Role of the health care sector in changing environments to promote healthy eating and physical activity: Follow-up findings from the HEAC healthcare sector evaluation

The California Endowment's Healthy Eating, Active Communities (HEAC) Program is a multi-year program focused on reducing disparities in obesity and diabetes in high-risk communities by improving food and activity environments for children. This presentation will describe 18-22 month follow-up findings from the HEAC evaluation efforts to assess whether healthcare providers' practices changed with respect to addressing obesity prevention in their clinical practice and to determine providers' perceived role and experience in advocacy for policies designed to prevent childhood obesity through improving community food and activity environments.

At baseline and follow-up, a self-administered survey was given to healthcare providers practicing in HEAC grantee sites (n=248 at baseline, n=173 at endpoint). The survey consisted of an 18-item questionnaire and survey questions focused on: BMI measurement and tracking, counseling with basic prevention messages, referrals to community programs, engagement in community advocacy efforts to change food and physical activity environments, tools and resources needed to engage in advocacy work.

Respondents agreed (95%) about the importance of healthcare providers being engaged in prevention and early detection of childhood obesity. Almost all reported having engaged in at least one advocacy activity and over 40% reported having engaged in three or more, which was a large increase from baseline. At baseline, 43% of respondents reported taking BMI measurements "usually" or "always" whereas on the follow-up survey this number was 68 percent. Healthcare providers need time, training, resources and institutional support to improve their ability to communicate obesity prevention messages in both clinical practice and as policy advocates.