Strategies

Delay school start times for middle and high schools to better align with adolescent sleep-wake cycles; often until after 8:30 or 9:00 a.m.

Provide messages that support physical activity to large and broad audiences using television, social media, radio, billboards, newspapers, and other print media

Provide continuous, comprehensive, whole person primary care that uses a coordinated team of medical providers across the health care system

Support a combination of land uses (e.g., residential, commercial, recreational) in development initiatives, often through zoning regulations or Smart Growth initiatives

Support fresh food carts or vehicles that travel to neighborhoods on a set schedule to sell fresh fruits and vegetables

Provide a fixed, multi-component set of fall prevention interventions to older adults, usually in community settings, without an individualized risk assessment

Attract new grocery stores that sell a variety of fresh foods, baked goods, packaged, and frozen items to underserved areas via financing initiatives, tax incentives, or zoning regulation

Focus heavily on reading and math achievement, enforce high behavioral expectations through a formal discipline system, lengthen instructional time, and increase feedback on teacher performance

Use regulation to extend nurse practitioners’ (NPs’) scope of practice to provide care to the full scope of their training and skills without physician oversight, especially for primary care

Improve work environments for nurses via establishment of strong nursing leadership, organizational support, etc.

Offer young children opportunities to eat healthy foods and engage in physical activity by providing fresh fruits and vegetables, incorporating physical activity into daily classroom routines, etc.

Offer time during the school day for children to play in the gym, often during lunch period; shared use agreements can expand open gym opportunities to community members outside school hours

Allow community members to gather, socialize, walk, run, bike, skate, etc. on streets temporarily to closed to motorized traffic; also called Ciclovía programs

Support home visits that teach parents about early childhood development and effective parenting strategies, with child development screenings, parental meetings, and links to community resources

Use payments, vouchers, and other incentives to encourage patients to undergo preventive care such as screenings, vaccinations, etc.

Incorporate classroom-based physical activities, such as classroom energizers, into academic lessons or as a break, usually for elementary students

Modify local environments to support physical activity, increase access to new or existing facilities for physical activity, or build new facilities

Place motivational signs on or near stairwells, elevators, and escalators that encourage individuals to use stairs

Teach positively stated behavior expectations to all students, often reinforced with prizes or privileges and supported with coaching and data

Support quality improvement efforts in early child care and preschool via financial incentives, standards, processes to monitor standards and ensure compliance, etc.

Provide center-based programs that support cognitive and social-emotional growth among children who are not old enough to enter formal schooling

Provide center-based programs that support cognitive and social development among young children from families with low incomes, with supports such as home visiting or parental education

Make pricing for hospital procedures and other health care services publicly available, often via websites, online databases, report cards, or similar tools

Provide interpretation services for patients with limited English proficiency (LEP) in outpatient and inpatient health care settings, following training and certification

Create a school culture of high behavioral and academic expectations, with intense tutoring, increased teacher performance feedback, lengthened instruction time, and health care services

Make clinician, hospital, clinic, long-term care facility, and insurance plan performance on health care quality measures publicly available via report cards, reporting websites, or similar tools

Make health care facilities’ health care-associated or hospital-acquired infection (HAI) rates readily available to patients and providers

Provide publicly funded pre-kindergarten (pre-K) education to 3- and 4-year-olds, through large-scale or universal efforts

Partner with doctors, nurse practitioners, and other medical professionals to incorporate literacy support into regular well-child visits, especially in lower income communities

Provide nutrition information on menus and signboards at restaurants and other food outlets

Conduct individual assessments that gauge older adults’ risk of falling and develop personalized approaches to help prevent falls

Promote walking and biking to school through education, incentives, and environmental changes; often called SRTS

Require school officials to apply predetermined consequences for certain infractions, regardless of situational context or circumstances; consequences are usually severe (e.g., suspension or expulsion)

Support programs to provide students with a nutritious breakfast in the cafeteria, from grab and go carts in hallways, or in classrooms

Limit access to competitive foods and beverages in schools via restrictions on foods that are not provided through the National School Lunch Program and School Breakfast Program.

Establish designated areas where students can garden with guidance, often with nutrition and food preparation lessons and opportunities for taste tasting and hands-on learning

Prohibit the sale of unhealthy foods such as sugar sweetened beverages, candy, and other non-nutritious snacks at school fundraisers, often as part of a broader nutrition policy

Regulate the quality of food that can be sold to students through the National School Lunch Program (NSLP), à la carte options, vending machines, etc.

Provide health care services on school premises to attending elementary, middle, and high school students; physical and mental health services provided by teams of nurses, nurse practitioners, and physicians

Address nutrition in schools via educational (e.g., classroom or curricula-wide efforts, peer training, etc.), environmental (e.g., school menus, classroom snacks, etc.), and other approaches

Expand or enhance school-based physical education (PE) by lengthening existing classes, increasing physical activity during class, adding new PE classes, etc.

Help students process trauma exposure and develop coping skills through individual or small group counseling with mental health professionals or school staff with trauma-specific training

Provide students from public schools, from low income backgrounds, or who have a high risk of dropping out and their families with information about social services and health care supports; also called community resource or family and community liaisons

Encourage children to spend time away from TV and other stationary screen media, often as part of a multi-faceted effort to increase physical activity and improve nutrition

Create contracts that support community access to existing public, private, or nonprofit facilities before or after business hours; also called joint use, open use, or community use agreements

Reduce the number of students in elementary school classrooms

Provide comprehensive early childhood services, including high quality educational child care, health, and family support to address local needs

Increase the price of sugar sweetened beverages (e.g., soda) by adding an excise or sales tax

Establish state level regulations that require nursing homes to employ at least a set number of licensed and non-licensed nursing staff, often set in terms of staff hours per resident day

Provide academic instruction to students during the summer, often along with enrichment activities such as art or outdoor activities