National Organizations Empowering Communities to Improve Population Health (White Paper)
This report documents accomplishments of the Partnering4Health project at the community and national levels.
During this three-year project, these diverse partners rolled up their sleeves and invested thousands of hours so that adults, children, and youth could have expanded opportunities to live longer, healthier lives.
The report suggests factors that contributed to the project’s success and ways to improve future projects that use a similar national organization model to make community-level changes.
The 94 communities each contributed to advance the evidence-based practice that will help others create healthier communities. Each national organization also strengthened its own commitment and resolve to foster community-based changes using policy, systems and environmental change approaches to reduce chronic diseases and promoting health equity.
Table of Contents
- EXECUTIVE SUMMARY
- PART I: STRATEGIES USED
- Core Strategies
- Community Needs Assessment
- Local Coalition Building
- National Coalition Building
- Intervention Strategies
- Improving Access to Healthier Foods and Beverages
- Physical Activity
- Community and Clinical Linkages
- Smoke-free Environments
- PART II: PROGRAM DESIGN STRATEGIES: RELATIONSHIPS
- PART III. PROGRAM DESIGN STRATEGIES: PROCESSES
- Training, Tools, and Technical Assistance
- PART IV: SUCCESSES, RESULTS, AND MORE RECOMMENDATIONS
- Successes and Results
- Overall Recommendations
Pullouts are expanded topics which are directly linked from the white paper’s PDF file. If a topic is of special interest to you, you may access it directly from the links below.
- Pullout #1 – Policy, Systems and Environmental (PSE) Change Approach
- Pullout #2 – Needs Assessment
- Pullout #3 – Working with Coalitions
- Pullout #4 – Communication Activities
- Pullout #4a – Health Equity
- Pullout #5 – Healthy Corner Stores
- Pullout #6 – Healthy Food Procurement
- Pullout #7 – Farmers' Markets and Mobile Markets
- Pullout #9 – Community Gardens
- Pullout #10 – Community Walkability and Bikeability
- Pullout #11 – Physical Education
- Pullout #12 – Supporting Breastfeeding
- Pullout #13 – Referrals To and From WIC
- Pullout #14 – American Heart Association (AHA)
- Pullout #14 - Appendix A – AHA Community Action Plan Template
- Pullout #15 – American Planning Association (APA)
- Pullout #16 – National WIC Association (NWA)
- Pullout #16 - Appendix A – NWA Community Action Plan Template
- Pullout #17 – Directors of Health Promotion and Education (DHPE) and Society for Public Health Education (SOPHE)
For the past two decades, the U.S. Centers for Disease Control and Prevention (CDC) has funded communities throughout the United States via a competitive process to promote healthy lifestyles and decrease morbidity and mortality due to costly chronic diseases. The aim of each funding initiative was to stimulate communities’ adoption of policies, systems, and environments (PSE) that would make communities healthier and promote individuals’ healthy choices. From 2014 to 2017, CDC provided five national organizations a total of $30 million to work with local communities and build their capacity for implementing sustainable changes that support healthy communities and lifestyles. The overall goal of CDC’s funding was to implement, evaluate, and disseminate evidence- and practice-based community health activities that promote health equity and eventually led to a 5% reduction in the rate of death and disability due to tobacco use, a 3% reduction in the prevalence of obesity, and a 3% reduction in the rates of death and disability due to diabetes, heart disease, and stroke.
Through a competitive process, CDC’s Division of Community Health selected three national organizations to work with their existing regional or local affiliates, chapters, or members: American Heart Association (AHA), American Planning Association (APA), and National WIC Association (NWA). These national organizations provided 97 funding awards to 94 communities in two cohorts. The funding supported communities’ work toward PSE changes that would increase access to smoke-free environments, healthier foods and beverages, and physical activity opportunities, as well as overall chronic disease prevention, risk reduction, and management initiatives. In addition to funding these three organizations, CDC funded two other national organizations to provide training, communication support, and technical assistance to the project: the Directors of Health Promotion and Education (DHPE) and the Society for Public Health Education (SOPHE).
The expectation was that the national organizations could leverage their existing networks, resources, and expertise to reach more communities especially smaller communities unlikely to compete successfully for direct federal awards to yield a positive return on the federal investment. National organizations would further the project’s reach by sharing lessons and expertise gained from this project with affiliates, chapters, and members in non-funded communities. To ensure this project functioned as a single project, the five national organizations formed a national coalition to share decision-making, coordinate resources, and communicate lesson learned with each other. They named the project Partnering4Health.
Through their own competitive processes, AHA, APA, and NWA selected two cohorts of diverse urban, rural, and tribal communities for 13 to 15 months of funding support. With modest funding, the 94 funded communities made remarkable strides in improving access to healthier opportunities where people live, work, and play. As a result of the project, more than 20 million people in communities throughout the United States now have more access to nutritious foods, physical activity, smoke-free environments, and/or clinical preventive services. Residents of 74 communities now have more access to healthy food and beverage options sold at corner stores, vending machines, mobile food trucks, farmers markets, or by planting new community gardens. More farmers markets and other sources of fresh produce in those communities now accept food stamps and WIC vouchers, making healthy food more available and affordable to those with low incomes. Residents of 36 communities have more opportunities for physical activity through the creation of bike- and walker-friendly spaces, strengthening of school physical education, addition of worksite wellness sites, and/or new shared use agreements that allowed the public access to unused facilities such as after-hours school gymnasiums or tracks. Those in six communities have more smoke-free parks, housing, or other environments. Mothers of young children in 29 communities can take advantage of breastfeeding-friendly environments and better links to health care professionals and community resources that promote healthy lifestyles. In the first 2½ years of the project alone, these remarkable achievements were disseminated in more than 39,000 media placements that reached over 177 million people and over 70,000 partners.
These impressive results in a short time frame were made possible by the funded national organizations’ existing chapters, affiliates, or other connections to states and local communities. The combination of national, respected reputations of each organization; nimble infrastructure; existing partnerships; and chronic disease expertise within the national organizations allowed them to leverage federal funds and expedite results. As a result of participating in this project, each national organization also strengthened its own commitment and resolve to foster community-based changes using PSE change approaches for reducing chronic diseases and promoting health equity.
During this 3-year project, diverse partners rolled up their sleeves and invested thousands of hours so that adults, children, and youth could have expanded opportunities to live longer, healthier lives. Without access to healthy foods, safe places to play or exercise, smoke-free environments, or breastfeeding-supportive policies, people’s opportunities to avoid chronic diseases are hampered. The 94 communities each contributed in their own ways to advancing the evidence-based practice that will help others create healthier communities. Each national organization has changed in structural, conceptual, or policy ways that will continue past the funding and advance the healthy communities movement.
This report documents accomplishments of the Partnering4Health project at the community and national levels. It also suggests factors that contributed to success and ways of improving future projects that use a similar national organization model to make community-level changes.