Supporting Community-based Healthy Eating and Active Living Efforts in Sustaining Beyond the Funding Cycle.

Abstract

Considerable research has been done to define, conceptualize, and study sustainability for public health initiatives. New research suggests evaluating sustainability through additional characteristics, like type of intervention or focus of change, may help uncover differences in approaches and resources needed for sustainability. Additionally, available research often misses perspectives from those involved on what is necessary to sustain strategies long term. Data collected through community reports and interviews with eight Colorado communities implementing large-scale community-based healthy eating and active living initiatives were used to document strategy characteristics, barriers to sustainability, and community-based perspectives on supports needed for long-term sustainability. Characteristics of implementation were also assessed based on intervention type (program, environment, policy) and to identify similarities and differences in implementation. Policy and environment interventions were sustained more often compared with program interventions. Coalitions or formal committees, community-level coordination, and diverse partnerships were associated with sustainable strategies regardless of intervention type, though primary transition partners varied by intervention type. Loss of a sole champion and shifts in institutional priorities were common barriers for sustainability. Communities requested supports for creative funding and formal coordination, public and political will-building, inclusivity, and advanced evaluation methods to support long-term sustainability. Findings suggest that community intervention strategies can be highly sustainable, particularly for environment and policy change, and suggest strategies may require similar, yet tailored, partnerships based on intervention type. Additionally, supports requested highlight sophisticated community needs, offering important insights for how providers and funders can best support communities in long-term sustainability efforts. This article is part of a supplement entitled Building Thriving Communities Through Comprehensive Community Health Initiatives, which is sponsored by Kaiser Permanente, Community Health.