Journal of Community Health

, Volume 37, Issue 5, pp 1081–1090 | Cite as

Fifty Communities Putting Prevention to Work: Accelerating Chronic Disease Prevention Through Policy, Systems and Environmental Change

  • Rebecca Bunnell
  • Dara O’Neil
  • Robin Soler
  • Rebecca Payne
  • Wayne H. Giles
  • Janet Collins
  • Ursula Bauer
  • Communities Putting Prevention to Work Program Group
Original Paper

Abstract

The burden of preventable chronic diseases is straining our nation’s health and economy. Diseases caused by obesity and tobacco use account for the largest portions of this preventable burden. CDC funded 50 communities in 2010 to implement policy, systems, and environmental (PSE) interventions in a 2-year initiative. Funded communities developed PSE plans to reduce obesity, tobacco use, and second-hand smoke exposure for their combined 55 million residents. Community outcome objectives and milestones were categorized by PSE interventions as they related to media, access, promotion, pricing, and social support. Communities estimated population reach based on their jurisdiction’s census data and target populations. The average proportion of each community’s population that was reached was calculated for each intervention category. Outcome objectives that were achieved within 12 months of program initiation were identified from routine program records. The average proportion of a community’s jurisdictional population reached by a specific intervention varied across interventions. Mean population reach for obesity-prevention interventions was estimated at 35%, with 14 (26%) interventions covering over 50% of the jurisdictional populations. For tobacco prevention, mean population reach was estimated at 67%, with 16 (84%) interventions covering more than 50% of the jurisdictional populations. Within 12 months, communities advanced over one-third of their obesity and tobacco-use prevention strategies. Tobacco interventions appeared to have higher potential population reach than obesity interventions within this initiative. Findings on the progress and potential reach of this major initiative may help inform future chronic disease prevention efforts.

Keywords

Chronic disease prevention Obesity Nutrition Physical activity Tobacco Community health Policy System Environmental change 

References

  1. 1.
    Centers for Disease Control and Prevention. (2009). The power of prevention. Atlanta, GA: US Department of Health and Human Services. Retrieved from http://www.cdc.gov/chronicdisease/pdf/2009-Power-of-Prevention.pdf.
  2. 2.
    Gulley, S. P., Rasch, E. K., & Chan, L. (2011). If we build it, who will come? Working-age adults with chronic health care needs and the medical home. Medical Care, 49(2), 149–155.PubMedCrossRefGoogle Scholar
  3. 3.
    Mokdad, A. H., Marks, J. S., Stroup, D. F., & Gerberding, J. L. (2004). Actual causes of death in the United States, 2000. Journal of the American Medical Association, 291(10), 1238–1245.PubMedCrossRefGoogle Scholar
  4. 4.
    Institute of Medicine. (2011). For the public’s health: Revitalizing law and policy to meet new challenges. Washington, DC: Institute of Medicine.Google Scholar
  5. 5.
    Brownson, R. C., Haire-Joshu, D., & Luke, D. A. (2006). Shaping the context of health: a eview of environmental and policy approaches in the prevention of chronic diseases. Annual Review of Public Health, 27, 341–370.PubMedCrossRefGoogle Scholar
  6. 6.
    Chambers, R., Turner, L., & Hunt, S. (2007). Application of ecological models to risks related to being overweight among nurses. Psychological Reports, 100(3), 815–816.PubMedCrossRefGoogle Scholar
  7. 7.
    Frieden, T. R. (2010). A framework for public health action: the health impact period. American Journal of Public Health, 100(4), 590–595.PubMedCrossRefGoogle Scholar
  8. 8.
    Convergence Partnership. (n.d.). Who we are. Retrieved April 14, 2011 from http://www.convergencepartnership.org.
  9. 9.
    Liao, Y., Tucker, P., Siegel, P., Liburd, L., & Giles, W. H. (2010). REACH 2010 investigators. Decreasing disparity in cholesterol screening in minority communities–findings from the racial and ethnic approaches to community health. Journal of Epidemiology and Community Health, 64(4), 292–299.PubMedCrossRefGoogle Scholar
  10. 10.
    Liao, Y., Tsoh, J. Y., Chen, R., et al. (2010). Decreases in smoking prevalence in Asian communities served by the Racial and Ethnic Approaches to Community Health (REACH) project. American Journal of Public Health, 100(5), 853–860.PubMedCrossRefGoogle Scholar
  11. 11.
    Brennan, L., Castro, S., Brownson, R. C., Claus, J., & Orleans, C. T. (2011). Accelerating evidence reviews and broadening evidence standards to identify effective, promising, and emerging policy and environmental strategies for prevention of childhood obesity. Annual Review of Public Health, 32, 199–223.PubMedCrossRefGoogle Scholar
  12. 12.
    Centers for Disease Control and Prevention. (n.d.). About MAPPS strategies. Retrieved October 14, 2011 from http://www.cdc.gov/CommunitiesPuttingPreventiontoWork/strategies/index.htm.
  13. 13.
    Milstein, B., Jones, A., Homer, J. B., Murphy, D., Essien, J., & Seville, D. (2007). Charting plausible futures for diabetes prevalence in the United States: a role for system dynamics simulation modeling. Preventing Chronic Disease, 4(3), A52.PubMedGoogle Scholar
  14. 14.
    Baby Friendly USA. (2010). Guidelines and Evaluation Criteria for Facilities Seeking Baby- Friendly Designation. Sandwich, MA: Baby Friendly USA. Retrieved from http://www.babyfriendlyusa.org/eng/docs/2010_Guidelines_Criteria_4.19.11.pdf.
  15. 15.
    Pomeranz, J. L., Teret, S. P., Sugarman, S. D., Rutkow, L., & Brownell, K. D. (2009). Innovative legal approaches to address obesity. Milbank Quarterly, 87(1), 185–213.PubMedCrossRefGoogle Scholar
  16. 16.
    Pomeranz, J. L., & Brownell, K. D. (2011). Advancing public health obesity policy through state Attorneys General. American Journal of Public Health, 101(3), 425–431.PubMedCrossRefGoogle Scholar
  17. 17.
    Huang, T. (2009). Solution-oriented research: converging efforts of promoting environmental sustainability and obesity prevention. American Journal of Preventive Medicine, 36(2(S)), S60–S62.PubMedCrossRefGoogle Scholar
  18. 18.
    COMMIT Research Group. (1995). Community Intervention Trial for Smoking Cessation (COMMIT): I. Cohort results from a four- year community intervention. American Journal of Public Health, 85, 183–192.CrossRefGoogle Scholar
  19. 19.
    COMMIT Research Group. (1995). Community Intervention Trial for Smoking Cessation (COMMIT): II. Changes in adult cigarette smoking prevalence. American Journal of Public Health, 85, 193–200.CrossRefGoogle Scholar
  20. 20.
    Cummings, K. (1999). Community-wide interventions for tobacco control. Nicotine & Tobacco Research: Official Journal of the Society for Research on Nicotine and Tobacco, 1(1(S)), S113–S116.CrossRefGoogle Scholar
  21. 21.
    Warner, K., & Mendez, D. (2010). Tobacco control policy in developed countries: yesterday, today, and tomorrow. Nicotine & Tobacco Research, 12(9), 876–887.CrossRefGoogle Scholar
  22. 22.
    National Cancer Institute. (1991). Monograph 1: Strategies to control tobacco use in the United States: A blueprint for public health action in the1990′s. US Department of Health and Human Service, Public Health Service, National Institutes of Health. NIH Publication 92-3316.Google Scholar
  23. 23.
    Chaloupka, F. J., Straif, K., & Leon, M. E. (2011). Effectiveness of tax and price policies in tobacco control. Tobacco Control, 20(3), 235–238.PubMedCrossRefGoogle Scholar
  24. 24.
    Lovato, C., Zeisser, C., Brown, K., et al. (2010). Adolescent smoking: effect of school and community characteristics. American Journal of Preventive Medicine, 39(6), 507–514.PubMedCrossRefGoogle Scholar
  25. 25.
    Institute of Medicine. (2007). Ending the tobacco problem: A blueprint for the nation. Washington, DC: The National Academies Press.Google Scholar
  26. 26.
    US Department of Health and Human Services. (1989). Reducing the health consequences of smoking: 25 years of progress–A report of the surgeon general. Washington, DC: US Department of Health and Human Services, Centers for Disease Control, Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health.Google Scholar
  27. 27.
    Institute of Medicine. (2000). State programs can reduce tobacco use. Washington, DC: The National Academies Press.Google Scholar
  28. 28.
    Skouteris, H., McCabe, M., Swinburn, B., Newgreen, V., Sacher, P., & Chadwick, P. (2011). Parental influence and obesity prevention in pre-schoolers: a systematic review of interventions. Obesity Reviews, 12(5), 315–328.PubMedCrossRefGoogle Scholar
  29. 29.
    Cheadle, A., Samuels, S. E., Rauzon, S., et al. (2010). Approaches to measuring the extent and impact of environmental change in three California community-level obesity prevention initiatives. American Journal of Public Health, 100(11), 2129–2136.PubMedCrossRefGoogle Scholar
  30. 30.
    Dawkins N., Wethington H., Khan L.K., et al. (2010). Applying the systematic screening and assessment method to childhood obesity prevention. In L. C. Leviton, L. Kettel-Khan & N. Dawkins (Eds.). New directions for evaluation. special issue: The systematic screening and assessment method: Finding innovations worth evaluating 125, 33–49.Google Scholar
  31. 31.
    Baker, E. L., Jr, & Koplan, J. P. (2002). Strengthening the nation’s public health infrastructure: historic challenge, unprecedented opportunity. Health Affairs, 21(6), 15–27.PubMedCrossRefGoogle Scholar
  32. 32.
    O’Donnell, M. P. (2011). Commentaries on “Workplace health promotion will become irrelevant in national policy if we do not learn to speak with one voice. American Journal of Health Promotion, 26(1), ei–eii.PubMedCrossRefGoogle Scholar
  33. 33.
    Centers for Disease Control and Prevention. (2011). Community transformation grant program. http://www.cdc.gov/ctg. Accessed October 14, 2011.
  34. 34.
    Centers for Disease Control and Prevention. (2011). Principles of community engagement, 2nd ed., NIH Publication No. 11-7782. Washington, DC: Government Printing Office.Google Scholar
  35. 35.
    World Health Organization. (2011). Spending on health: A global overview. World Health Organization Web site. http://www.who.int/mediacentre/factsheets/fs319.pdf. Accessed April 14, 2011.
  36. 36.
    Central Intelligence Agency. (2011). Country comparison: Life expectancy at birth. The World Factbook. Central Intelligence Agency Web site. http://www.cia.gov/library/publications/the-world-factbook/rankorder/2102rank.html. Accessed April 14, 2011.

Copyright information

© Springer Science+Business Media, LLC (outside the USA) 2012

Authors and Affiliations

  • Rebecca Bunnell
    • 1
  • Dara O’Neil
    • 2
  • Robin Soler
    • 1
  • Rebecca Payne
    • 1
  • Wayne H. Giles
    • 3
  • Janet Collins
    • 4
  • Ursula Bauer
    • 5
  • Communities Putting Prevention to Work Program Group
  1. 1.Division of Community HealthNational Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and PreventionAtlantaUSA
  2. 2.ICF InternationalAtlantaUSA
  3. 3.Division of Population HealthNational Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and PreventionAtlantaUSA
  4. 4.Centers for Disease Control and PreventionAtlantaUSA
  5. 5.National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and PreventionAtlantaUSA

Personalised recommendations