Evaluating the efforts of foundations will include consideration of the long-term sustainability of funding for projects related to obesity prevention and the extent to which obesity prevention initiatives are a funding priority.

Developing and Strengthening Community Coalitions

As noted earlier, the development of community coalitions is a particularly relevant approach to the prevention of childhood obesity. The efforts of groups and individuals with many diverse areas of expertise are needed to move obesity prevention efforts forward and can have a synergistic effect when coordinated. Community coalitions relevant to childhood obesity prevention often focus on broader but related issues, such as encouraging healthy lifestyles or preventing chronic diseases, such as type 2 diabetes, in children, youth, and adults. The healthy communities movement, and its outgrowth, the Coalition for Healthier Cities and Communities, provide an example of an initiative focused on health promotion and disease prevention that measures community-based outcomes including improved cardiovascular health, reductions in crime, reduction of the rates of teen pregnancy, and declines in the numbers of new human immunodeficiency virus (HIV) infections (Norris and Pittman, 2000).

Another example is the Border Health Strategic Initiative (Border Health ¡SI!), a diabetes prevention intervention that involves several communities along the Arizona–Mexico border, which developed community coalitions focused on building partnerships with local universities, community health workers (promotores de salud), and other community stakeholders. The initiative used the REACH 2010 community-based participatory research model to focus on implementing policy changes in schools, involving planning and zoning commissions, in long-range community planning, and organizing an annual community forum for elected and appointed local officials to discuss policy changes to promote health (Meister and de Zapien, 2005) (Chapter 3).

Examples of community coalitions and initiatives (Boxes 6-3 and 6-4) highlight the range of stakeholders and the importance of leadership in initiating and sustaining community efforts. Often, the mayor or another key community leader can galvanize the political will and multistakeholder support that is needed to build a coalition focused on improving the health of the community. Generally, these efforts focus on all citizens, including children and youth.

Community coalitions often conduct local surveys and assessments as they get under way to provide baseline information; follow-up assessments can then be performed during the course of the coalition’s work to assess progress. The Bexar County (Texas) Community Health Collaborative be-



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