Challenges to establishing successful partnerships in community health promotion programs: local experiences from the national implementation of healthy eating activity and lifestyle (HEAL™) program.

ISSUE ADDRESSED: Community-based programs to address physical activity and diet are seen as a valuable strategy to reduce risk factors for chronic disease. Community partnerships are important for successful local implementation of these programs but little is published to describe the challenges of developing partnerships to implement health promotion programs. The aim of this study was to explore the experiences and opinions of key stakeholders on the development and maintenance of partnerships during their implementation of the HEAL™ program. METHOD: Semi-structured interviews with key stakeholders involved in implementation of HEAL™ in four local government areas. The interviews were transcribed verbatim and analysed thematically. RESULTS: Partnerships were vital to the success of the local implementation. Successful partnerships occurred where the program met the needs of the partnering organisation, or could be adapted to do so. Partnerships took time to develop and were often dependent on key people. Partnering with organisations that had a strong influence in the community could strengthen existing relationships and success. In remote areas partnerships took longer to develop because of fewer opportunities to meet face to face and workforce shortages and this has implications for program funding in these areas. CONCLUSION: Partnerships are important for the successful implementation of community preventive health programs. They take time to develop, are dependent on the needs of the stakeholders and are facilitated by stable leadership. SO WHAT?: An understanding of the role of partnerships in the implementation of community health programs is important to inform several aspects of program delivery, including flexibility in funding arrangements to allow effective and mutually beneficial partnerships to develop before the implementation phase of the program. It is important that policy makers have an understanding of the time it takes for partnerships to develop and to take this into consideration when programs are funded and implemented in the community.

Assessing the real world effectiveness of the Healthy Eating Activity and Lifestyle (HEAL) program.

ISSUE ADDRESSED: Community-based lifestyle modification programs can be a valuable strategy to reduce risk factors for chronic disease. However, few government-funded programs report their results in the peer-reviewed literature. Our aim was to report on the effectiveness of the Healthy Eating Activity and Lifestyle (HEAL) program, a program funded under the Australian government's Healthy Communities Initiative. METHODS: Participants (n = 2827) were recruited to the program from a broad range of backgrounds and each week completed an hour of group-based physical activity followed by an hour of lifestyle education for 8 weeks. Physical activity, sitting time, fruit and vegetable consumption, anthropometric measures, blood pressure and functional capacity data were gathered at baseline and post-program. RESULTS: HEAL participation resulted in significant acute improvements in frequency and volume of physical activity, reductions in daily sitting time and increases in fruit and vegetable consumption. HEAL participation led to reductions in total body mass, body mass index, waist circumference and blood pressure and to improvements in functional capacity (P < 0.001). CONCLUSIONS: Based on these findings and the coordinated approach to program delivery, the HEAL program warrants consideration as a behaviour change strategy in primary health care networks, local government or community settings. SO WHAT? These findings should inform future policy development around implementation of lifestyle modification programs; they strengthen the case for support and promotion of lifestyle modification programs to improve public health, lessening the financial and personal burden of chronic conditions.