With the goal of preventing childhood obesity, the Healthy Kids, Healthy Communities (HKHC) national program, funded by the Robert Wood Johnson Foundation (RWJF), provided grants to 49 community partnerships across the United States.
Healthy eating and active living policy, system, and environmental changes were implemented to support healthier communities for children and families.
Transtria, LLC and Washington University Institute for Public Health received funding from RWJF to evaluate the HKHC national program; the focus of this evaluation is on the Washington DC HKHC partnership. In December 2008, the DC partnership, led by the Summit Health Institute for Research and Education, Inc. (SHIRE), received a four-year, $400,000 grant as part of the HKHC national program. Strategies of the partnership included: community engagement; employing local residents as park ambassadors to watch over parks and playground spaces; an after school meal program that reached 46,393 children in 102 schools; promotion of healthy eating initiatives focusing on increasing access to healthy foods at convenience stores and through healthy vending; and collaboration with the Department of Health to create policies to reimburse community-based fitness and healthy living programs by insurers.
- Community engagement: The partnership anticipated conducting Town Hall meetings as part of the community consultation process. It ended up being the case that partners educated senior Department of Health (DOH) officials on HKHC DC policies, and frequently made mention of HKHC DC policies at DOH convened Town Hall meetings.
- Park ambassadors: In collaboration with a diverse leadership team, Outdoors for Health initiatives were designed for community residents and partners to use in advocating for park improvements and increase usage. A policy analysis conducted to identify the feasibility of institutionalizing a paid Park Ambassador workforce unveiled that funding needed to be available for park ambassador positions.
- After school meal program: Though there was a desire to ensure any site hosting a supper program was a safe place, there was no policy in place in DC that applied to community-based sites interested in hosting a supper program. Additionally, sites need guidance navigating contracts with large food supply companies. Smaller nonprofits, including DC Central Kitchen and the food bank, were utilized to decrease dependence on large food supply companies, but demand outpaced capacity.
- Healthy eating initiatives: Conversations from community members shifted the focus from limiting unhealthy food options to increasing healthy options. This adaptation of strategy and goals to meet needs in communities increased momentum around healthy eating.
- Third-party reimbursement: Partnership with the Department of Health Care Finance, a sister agency of the Department of Health, is essential for successful implementation of third-party reimbursement strategy and broad system change to the way Medicaid handles reimbursement for physical activity.
Moving forward beyond HKHC, SHIRE will continue to act as the lead agency in future endeavors. Responsibilities will expand as the group begins work on improving active living accessibility thru a newly-formed, city-wide outdoor coalition that is a continuation of the Park Ambassadors initiative.
SHIRE will continue to bring necessary components and partners together to accomplish objectives and reach out to partner agencies with topical expertise in HKHC strategies. These include Groundwork Anacostia and The National Parks Service, which both have strengths that contribute to parks initiatives, and DC Hunger Solutions, which provides expertise for healthy eating initiatives. SHIRE will support these partners’ efforts and provide cohesiveness to the work.
About the Evaluation
Evaluators tracked plans, processes, strategies, and results related to active living and healthy eating policy, system, and environmental changes as well as influences associated with partnership and community capacity and broader social determinants of health. Reported actions, or steps taken by community partnerships to advance their goals, tactics, activities, or benchmarks from their workplans, formed community progress reports tracked through the HKHC Community Dashboard program website. In addition, evaluators collaborated with community partners to conduct individual and group interviews with partners and community representatives, environmental audits and direct observations in specific project areas (where applicable), and group model building sessions. Data from an online survey, photos, community annual reports, and existing surveillance systems (e.g., U.S. census) supplemented information collected alongside community partnerships.