Strategies

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

Integrate legal services into health care settings to address legal issues that affect health (e.g., housing, food, utilities); services provided by private practice lawyers, law students, etc.

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

Combine educational, environmental, and behavioral activities that increase physical activity and improve nutrition (e.g., nutrition education, aerobic/strength training, dietary prescriptions, etc.) in various settings

Deliver educational, behavioral, environmental, and other obesity prevention efforts (e.g., education classes, enhanced physical education, healthy food promotion, family outreach, etc.) in schools

Provide physical infrastructure (e.g., bike parking or showers), educational or social support (e.g., walking groups), and financial incentives that support active commuting

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

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.

Provide prescriptions with healthy eating goals for patients and families, often accompanied by progress checks at office visits; can include partnerships with local farmers markets via FVRx programs

Use internet-based shopping sites to supply refrigerated, frozen, and non-perishable groceries for residential ordering and delivery

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

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

Provide culturally sensitive assistance and care coordination, and guide patients through available medical, insurance, and social support; also called systems navigators

Use visual tools to prompt safe practices, standardize communication, and ensure no step is forgotten before, during, or after a medical procedure or other health care situation

Support joint decision making between health care practitioners and patients through shared decision making (SDM); part of patient-centered care

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

Place motivational signs on posters, front of package labels, or shelf labels near fruits, vegetables, and other items that encourage individuals to purchase healthier food options

Engage practice coaches or facilitators to work with primary care clinic staff to redesign clinical practices, organize quality improvement efforts, improve communication, share best practices, etc.

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

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

Offer opportunities for adults to play athletic games such as soccer, softball, kickball, basketball, etc. at beginner, intermediate, and competitive levels

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

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.

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.

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

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

Shift the way health care organizations approach trauma by adopting universal trauma precautions and providing trauma-specific care

Increase the price of snack products high in sugar and fat by adding an excise or sales tax

Support food-producing and income-earning activities in urban environments (e.g., edible landscapes, front yard or rooftop gardens, window farming, hydroponics, livestock, etc.)

Create financial incentives or remove financial disincentives to affect consumer choices and incentivize provision of cost efficient health care services

Use the purchasing power of employers and groups of insured individuals to create incentives and disincentives for health care providers to deliver high quality, high value care

Arrange active transportation with a fixed route, designated stops, and pick up times when children can walk to school with adult chaperones