The Five-Year Impact of State and Community Program Efforts to Increase Opportunities for Healthy Eating and Active Living, 2018 to 2023

The burden of obesity and other chronic diseases negatively affects the nation's health, businesses, economy, and military readiness. From 2018 to 2023, the Centers for Disease Control and Prevention's Division of Nutrition, Physical Activity, and Obesity (DNPAO) awarded funding to 71 recipients to advance evidence-based strategies to increase opportunities for healthy eating, physical activity, breastfeeding, and tobacco-free living. Recipients consisted of states, universities, and communities funded through the following three cooperative agreements: State Physical Activity and Nutrition (SPAN), Racial and Ethnic Approaches to Community Health (REACH), and the High Obesity Program (HOP). Recipients tailored efforts to their state or local contexts by using community engagement methods, needs assessments, and coalitions to accomplish their work. DNPAO transparently developed an evaluation approach that was feasible for recipients. DNPAO annually collected and validated recipient self-reported data using a two-way cloud-based platform to increase the visibility around data sharing and to ensure real-time communication. SPAN, REACH, and HOP recipients made considerable impact in funded states and communities. For example, more than 28 million people have increased access to places to be physically active, and more than 9 million people have increased access to places with healthy nutrition standards. Recipients also leveraged additional resources from a source other than the granting organization totaling almost US$400 million during the five-year cooperative agreement period. This article documents the combined five-year impact of three public health programs funded by one CDC Division and illustrates the rigorous methods used to evaluate impact.