Division of Public Health Sciences, Department of Surgery, Washington University in St Louis School of Medicine, St. Louis, United States

Introduction: Chronic diseases are a leading public health concern in the Americas, and physical inactivity contributes significantly to their burden. Open streets programs — community initiatives that temporarily close urban streets to vehicles — promote physical activity and community engagement, demonstrating positive health and social impacts. Effective implementation depends on identifying suitable strategies and frameworks. The Expert Recommendations for Implementing Change (ERIC) taxonomy, developed for clinical/healthcare contexts, has not been widely assessed for community-based interventions such as Open Streets. Implementation strategies could lead to specific outcomes (e.g., adoption, sustainability) that differ from program outcomes (e.g., PA levels, chronic disease prevalence). This scoping review focuses on the strategies that influence implementation outcomes. The primary aims of this review are to 1) identify implementation strategies for Open Streets programs and 2) identify opportunities for Open Streets programs to promote chronic disease prevention and physical activity, specifically in the Americas. Methods: A scoping review was conducted using Joanna Briggs Institute methodology and PRISMA-ScR guidelines. Six databases (PubMed, Scopus, Scielo, Web of Science, TRIS, and LILACS were searched for studies on Open Streets programs in the Americas (January 2004-April 2024). Three reviewers independently screened studies in Rayyan. Strategies were extracted and coded against the 73 ERIC taxonomy strategies. Quality appraisal used MMAT for empirical studies, AMSTAR-2 for reviews, and AACODS for grey literature. Results: Fifty-nine studies met the inclusion criteria, yielding 63 distinct implementation strategies for Open Street programs. All 63 strategies were classified within the ERIC taxonomy. Frequently aligned ERIC strategies included building coalitions, capturing local knowledge, conducting needs assessments, and fostering stakeholder engagement. Unique strategies emphasized multisectoral collaboration, cultural adaptation, equity, and sustainability. Discussion: Among the 63 identified Open Streets strategies, many aligned with ERIC, providing a foundation in stakeholder engagement, coalition building, and flexible, context-sensitive implementation. However, some were unique to Open Streets, underscoring that while many ERIC strategies were applicable, not all suited this setting. Open Streets programs may require supplemental approaches to address equity, cultural competence, and multisectoral collaboration. Findings present opportunities to tailor, test, and scale strategies that maximize the population health impact of Open Streets programs.