Community Interventions

Craig Andrade, DrPH

Director, Office of Community Health, Massachusetts Department of Public Health
Q&A with Craig Andrade, MPH

As the Director of the Office of Community Health at MDPH, Craig oversees the development and implementation of a range of programs and strategies to support and reinforce healthful behaviors in communities.

What are some of the community-based programs you’re currently involved with at MDPH that target the problem of obesity?

Mass in Motion is our signature department initiative that provides funding, resources and technical assistance to 52 communities. The goal is to change their community environment to better support healthy eating and active living; aiming to make the healthy choice the easy choice.

We are also targeting the built environment through the Healthy Community Design Initiative to create conditions that help cities and towns make health a foundational part of their policy and practice. For example, we promote municipal “complete street” policies that include bike lanes, sidewalks and safer conditions for pedestrians to encourage physical activity. We’re working on demonstration grants that focus on health impact assessments so that communities can find ways to more effectively embed health into their policies, regulations, and practices.

We have implemented a series of school-based programs, including Coordinated School Health to create environments that support student health and wellness. We are also working to increase access to healthy food in schools – making sure that vending machines, school stores and a la carte sales in the cafeteria follow the new state standards for competitive foods and beverages.  In 2009, we began collecting BMI data in grades 1, 4, 7, and 10, and we share it with parents so that they can better partner with clinicians. We also provide resources to educate parents on ways to address their child’s overweight or obese status.

Another program we’re doing is called Working on Wellness, and it involves collaborating with businesses across the state to encourage them to create environments in the workplace that make it easier for their employees to make healthy choices at work.

What are you doing to measure the success of these programs?

We are among a rare group of states working to prevent and have an impact on obesity in a comprehensive way.  Therefore, it’s important to demonstrate that the work we’re doing is making a difference. We start by partnering with evaluators at every stage of program planning, implementation and assessment. One nice illustration of measuring improvement is student BMI. Our analysis showed a significant drop in BMI in the public schools of five Mass in Motion communities chosen for early analysis.

Why are community interventions rather than individual interventions so important?

Every element of how and where we live impacts our health-related choices or whether we have choices, and ultimately it affects the outcomes of our overall health. We have to dissect all those different elements and have those conversations from multiple perspectives. It’s important to work collaboratively with stakeholder communities, neighborhoods, businesses, local municipalities, health care institutions and public health departments, as well as state and federal governments. This kind of collaboration will ensure we make a difference. Our present environment makes it difficult for well-resourced individuals to live well and it’s especially difficult for those who are under-resourced. So, it’s important to engage a creative social and ecological approach that engages all sectors and levels of the world where we live. When people live in health-friend communities, it’s easier to live healthier lifestyles. Presently most people live in environments where it’s difficult to live well.

FOR MORE ON THE TOPIC VISIT:

  • The Community Guide is an evidenced-based resource for many types of public health interventions, including obesity. It is overseen by a Task Force, a panel of independent, non-federal, non-compensated experts who help inform judgment about the quality of the evidence for particular intervention strategies.
  • CDC’s Division of Nutrition, Physical Activity, and Obesity website includes a State and Community Programs page offering tools, recommendations and examples of effective community-based interventions to combat obesity. a portal for healthy living tips as well as national statistics, fact sheets, and information about state and community wellness initiatives.
  • Peer-reviewed article in Preventing Chronic Disease discusses use of Community Readiness Model to inform methods and strategies for community-based obesity prevention programs.