of prioritization of outcomes helped to cultivate buy-in and kept any one stakeholder group from having undue influence on the process and outcomes. This also helped establish baselines for future evaluation efforts.


The discussion opened with a question about sustainability. Patricia Baker of the Connecticut Health Foundation wondered how it is possible to translate what is learned from a successful program into longer-lasting policy change. Mildred Thompson responded with an example of a successful scaled-up policy: California was the first state to ban soft drinks in schools. This ban was implemented in steps, however, rather than all at once. The initial focus was on elementary schools, and the case was made—on the basis of the scientific evidence—that sugar-sweetened beverages are linked to childhood obesity. Then, later, the ban was taken to the high school level, with the eventual result being that all schools in California became soda free. Other states followed California’s model, providing an example of how a promising practice at the local level can be scaled up.

A second example, explained Thompson, is the Fresh Food Financing Initiative that began in Philadelphia. This is a public-private partnership effort to bring large-scale grocery stores (as opposed to corner markets) into food deserts, which are urban areas without access to fresh, healthy, affordable fruits and vegetables. This initiative has now expanded to Detroit, Michigan, and New York City as well, with the Obama administration trying to take it to the national level with the Healthy Food Financing Initiative.

Mary Lou Fulton of TCE explained that it is critical to focus funding on both place and policy. Although community-level investments are crucial, funding for advocacy efforts at the regional, statewide, and national levels should also be provided. Both are necessary, she said, to make large-scale changes.

Lisa Egbuonu-Davis of the Gateway Institute for Pre-College Education asked about the inclusion of community businesses and entrepreneurs in the process described by Fulton. She stated that inclusion of these groups among the stakeholders could be important to the long-term sustainability of the systems changes that TCE is expecting. Ross explained that local businesses and entrepreneurs were a part of the partnerships created with their program in City Heights. All of the work of the Mid-City CAN was community driven, she said.

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