Robert E. Aronson, DrPH, MPH¹, Michelle C. Kegler, DrPH², Barbara L. Norton, MPH, MBA³, Kai H. Young⁴, Arma Fernandez⁴, Joan M. Twiss, MA⁵, Shirley Duma, MA⁶, and Joy Dickinson, BA⁶. (1) School of Health & Human Performance, Dept. of Public Health Education, University of North Carolina at Greensboro, 437 HHP Bldg, P.O. Box 26169, Greensboro, NC 27402-6169, 336-256-0119, rearonso@uncg.edu, (2) Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA 30322, (3) Department of Health Promotion Sciences, College of Public Health, University of Oklahoma, P.O. Box 26901, Room 369, Oklahoma City, OK 73190, (4) Department of Behavioral Science & Health Education, Emory University, Clifton Road, Atlanta, GA 30333, (5) Center for Civic Partnerships, 1851 Heritage Lane, Suite 250, Sacramento, CA 95815, (6) Center for Civic Partnerships, California Healthy Cities and Communities, 1851 Heritage Lane, Suite 250, Sacramento, CA 95815

Healthy cities and communities efforts, by definition, seek to achieve community change through improved physical and social environments that support health. Community level outcomes represent one level of the social ecology which was examined in an evaluation of CHCC. In defining community level outcomes, we chose to examine a wide range of potential effects, from public policy changes, to changes in community norms and values, to changes in the physical environment. This presentation will describe community level changes resulting from the California Healthy Cities and Communities initiative. The evaluation design was a multiple case study of 20 participating communities with cross-case analysis. Data collection involved: review of program documents; participant surveys in the first and third years of the project (n=330 and N=243, respectively); 165 in-depth interviews with local coordinators, community leaders, sponsoring organization directors and CHCC staff; and 26 focus groups in 9 communities selected for site visits (n=176). Types and specific examples of community level changes will be presented, including public policy changes, changes in community problem solving norms, changes in sense of community, and physical changes in the community. Differences by rural/urban nature of the community and factors which facilitate or inhibit change will be described and discussed.

Learning Objectives: At the end of the session, participants (learners) will be able to

• Identify specific types of community level change that can be examined in the evaluation of healthy cities and communities initiatives;
• Describe the types of community level changes achieved in the CHCC initiative;
• Identify differences in community level change by the rural/urban nature of the community;
• Discuss factors which inhibit or facilitate community level change that were identified in the CHCC evaluation.

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.