Translational Behavioral Medicine

, Volume 6, Issue 4, pp 638–647 | Cite as

Examining the role of a community coalition in facilitating policy and environmental changes to promote physical activity: the case of Get Fit Kaua‘i

  • Lehua B. ChoyEmail author
  • Jay E. Maddock
  • Beverley Brody
  • Katherine L. Richards
  • Kathryn L. Braun
Case Study


Community coalitions help to generate policy and environmental changes that address community health problems. This qualitative study examined how one community coalition, Get Fit Kaua‘i, catalyzed built environment (BE) policy and infrastructure changes in a rural county in Hawai‘i. The purpose was to develop a theory that explained the process by which the community coalition facilitated BE changes to support physical activity. Using a grounded theory approach, semi-structured interviews were conducted with a purposeful sample of 25 stakeholders engaged in the coalition’s BE activities. The model to emerge from the coalition interviews consisted of five phases: (1) coalition formation, (2) capacity building, (3) policy development, (4) policy passage, and (5) policy implementation. Community context influenced all of these phases. Although community context limits generalizability, other community coalitions pursuing BE changes can learn from the process of the coalition under study.


Collaboration Multisector Built environment Physical activity Policy 



This study was funded by the Healthy Hawai‘i Initiative, Hawai‘i State Department of Health, using Tobacco Settlement Special Funds and through a contract with the University of Hawai‘i, Office of Public Health Studies (Jay Maddock served as Principal Investigator). Get Fit Kaua‘i also received funding from the Healthy Hawai‘i Initiative, Hawai‘i State Department of Health. The authors would like to thank Jodi Drisko, Marie Williams, and Lee Steinmetz for their guidance with carrying out this study. We are also grateful to all of the interview participants who shared their valuable insights.

Compliance with ethical standards

The authors have complied with ethical standards.


This study was funded by the Hawai‘i State Department of Health, Healthy Hawai‘i Initiative, using Tobacco Settlement Special Funds.

Conflict of interest

The authors declare that they have no competing interests.

Ethical approval

This study was approved by the University of Hawai‘i Human Studies Program.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Supplementary material

13142_2015_379_MOESM1_ESM.pdf (47 kb)
ESM 1 (PDF 47 kb)


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Copyright information

© Society of Behavioral Medicine 2015

Authors and Affiliations

  • Lehua B. Choy
    • 1
    Email author
  • Jay E. Maddock
    • 2
  • Beverley Brody
    • 1
  • Katherine L. Richards
    • 3
  • Kathryn L. Braun
    • 1
  1. 1.Department of Public Health SciencesUniversity of Hawai‘i at MānoaHonoluluUSA
  2. 2.School of Public HealthTexas A & M Health Science CenterCollege StationUSA
  3. 3.Healthy Hawai‘i InitiativeHawai‘i State Department of HealthHonoluluUSA

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