Strategies to promote healthy weight, nutrition, and physical activity are commonly identified in large local health department Community Health Improvement Plans, yet not all strategies have the strongest evidence for effectiveness or for reducing health disparities.

We recently published an article entitled “Use of Evidence-Based Interventions to Promote Healthy Weight, Nutrition, and Physical Activity in Community Health Improvement Plans for Large Local Health Departments” in the Journal of Public Health Management and Practice that was inspired by our Center’s work with state and local health departments. At the Harvard Prevention Research Center on Nutrition and Physical Activity, we have been partnering and supporting local health departments for over two decades in their efforts to curb childhood and adult obesity using effective and cost-effective strategies.

Community Health Improvement Plans—or CHIPs—are an increasingly important and common tool for local health departments big and small. These plans, which are required as part of the accreditation process with the Public Health Accreditation Board, are an opportunity for health departments, community organizations, and researchers to come together to create a set of common goals, objectives, and strategies to promote the community’s health over a specific timeframe. These are typically crafted in response to the strengths and weaknesses identified through a community needs assessment. What is exciting about CHIPs is the opportunity for community partners to work together or in parallel to promote shared health goals, using the best available science.

Indeed, multiple free and vetted tools, repositories, and databases exist collating data on public health interventions and strategies. These include Healthy People 2030, The Community Guide, and What Works for Health. These offer a menu of opportunities for organizations looking to implement strategies in their communities that will meet their stated goals and match the community’s interest. What Works for Health by the County Health Rankings and Roadmaps is a repository that not only provides information on strategies by topic area, but also rates the existing evidence for its effectiveness as well as its likely impact on health disparities.

In our recently published paper, we sought to analyze the content of CHIPs from large local health departments to identify the strength of the evidence for public health impact and for reducing health disparities of the most commonly identified strategies to promote healthy weight, nutrition, and physical activity. To do this, we categorized the strategies we identified in the most recent CHIPs to a strategy listed in What Works for Health. We found that 55 of the 72 large local health department CHIPs included strategies to promote healthy weight, nutrition, and physical activity.

Of the 739 strategies we identified across all CHIPs, two-thirds (62.5%) were rated for outcomes related to healthy weight, nutrition, and physical activity. Among those, we found that half (50.6%) had the highest evidence rating for effectiveness but only one-fifth (19.5%) were rated as likely to decrease health disparities. These findings are both promising—large local health departments and their community partners are working to promote healthy weight, nutrition, and physical activity—and point to potential unmet needs of large local health departments.

With limited resources, it is important that local health departments invest in strategies with the highest evidence for effectiveness and for reducing health disparities. To this we would also add: invest in strategies that are cost-effective. However, many of the resources available to health departments when identifying and selecting strategies lack this information.

Overall, in “Use of Evidence-Based Interventions to Promote Healthy Weight, Nutrition, and Physical Activity in Community Health Improvement Plans for Large Local Health Departments,” we conclude that large local health departments play an important role in directing resources to implement strategies and may benefit from additional technical assistance to identify those interventions that have the strongest evidence for impact.

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Co-authors

Jennifer Reiner, MPH, is a Project Manager at the Prevention Research Center on Nutrition and Physical Activity in the Department of Social and Behavioral Sciences at the Harvard T.H. Chan School of Public Health.

Santana Silver, MPH, is the Assistant Director for the Evans Center for Implementation and Improvement Sciences at Boston University.

Jessica Barrett, MPH, is a Senior Research Analyst at the Prevention Research Center on Nutrition and Physical Activity in the Department of Social and Behavioral Sciences at the Harvard T.H. Chan School of Public Health.

James Daly, MPH, is a Research Project Manager at the Prevention Research Center on Nutrition and Physical Activity in the Department of Social and Behavioral Sciences at the Harvard T.H. Chan School of Public Health.

Rebekka Lee, ScD, is a Research Scientist in the Department of Social and Behavioral Sciences at the Harvard T.H. Chan School of Public Health.

Steven Gortmaker, PhD, is a Professor of the Practice of Health Sociology and the Director of the Prevention Research Center on Nutrition and Physical Activity in the Department of Social and Behavioral Sciences at the Harvard T.H. Chan School of Public Health.

Angie Cradock, ScD, is a Principal Research Scientist and Deputy Director of the Prevention Research Center on Nutrition and Physical Activity in the Department of Social and Behavioral Sciences at the Harvard T.H. Chan School of Public Health.

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