Evaluating policy change for population-based obesity prevention efforts in Latino communities

The Communities Putting Prevention to Work (CPPW) program is a Centers for Disease Control (CDC) program funded through the American Recovery and Reinvestment Act (ARRA) of 2009. A nationwide CPPW application process resulted in the selection of 50 cities in March of 2010 to implement population health policy and environmental changes in the areas of obesity and tobacco use. Among those, 28 communities are addressing obesity. The strategies employed by communities to institute policy, systems and environmental changes are known as MAPPS strategies: target (M)edia promotion and marketing of healthy foods and physical activity, increased (A)ccess to healthy foods and recreational opportunities, (P)oint of decision information regarding food purchase and alternative transportation options, (P)rice reduction for healthy options, and (S)upport Services in schools, worksites and community organizations. CPPW is implementing population-based health strategies that have been conceptualized by the research community but largely unapplied by the practice community. Policy change based in understandings of social inequality as the engine behind health disparities is often seen as unrelated to health and faces significant resistance from policy makers with traditional understandings of health and disease. As innovators and early adopters, CPPW communities are facing the challenge of being the vanguard of these strategies for obesity prevention. Evaluation of policy and environmental changes has been challenging as few evaluation models exist that marry top down social determinants policy with community-based interventions. The evaluators for the Pima County, Arizona and San Antonio, Texas CPPW grants will present an overview of the CPPW obesity prevention approach and identify models that have informed the evaluation process and structure for these two majority Latino communities.