title: The healthy Hawaii initiative: A social ecological approach promoting healthy communities.
abstract: OBJECTIVE
  The tobacco settlement has provided the opportunity for the state of Hawaii to implement the Healthy Hawaii Initiative (HHI), targeting smoking, poor nutrition and physical inactivity. The purpose of this paper is to describe and document preliminary findings.
  
  
  METHODS
  The social ecological model is translated into practice through school and community grants to create systems, environmental and policy changes, teacher training on health and physical education standards, continuing education for the medical community in behavioral health, and a public education campaign. A comprehensive evaluation provides ongoingfeedback for program improvement and progress on the effects of psychosocial mediators, behaviors, and long-term chronic diseases.
  
  
  CONCLUSIONS
  Preliminary process results presented here are promising. The components are thought to interact synergistically to bring about behavior changes statewide. The HHI is one example of how to implement a multilevel initiative to target the three major behavioral determinants of chronic disease (tobacco use, physical inactivity, and poor nutrition) and build healthier communities.
authors.affiliation: Department of Public Health Sciences and Epidemiology, University of Hawaii at Manoa, 1960 East-West Road, Honolulu, HI 96822. cnigg@hawaii.edu
authors.forename: Claudio
authors.initials: C
authors.lastname: Nigg
authors.forename: Jay
authors.initials: J
authors.lastname: Maddock
authors.forename: Jessica
authors.initials: J
authors.lastname: Yamauchi
authors.forename: Virginia
authors.initials: V
authors.lastname: Pressler
authors.forename: Betty
authors.initials: B
authors.lastname: Wood
authors.forename: Susan
authors.initials: S
authors.lastname: Jackson
mesh_terms: D003153:Community Health Services / Q000191:economics / Q000458:organization & administration*; D006254:Hawaii; D015438:Health Behavior; D006266:Health Education / Q000379:methods*; D006291:Health Policy; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D012574:Schools