Kaiser Permanente's Community Health Initiative in Northern California: Evaluation Findings and Lessons Learned (original) (raw)
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American journal of preventive medicine, 2018
A growing number of health systems are leading health promotion efforts in their wider communities. What impact are these efforts having on health behaviors and ultimately health status? This paper presents evaluation results from the place-based Kaiser Permanente Healthy Eating Active Living Zones obesity prevention initiative, implemented in 2011-2015 in 12 low-income communities in Kaiser Permanente's Northern and Southern California Regions. The Healthy Eating Active Living Zones design targeted places and people through policy, environmental, and programmatic strategies. Each Healthy Eating Active Living Zone is a small, low-income community of 10,000 to 20,000 residents with high obesity rates and other health disparities. Community coalitions planned and implemented strategies in each community. A population-dose approach and pre and post surveys were used to assess impact of policy, program, and environmental change strategies; the analysis was conducted in 2016. Populat...
Prevention Program: Changing Nutrition and Physical Activity Environments in California's Heartland
2010
The goals of the Central California Regional Obesity Prevention Program (CCROPP) are to promote safe places for physical activity, increase access to fresh fruits and vegetables, and support community and youth engagement in local and regional efforts to change nutrition and physical activity environments for obesity prevention. CCROPP has created a community-driven policy and environmental change model for obesity prevention with local and regional elements in low-income, disadvantaged ethnic and rural communities in a climate of poor resources and inadequate infrastructure. Evaluation data collected from 2005-2009 demonstrate that CCROPP has made progress in changing nutrition and physical activity environments by mobilizing community members, engaging and influencing policymakers, and forming organizational partnerships.
American Journal of Public Health, 2010
The goals of the Central California Regional Obesity Prevention Program (CCROPP) are to promote safe places for physical activity, increase access to fresh fruits and vegetables, and support community and youth engagement in local and regional efforts to change nutrition and physical activity environments for obesity prevention. CCROPP has created a community-driven policy and environmental change model for obesity prevention with local and regional elements in low-income, disadvantaged ethnic and rural communities in a climate of poor resources and inadequate infrastructure. Evaluation data collected from 2005-2009 demonstrate that CCROPP has made progress in changing nutrition and physical activity environments by mobilizing community members, engaging and influencing policymakers, and forming organizational partnerships.
The California Endowment's Healthy Eating, Active Communities Program: A Midpoint Review
American Journal of Public Health, 2010
Objectives. We conducted a midpoint review of The California Endowment's Healthy Eating, Active Communities (HEAC) program, which works in 6 low-income California communities to prevent childhood obesity by changing children's environments. The HEAC program conducts interventions in 5 key childhood environments: schools, after-school programs, neighborhoods, health care, and marketing and advertising. Methods. We measured changes in foods and beverages sold at schools and in neighborhoods in HEAC sites; changes in school and after-school physical activity programming and equipment; individual-level changes in children's attitudes and behaviors related to food and physical activity; and HEAC-related awareness and engagement on the part of community members, stakeholders, and policymakers. Results. Children's environments changed to promote healthier lifestyles across a wide range of domains in all 5 key childhood environments for all 6 HEAC communities. Children in HE...
Childhood obesity (Print), 2015
Community-based interventions are promising approaches to obesity prevention, but few studies have prospectively evaluated them. The aim of this study was to evaluate a natural experiment-a community intervention designed to promote active living and decrease obesity within a small southern town. In 2011, community leaders implemented the Mebane on the Move intervention-a community-wide effort to promote physical activity (PA) and decrease obesity among residents of Mebane, North Carolina. We measured child PA and BMI before and after the intervention, using a nearby town not implementing an intervention as the comparison. In total, we assessed 64 children from Mebane and 40 from the comparison community 6 months before, as well as 34 and 18 children 6 months after the intervention. We assessed PA with accelerometers worn for 7 days and calculated BMI z-scores using children's height and weight. We conducted multivariable linear regressions examining pre- to postintervention cha...
Community-Engaged Interventions on Diet, Activity, and Weight Outcomes in U.S. Schools
American Journal of Preventive Medicine, 2012
Context: Community engagement literature suggests that capacity-building approaches and community partnership in health intervention design, delivery, and analysis improve outcomes. School communities influence childhood diet and activity patterns affecting lifelong obesity risk. This systematic review's purpose is to assess whether incorporating community engagement principles in school-based interventions influences weight-related outcomes. Evidence acquisition: Obesity-prevention interventions (published January 2000-2011) in diverse U.S. schools, meeting a minimum threshold of community engagement and targeting weight-, diet-or activity-related outcomes were identifıed in MEDLINE, PsycINFO, and CINAHL (December 2010-March 2011). Two reviewers scored community engagement performance on 24 metrics of capacity building and partner involvement along four research stages. Outcome performance was calculated as percentage of targeted primary and/or secondary outcomes achieved. Evidence synthesis: Sixteen studies were included, targeting anthropometric (n ϭ 12); dietary (n ϭ 13); and activity (n ϭ 10) outcomes in schoolchildren (mean ageϭ10.7 years). Studies averaged 46% of targeted outcomes (95% CI ϭ 0.33, 0.60) and met 60% of community engagement metrics. Positive correlations existed between community engagement performance and all-outcome performance (r ϭ 0.66, 95% CI ϭ 0.25, 0.87) and secondary-outcome performance (r ϭ 0.67, 95% CI ϭ 0.22, 0.89), but not primary-outcome performance (r ϭ 0.26, 95% CI ϭ Ϫ0.27, 0.67). Number of outcomes met was not correlated with number of outcomes targeted, number of partners, or study size. Specifıc qualitative and quantitative trends suggested that capacity-building efforts, engagement in needs assessments and results dissemination, and durable partnerships positively influence outcomes. Conclusions: Results suggest that meaningful partnership of diverse school communities within obesity prevention interventions can improve health outcomes.
International Journal of Nursing & Clinical Practices, 2016
Objective: To observe outcomes of a community-centered approach to identifying behavioral and environmental factors that influence overweight and obesity in 6 th -8 th grade youth in selected lowincome, racial/ethnic communities. Design: Five-year, tri-state, quasi-experimental design with environmental assessments and a questionnaire measuring nutrition and physical activity knowledge and behavior conducted in all communities at pre and post. Setting: Low-income, minority communities targeting 6 th -8 th grade youth. Participants: One experimental and one control communities will be selected via each state's Cooperative Extension network through an application and review process with the random selection of participating communities. Intervention(s): Academic institutions will work with community leaders to establish and help support community committees tasked to plan, implement and evaluate one nutrition and one physical activity intervention. Main Outcome Measure(s): Assess environmental changes associated with increased intake and variety of fruits and vegetables; decreased intake of foods high in solid fats and added sugars; and an increase in physical activity among 6 th -8 th grade youth. Analysis: Baseline and post environmental data and pre and post questionnaire data will be analyzed using t-tests, chi-square, and ANOVA with a p < 0.05 to establish statistical significance.