Changing community nutrition and physical activity environments: What does it take?

In 2005, the Health Funders' Partnership of Orange County (HFPOC), representing private and public health funders in Orange County, California, created and funded the Community Advocacy Initiative (CAI). The project focused on reducing disparities in Type II diabetes by improving food and physical activity environments through policy advocacy. HFPOC provided grants to a school district, healthcare facility, and several community based collaboratives, which are located in predominantly low-income communities throughout the county. Grantees developed site-specific logic models and received technical assistance to guide their progress toward goals and objectives. Samuels & Associates evaluated the CAI using a multi-method evaluation approach, including: 1) self-reported interviews from grantees on project successes, challenges, and achievements, and 2) baseline and endpoint stakeholder interviews of community residents, project staff and local policymakers to assess engagement in activities to change food and physical activity environments in the grantee communities. Analysis revealed key strategies employed across grantee sites to accomplish their policy and environmental change goals, including community mobilization, local policymaker engagement, and collaboration with other organizations. Results also suggested elements that would help build a county-wide movement to prevent diabetes. The assessment findings and methods can serve as a model for other communities engaging in efforts to change food and physical activity environments. The lessons learned and policy and advocacy strategies that emerged from the multi-year initiative could also help to shape future funding opportunities in this area.