This issue of the UC ANR Nutrition Policy Institute's Research to Action news brief examines Kaiser Permanente's decade of work improving community health via the Community Health Initiative.
Research to Action - The Nutrition Policy Institute news brief

May 2018 | Vol. 2, No. 2

Improving Community Health,
One Neighborhood at a Time

Reducing the rising levels of obesity, cardiovascular disease and diabetes is at the top of the public health agenda. Root causes are complex and require concerted efforts to reshape community conditions that contribute to the problems.

Making meaningful changes to improve health often requires reaching beyond the walls of medical offices and clinics. Starting in 2004, Kaiser Permanente, a partner of the Nutrition Policy Institute, launched the Community Health Initiative to do just that. It supported collaborative work in more than 60 low-income neighborhoods to produce concrete changes that enable safe places for physical activity and easy access to healthy foods, promoting overall wellness among residents.

Why is this important?

Community environments and policies are vital shapers of health that can promote wellness and prevent disease. Kaiser Permanente recognized that empowering residents to make health-promoting changes in their neighborhoods was an important element in establishing conditions where all people can easily make healthy food choices and live active lives that reduce many chronic conditions such as obesity, diabetes and heart disease.

It is widely recognized that community change at a scale and reach that improves overall population health is a tall order. It is hard work and takes time. What can be learned from Kaiser Permanente’s Community Health Initiative?

What works?

Results from Kaiser Permanente’s decade of community health investment were recently released, including eleven studies that highlight the successes and challenges of this model effort by a health plan to promote community health. With a focus on healthy eating and physical activity, these studies demonstrate where the most impact occurred. Researchers at the Nutrition Policy Institute participated in examining this decade of work by Kaiser Permanente’s Community Health Initiative to improve community health and co-authored five of the eleven studies.

Important insights from these studies include:

  • Significant change is possible when working with youth, especially in schools and on physical activity. With daily exposure through most of the year in schools, youth experience food offerings that are shaped by school nutrition standards, and there is greater opportunity to schedule regular exposure to physical activity in this setting.
  • Large reach and strong strategies matter. To improve health on a population scale, the initiatives need to reach a lot of people with strong strategies that lead to lasting behavior changes. This “population dose” concept was developed and tested by the evaluation team that included researchers from the Nutrition Policy Institute.
  • Community-based obesity initiatives need to be flexible. Community priorities come first. For example, violence prevention may need to be the first step before creating environments that provide access to physical activity.
  • Lasting results require permanent changes to the environment and the policy that supports use and access. These efforts take time and may require working beyond the confines of a neighborhood to the larger jurisdictions at the city, county, regional and even state level that affect the assets in a neighborhood.
Additional information about the Kaiser Permanente Community Health Initiative
Current Nutrition Policy Institute staff who contributed to the Kaiser Permanente Community Health Initiative project include:
  • Suzanne Rauzon, directed the implementation of the national cross-site evaluation of the Community Health Initiative
  • Pat Crawford, member of Kaiser Permanente’s Community Health Initiative National Evaluation Advisory Committee
  • Gail Woodward-Lopez, led the evaluation of Healthy Eating Active Living (HEAL) interventions in specific settings such as stores, schools and childcare in Northern California
  • Janice Kao, coordinated 11 of the evaluations of Healthy Eating Active Living (HEAL) interventions in specific settings such as stores, schools and childcare in Northern California
  • Hallie Randel-Schreiber, Launa Craig and Nicole Vital, coordinated school youth and adult surveys 
  • Claudia Olague, Shelly Mandel and Temika Green, data management
  • Rocio Cazares, Blanca Cazares and Fatima Espinoza, Healthy Eating Active Living (HEAL) survey data collection
  • Christina Becker, childcare data collection and manuscript preparation

Research to Action is a periodic news brief from the Nutrition Policy Institute. Please share Research to Action with colleagues who would be interested in receiving it, and please subscribe if you haven't already done so.



Wang MC, Crespi CM, Jiang LH, Nobari T, Roper-Fingerhut H, Rauzon S, Robles B, Blocklin M, Davoudi M, Kuo T, MacLeod KE, Seto E, Whaley S, Prelip M. Developing an index of dose of exposure to early childhood obesity community interventions. Preventive Medicine, Volume 111, June 2018, Pages 135-141. DOI:[Abstract]

Research Brief: A Modest State Supplement to Federal Reimbursement for Meals Served in Child and Adult Care Food Program Sites Can Improve the Nutrition and Health of Young Children and Support Child Care. UC Agriculture and Natural Resources Nutrition Policy Institute, May 2018. [Full Text]

Harner LT, Kuo ES, Cheadle A, Rauzon S, Schwartz PM, Parnell B, Kelly C, Solomon L. Using Population Dose to Evaluate Community-level Health Initiatives. American Journal of Preventive Medicine, Volume 54, Issue 5, Supplement 2, May 2018, Pages S117–S123. DOI:[Abstract]  [Full Text]

Cheadle A, Atiedu A, Rauzon S, Schwartz PM, Keene L, Davoudi M, Spring R, Molina M, Lee L, Boyle K, Williamson D, Steimberg C, Tinajero R, Ravel J, Nudelman J, Azuma A, Kuo ES, Solomon L. A Community-Level Initiative to Prevent Obesity: Results From Kaiser Permanente’s Healthy Eating Active Living Zones Initiative in California. American Journal of Preventive Medicine, Volume 54, Issue 5, Supplement 2, May 2018, Pages S150–S159. DOI:[Abstract]  [Full Text]

Woodward-Lopez G, Kao J, Kuo ES, Rauzon S, Taylor AC, Goette C, Collins C, Gonzalez EP, Ronshausen DR, Boyle K, Williamson D, Cheadle A. Changes in Consumer Purchases in Stores Participating in an Obesity Prevention Initiative. American Journal of Preventive Medicine, Volume 54, Issue 5, Supplement 2, May 2018, Pages S160–S169. DOI:[Abstract]  [Full Text]

Woodward-Lopez G, Kao J, Kuo ES, James P, Lenhart K, Becker CM, Boyle K, Williamson D, Rauzon S. Changes in Nutrition Policies and Dietary Intake in Child Care Homes Participating in Healthy Eating and Active Living Initiative. American Journal of Preventive Medicine, Volume 54, Issue 5, Supplement 2, May 2018, Pages S170–S177. DOI:[Abstract] [Full Text]

Kao J, Woodward-Lopez G, Kuo ES, James P, Becker CM, Lenhart K, Boyle K, Williamson D, Rauzon S. Improvements in Physical Activity Opportunities: Results From a Community-Based Family Child Care Intervention. American Journal of Preventive Medicine, Volume 54, Issue 5, Supplement 2, May 2018, Pages S178–S185. DOI:[Abstract]  [Full Text]

Borger C, Weinfield N, Zimmerman T, MacAllum C, DeMatteis J, Whaley S, Ritchie L, Sallack L, Au L, Jenkins F, May L. WIC Infant and Toddler Feeding Practices Study-2: Second Year Report. USDA, April 20, 2018. [Report]

Final Evaluation Report: Kaiser Permanente Community Health Initiative. Kaiser Permanente Washington Health Research Institute, Center for Community Health and Evaluation, and University of California, Nutrition Policy Institute, April 2018. [Report]

Au LE, Ehrens K, Burda N, Zumbrun E. The Academy of Nutrition and Dietetics' Priorities in the 2018 Farm Bill. Journal of the Academy of Nutrition and Dietetics, April 2018, Volume 118, Issue 4, Pages 767–770. DOI:[Abstract] [Full Text]

Au LE, Gurzo K, Gosliner W, Webb KL, Crawford PB, Ritchie LD. Eating School Meals Daily Is Associated with Healthier Dietary Intakes: The Healthy Communities Study. Journal of the Academy of Nutrition and Dietetics, E-pub March 16, 2018. DOI:[Abstract] [Full Text]

Gosliner W, Brown DM, Sun BC, Woodward-Lopez G, Crawford PB. Availability, quality and price of produce in low-income neighbourhood food stores in California raise equity issues. Public Health Nutrition, published online 15 March 2018. DOI:[Abstract]

Gupta C, Bianchi M, Moritz M, Ritchie L. Documenting and Supporting Policy Efforts and Impacts: Enhancing Use of the Academic Performance Review Process in UC ANR. Division of Agriculture and Natural Resources, University of California. February 2018. [Full Text]

Strauss WJ, Nagaraja J, Landgraf AJ, Arteaga SS, Fawcett SB, Ritchie LD, John LV, Gregoriou M, Frongillo EA, Loria CM, Weber SA, Collie-Akers VL, McIver KL, Schultz J, Sagatov RDF, Leifer ES, Webb K, Pate RR, and on behalf of the Healthy Communities Study Team. The longitudinal relationship between community programmes and policies to prevent childhood obesity and BMI in children: the Healthy Communities Study. Pediatric Obesity, 2018 Feb 28, DOI: [Epub ahead of print]. [Abstract]


Student Fellowship Opportunity: Seeking outstanding UC student with a passion for communicating about food systems for UC Global Food Initiative Fellowship. Apply by May 28, 2018—deadline extended! More info:

State agencies that administer the Child and Adult Care Food Program (CACFP) are eligible to receive $100,000 in grant funding to support meal service training activities. Learn more about this funding opportunity by visiting the U.S. Department of Agriculture Team Nutrition webpage, viewing the recorded FY 2018 CACFP Meal Service Training Grants for State Agencies webinar, or visiting Applications are due May 30, 2018.

The Agricultural Marketing Service of the U.S. Department of Agriculture requests comments on the proposed National Bioengineered Food Disclosure Standard. Comments are due by July 3, 2018. 

Read the latest news from the National Drinking Water Alliance to access helpful resources on drinking water, including fact sheets, toolkits, webinars, workshops and more. 


Sara ElShafie, doctoral candidate in Integrative Biology at UC Berkeley, discusses the importance of communicating science through storytelling in an article for the SciCommPLOS blog. ElShafie recently partnered with story artists at Pixar Animation to present a symposium, Science Through Narrative: Engaging Broad Audiences.


June 11, 2018
Nutrition 2018 Conference
Boston, Massachusetts

Lorrene Ritchie discusses characteristics of successful programs to promote healthy weight among middle schoolers.

June 29, 2018
National Association for Family Child Care Conference
Chicago, Illinois

Christina Hecht and Laura Vollmer present a workshop: Just Add Water! Healthy Beverages in Child Care.



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The Nutrition Policy Institute (NPI) conducts research on the impact of nutrition and physical activity on public health. NPI translates research findings into recommendations to provide a basis for effective decision-making, particularly related to the federal nutrition assistance programs.

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