Community-based programs may address positive health behaviors and wellness for the individual child as well as the entire family. Habits and attitudes toward health can be shaped through strengthening the relationships within families as well as the community. This model of program design allows for two-way learning between various individuals and groups within the community, which cultivates relationships and encourages social cohesion. Community-based models also help facilitate culturally sensitive services, because they can be tailored to the various needs of the communities served and organizations may choose to engage trusted community champions.
Community-based organizations, including faith-based organizations and nonprofits, are able to impact health behaviors in significant ways. Community organizations may:
- Make healthy food choices available at meetings and gatherings
- Implement health-related policies and practices
- Make sure healthy foods are available in local food pantries
- Promote and support breastfeeding
- Encourage physical activity by enhancing physical structures or adding point-of-decision prompts to encourage walking
- Allow community members to use their space for physical activity
The Community Preventive Services Task Force (CPSTF) recommends community-wide campaigns as a strategy to increase physical activity, particularly those involving cross-sector collaboration. In addition, the CPSTF found that community-wide health communication and social marketing campaigns can improve health behaviors, particularly the use of child safety seats, the use of safety helmets, smoking cessation, and sun safety.
Examples of Community-Based Models
4-H Food Smart Families educates families eligible for or receiving Supplemental Nutrition Assistance Program (SNAP) and/or Women, Infants & Children (WIC) benefits on how to plan, shop for, and prepare healthy meals. This helps to create more food secure homes by addressing the barrier of limited resources with feasible methods for buying and cooking nutritious meals. The 4-H Food Smart Families program is currently in nine states: Arizona, Florida, Louisiana, Mississippi, New York, Nebraska, Tennessee, Washington, and Wisconsin.
Eat Smart, Move More North Carolina is a statewide effort designed to increase residents' opportunities for healthful eating and improved physical activity. Materials are designed for a variety of settings, including communities, schools, and businesses. The program offers several online guides and resources on how to implement obesity prevention efforts in communities. Materials include guides on bringing fresh produce to settings, cooking, creating active outdoor spaces, and establishing community coalitions.
La Leche League USA is a volunteer-organized and -led international organization that provides free in-person meetings for breastfeeding education, information, and support. Each community volunteer leader completes the training provided by La Leche League, with all of the training material provided for a small fee. The leader receives support from La Leche League for setting up meetings, marketing the meetings, and setting up social media platforms. La Leche League has meetings in all 50 U.S. States, Puerto Rico, and the Virgin Islands. Meeting locations and times vary based on local need and the leaders' availability. Some meetings serve multiple counties, whereas others serve individual communities. Some communities also offer virtual meetings and online forums to accommodate participants who are unable to attend in-person meetings.
Let's Go! is an obesity prevention program that engages the entire community to help foster environments that encourage healthy behaviors. Their resources provide evidence-based health promotion strategies for community use within multiple settings, including schools, child care, healthcare practices, and workplaces, as well as for families to use in their homes. The program primarily works in Maine and New Hampshire, but has partnerships across the U.S. focused on children from birth to age 18. The Let's Go! Toolkit for Children with Intellectual and Developmental Disabilities addresses the unique health needs of children with intellectual and developmental disabilities related to obesity prevention, focusing on healthy eating and physical activity.
4-H Healthy Habits helps create action plans to improve the nutrition, physical activity, and safety of the communities they support. The partnership with the communities enables teenagers to have leadership roles as program teachers and mentors for younger children. These youth work to provide underserved or at-risk youth and their families with education about healthy eating and physical activity. 4-H Healthy Habits assists communities across the nation with culturally-relevant programs.
Healthy Monadnock began in 2007 with the Cheshire Medical Center's challenge to Monadnock Region residents to become “the healthiest community in the nation.” The initiative holistically promotes healthy lifestyles by addressing physical health (including nutrition, physical activity, and tobacco use), mental well-being, emergency preparedness, healthcare access, and social determinants of health including employment, income, and education. Healthy Monadnock engages all community stakeholders, including schools seeking to advance policy, systems, and environment changes. The program supports use of school champions to promote healthy lifestyles among students.
South Dakota's Child Safety Seat Distribution Program provides child seats to eligible parents across the state based on financial need. There is strong evidence that car seat distribution and education programs increase car seat use and increase the correct use of car seats. Research also finds that child seat distribution programs are transferable to and effective in tribal communities.
Child bicycle helmet safety programs typically provide bicycle safety information for children and parents, free or subsidized helmet distribution, and media campaigns. Evidence demonstrates these programs to be effective at increasing helmet use and reducing both fatal and non-fatal injuries – ultimately reducing healthcare costs. North Carolina's Bicycle Helmet Initiative distributes helmets to various agencies in the state and conducts bicycle safety events, particularly targeting underprivileged children. The program is funded by proceeds from a specialty license plate available in the state. Programs may be school or community based, however research suggests that community-based interventions are especially effective.
Faithful Families Thriving Communities brings together nutrition and health educators with lay workers to deliver health programs in faith settings. The program uses direct peer education, policy and environmental supports, and community engagement to connect faith communities with messages about long-term health.
Program Clearinghouse Examples:
- La Leche League of Colorado and Wyoming
- Food Smart Families in Taylor County
- Let's Go! 5-2-1-0
- Drop Sugary Drinks!
Considerations for Implementation
Community buy-in. Programs are much more likely to be successful if they obtain community buy-in. Community buy-in may take a lot of time and effort to gain. If community members and partner organizations do not feel like the program is worth their time, they may fail to meet their commitments or fully engage.
Resources. Community-wide programs take time to coordinate and organize. Organizing a community-based program requires well-trained staff with sufficient resources to carry out plans. Without enough of the right resources, community-level interventions may not reach their intended audience or achieve the desired behavior change. If the intervention involves creating or improving physical spaces, building and/or labor costs can become expensive.
Resources to Learn More
Center for Breastfeeding
Conducts research and educates providers on breastfeeding and lactation management. Supports interdisciplinary communication and care through courses, seminars, and self-study modules. Offers a comprehensive, evidence-based online lactation counselor training course (LCTC) focused on clinical counseling and assessment skills for in-person, home-based services.
Organization(s): Healthy Children Project, Inc.
Rural Communities to Prevent Childhood Obesity: A Toolkit
Describes a community development approach focused on supporting existing community coalitions in their efforts to build and sustain physical environments to prevent childhood obesity in rural preschool aged children.
Author(s): Avila, B., Contreras, D., Lobb, J., et al.
Organization(s): Communities Preventing Childhood Obesity, Ohio State University College of Public Health
Developmental Screenings and Services in Rural Communities
Describes the importance of developmental screenings for children's health. Highlights a community coalition in rural Nome, AK focused on raising awareness and increasing access to early childhood developmental screenings.
Organization(s): National Institute for Children's Health Quality
A Quasi-Experimental Study to Mobilize Rural
Low-Income Communities to Assess and Improve the Ecological Environment to Prevent Childhood Obesity
Examines the ability of low income, rural communities to support and incorporate community coaching as a method to create and maintain an environment of healthy eating and physical activity for the prevention of childhood obesity.
Author(s): Peters, P., Gold, A., Abbott, A., et al.
Citation: BMC Public Health, 16, 376