title: Kaiser Permanente's Community Health Initiative in Northern California: evaluation findings and lessons learned.
abstract: OBJECTIVE
  To describe the evaluation findings and lessons learned from the Kaiser Permanente Healthy Eating Active Living-Community Health Initiative.
  
  
  METHODS
  Mixed methods design: qualitative case studies combined with pre/post population-level food and physical activity measures, using matched comparison schools for youth surveys.
  
  
  METHODS
  Three low-income communities in Northern California (combined population 129,260).
  
  
  METHODS
  All residents of the three communities.
  
  
  METHODS
  Five-year grants of $1.5 million awarded to each community to support the implementation of community- and organizational-level policy and environmental changes. Sectors targeted included schools, health care settings, worksites, and neighborhoods.
  
  
  METHODS
  Reach (percentage exposed) and strength (effect size) of the interventions combined with population-level measures of physical activity (e.g., minutes of physical activity) and nutrition (e.g., fruit and vegetable servings).
  
  
  METHODS
  Pre/post analysis of population level measures, comparing changes in intervention to comparison for youth survey measures.
  
  
  RESULTS
  The population-level results were inconclusive overall, but showed positive and significant findings for four out of nine comparisons where "high-dose" (i.e., greater than 20% of the population reached and high strength) strategies were implemented, primarily physical activity interventions targeting school-age youth.
  
  
  CONCLUSIONS
  The positive and significant changes for the high-dose strategies suggest that if environmental interventions are of sufficient reach and strength they may be able to favorably impact obesity-related behaviors.
authors.affiliation: Center for Community Health and Evaluation, Group Health Research Institute, Seattle, Washington 98101, USA. cheadle.a@ghc.org
authors.forename: Allen
authors.initials: A
authors.lastname: Cheadle
authors.forename: Suzanne
authors.initials: S
authors.lastname: Rauzon
authors.forename: Rebecca
authors.initials: R
authors.lastname: Spring
authors.forename: Pamela M
authors.initials: PM
authors.lastname: Schwartz
authors.forename: Scott
authors.initials: S
authors.lastname: Gee
authors.forename: Esmeralda
authors.initials: E
authors.lastname: Gonzalez
authors.forename: Jodi
authors.initials: J
authors.lastname: Ravel
authors.forename: Coire
authors.initials: C
authors.lastname: Reilly
authors.forename: Anthony
authors.initials: A
authors.lastname: Taylor
authors.forename: Dana
authors.initials: D
authors.lastname: Williamson
mesh_terms: D002140:California; D019058:Community Networks; D005247:Feeding Behavior; D006293:Health Promotion / Q000379:methods / Q000592:standards; D006801:Humans; D008329:Managed Care Programs; D009043:Motor Activity; D009765:Obesity / Q000517:prevention & control; D011204:Poverty Areas; D015397:Program Evaluation / Q000379:methods; D036301:Qualitative Research; D011795:Surveys and Questionnaires