Evaluation of a statewide program to reduce chronic disease: The Healthy Hawaii Initiative, 2000–2004

Abstract

Physical inactivity and poor nutrition are major contributors to premature morbidity and mortality in the United States. Multilevel interventions using a social ecological approach may be necessary to change population behaviors contributing to the rise of obesity. The Healthy Hawaii Initiative is a statewide program funded by tobacco settlement funds designed to reduce these risk factors. Started in 2000, this program implements interventions in school and communities and through public and professional education to improve physical activity and nutrition. Evaluation of these programs includes long-term objectives focusing on health outcomes, intermediate objectives focusing on health behaviors and short-term objectives focusing on stage of change, attitude, subjective norms, self-efficacy and perceived environment. Results show positive trends in adults for increased fruits and vegetable consumption and a reduction in no leisure time physical activity. Improvements in health behavior among youth have not yet been demonstrated. Some changes in short-term objectives have occurred especially for fruit and vegetable consumption. In conclusion, the Healthy Hawaii Initiative appears to be having some impact in short-term indicators and some effects of fruit and vegetable consumption. More years of data collection are necessary before true trends can be detected to assess the overall impact of this initiative.