Strategies

What Works for Health includes evidence-informed strategies to create communities where everyone can thrive.

Active recess

Establish a break from the school day, typically before lunch, that involves planned, inclusive, actively supervised games or activities; also called semi-structured, or structured recess

Evidence Rating:

Scientifically Supported

Activity programs for older adults

Offer group educational, social, creative, musical, or physical activities that promote social interactions, regular attendance, and community involvement among older adults

Evidence Rating:

Scientifically Supported

Support alternative fuel and vehicle use via financial incentives (e.g., tax benefits, rebates, etc.), mandates (e.g., consumption targets or renewable fuel standards), research and development investments, etc.

Evidence Rating:

Expert Opinion

Bicycle & pedestrian master plans

Establish a framework to increase walking and biking trails and improve connectivity of non-auto paths and trails in a particular area

Evidence Rating:

Some Evidence

Breastfeeding promotion programs

Provide education, information, counseling, and support for breastfeeding to parents throughout pre- and post-natal care

Evidence Rating:

Scientifically Supported

CAFO regulations

Establish local regulations for confined animal feeding operations (CAFOs) that address location, size, facility management, and pollution contributions to complement U.S. EPA regulations

Evidence Rating:

Expert Opinion

Carpool & rideshare programs

Help participants share transportation via informal arrangements between individuals, formally arranged ridesharing programs, or other ride-matching services

Evidence Rating:

Expert Opinion

Child-focused advertising restrictions for unhealthy foods & beverages

Restrict child-focused advertising for unhealthy foods and beverages via bans on unhealthy food and drink ads during children’s TV programs, product placement in children’s movies, etc.

Evidence Rating:

Some Evidence

Clean diesel technology fleet transition programs

Replace or retrofit diesel buses or other vehicles to operate with clean diesel technology

Evidence Rating:

Scientifically Supported

College-based obesity prevention educational interventions

Support multi-component educational interventions for college students that address nutrition, physical activity, and healthy weight management; often with environmental modifications

Evidence Rating:

Some Evidence

Community fitness programs

Offer exercise classes (e.g., aerobic dance, yoga, Tai Chi, cycling, etc.) and fitness program support in community, senior, fitness, and community wellness centers

Evidence Rating:

Scientifically Supported

Community gardens

Establish and support land that is gardened or cultivated by community members via community land trusts, gardening education, zoning regulation changes, or service provision (e.g., water or waste disposal)

Evidence Rating:

Some Evidence

Community kitchens for food processing

Establish shared kitchen spaces that support licensed, commercial food processing and connect specialty food processors, farmers, and others who produce value-added goods

Evidence Rating:

Expert Opinion

Community kitchens for nutrition education

Use existing kitchen spaces for community members to share knowledge, resources, and labor to prepare, cook, and consume food, often with nutrition education provided for participants experiencing food insecurity

Evidence Rating:

Insufficient Evidence

Community land trusts

Purchase the land a home is on to lease to homeowners with low and middle incomes and require homeowners to sell the home back to the trust or to another resident with low income upon moving

Evidence Rating:

Some Evidence

Community supported agriculture (CSA)

Establish partnerships between farmers and consumers in which consumers purchase a share of a farm’s products in advance

Evidence Rating:

Expert Opinion

Community weight loss challenges

Support temporary programs that work to energize participants to lose weight via prizes, often combined with education, weight status and food intake tracking, regular check-ins, and group support

Evidence Rating:

Expert Opinion

Community-based social support for physical activity

Build, strengthen, and maintain social networks that provide supportive relationships for behavior change through walking groups or other community-based interventions

Evidence Rating:

Scientifically Supported

Community-wide physical activity campaigns

Engage a variety of partners in a highly visible, multi-component effort to increase physical activity, often with efforts to address cardiovascular disease risk factors

Evidence Rating:

Some Evidence

Competitive pricing for healthy foods

Assign higher costs to non-nutritious foods than nutritious foods via incentives, subsidies, or price discounts for healthy foods and beverages or disincentives or price increases for unhealthy choices

Evidence Rating:

Scientifically Supported

Complete Streets & streetscape design initiatives

Enhance streetscapes with greater sidewalk coverage and walkway connectivity, street crossing safety features, traffic calming measures, and other design elements

Evidence Rating:

Scientifically Supported

Composting

Use aerobic, natural decomposition to divert food and yard waste from landfills and create a nutrient-rich soil amendment product on an individual or large scale

Evidence Rating:

Scientifically Supported

Conservation Reserve Enhancement Program (CREP)

Support the federal-state partnership that pays participating landowners an annual rental rate for removing environmentally sensitive land from production and introducing conservation practices on the land.

Evidence Rating:

Some Evidence

Conservation tillage practices

Encourage methods of soil cultivation that keep at least one-third of cultivated soil covered with the previous year’s crop residue (e.g., mulch till, ridge till, strip till, or no-till)

Evidence Rating:

Scientifically Supported

Electric vehicle initiatives

Replace internal combustion engine vehicles with all-electric vehicles through financial incentives, regulations, and multi-component initiatives

Evidence Rating:

Scientifically Supported

Electronic Benefit Transfer payment at farmers markets

Enable farmers markets to accept EBT, the electronic payment system of debit cards used to issue and redeem Supplemental Nutrition Assistance Program (SNAP) benefits

Evidence Rating:

Expert Opinion

Exercise prescriptions

Provide patients with prescriptions for exercise plans, often accompanied by progress checks at office visits, counseling, activity logs, and exercise testing

Evidence Rating:

Scientifically Supported

Extracurricular activities for physical activity

Provide chances for kids and adolescents to be active and play sports at various skill levels via structured or unstructured after and before school athletic activities

Evidence Rating:

Some Evidence

Family-based physical activity interventions

Increase family members’ support for physical activity, often via educational sessions on health, goal-setting, problem-solving, or family behavioral management

Evidence Rating:

Some Evidence

Farm to school programs

Incorporate locally grown foods into school meals and snacks, often with visits from food producers, cooking classes, nutrition and waste reduction efforts, and school gardens

Evidence Rating:

Some Evidence

Farmers markets

Support multiple vendor markets where producers sell goods such as fresh fruit and vegetables, meat, dairy items, and prepared foods directly to consumers

Evidence Rating:

Some Evidence

Financial rewards for employee healthy behavior

Offer payments, credits toward health insurance premiums, or other financial rewards to encourage employees to lose weight, eat more healthily, quit smoking, engage in physical activity, etc.

Evidence Rating:

Some Evidence

Food buying clubs & co-ops

Offer opportunities for group purchase and distribution of selected grocery items, generally at a reduced price

Evidence Rating:

Expert Opinion

Food hubs

Support businesses or organizations that aggregate, distribute, and market local and regional food products (e.g., fresh fruits and vegetables, meat, dairy, grains, and prepared items)

Evidence Rating:

Expert Opinion

Fruit & vegetable gleaning initiatives

Gather food left in fields after a primary harvest, food in fields where harvesting is not profitable, or excess produce from orchards, packing houses, urban agriculture sites, etc.

Evidence Rating:

Expert Opinion

Fruit & vegetable incentive programs

Offer participants with low incomes matching funds to purchase healthy foods, especially fresh fruits and vegetables; often called bonus dollars, market bucks, produce coupons, or nutrition incentives

Evidence Rating:

Scientifically Supported

Fruit & vegetable taste testing

Offer samples of fresh fruits and vegetables in cafeterias, nutrition classes, school gardens, or workplace well-being meetings, often as part of a multi-faceted nutrition intervention

Evidence Rating:

Some Evidence

Green space & parks

Increase green space through new parks or open spaces, renovation or enhancement of under-used recreation areas, rehabilitation of vacant lots, brownfields, etc.

Evidence Rating:

Some Evidence

Healthy food in convenience stores

Encourage convenience stores, corner stores, or gas station markets to carry fresh produce and other healthier food options

Evidence Rating:

Some Evidence

Healthy food initiatives in food pantries

Combine hunger relief efforts with nutrition information and healthy eating opportunities, often with on-site cooking demonstrations, recipe tastings, produce display stands, etc.

Evidence Rating:

Some Evidence

Healthy foods at catered events

Provide more fresh fruits and vegetables, smaller portions, low fat, and reduced sodium or reduced sugar food options and other healthy foods at catered events

Evidence Rating:

Expert Opinion

Healthy school lunch initiatives

Modify the school lunch food environment or school lunch schedules by increasing the convenience of healthy foods, providing healthy options, or ensuring students have enough time to eat

Evidence Rating:

Scientifically Supported

Healthy vending machine options

Increase healthy options in vending machines by reducing the price of healthy choices, increasing the number of healthy choices compared to unhealthy choices, etc.

Evidence Rating:

Scientifically Supported

Homework or extra credit for PE class

Assign homework or extra credit activities for physical education (PE) or health classes that require students to be physically active outside of school

Evidence Rating:

Some Evidence

Household lead control education interventions

Inform parents and caregivers about lead exposure pathways from contaminated dust, soil, water, and air as well as the irreversible health consequences of lead exposure

Evidence Rating:

Evidence of Ineffectiveness

Inclusionary zoning & housing policies

Require developers to reserve a proportion of housing units for residents with low incomes via mandatory requirements or incentives, such as density bonuses

Evidence Rating:

Some Evidence

Individually-adapted physical activity programs

Teach behavioral skills that can help individuals incorporate physical activity into their daily routines

Evidence Rating:

Scientifically Supported

Integrated pest management (IPM) for agriculture & outdoor use

Support a four-tiered approach to outdoor pest control that minimizes potential hazards to people, property, and the environment

Evidence Rating:

Scientifically Supported

Land banking

Acquire, hold, manage, and develop properties such as vacant lots, abandoned buildings, or foreclosures, and transition them to productive uses, often affordable housing developments

Evidence Rating:

Some Evidence

Lead contaminated soil abatement interventions

Clean, remove, replace, or cover lead contaminated soil with non-contaminated soil, mulch, sod, grass, or concrete

Evidence Rating:

Some Evidence

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