Development of the Community Healthy Living Index: A tool to foster healthy environments for the prevention of obesity and chronic disease

Abstract

Objectives. This paper presents a new, comprehensive tool for communities to assess opportunities for active living and healthy eating and to mobilize all sectors of society to conquer obesity and chronic disease. Method. Relevant existing tools and input from an expert panel were considered to draft the Community Healthy Living Index (CHLI). CHLI covers five major sectors where people live, work, learn, and play: schools, afterschools, work sites, neighborhoods, and the community-at-large. CHLI and the accompanying procedures enable community teams to assess programs, the physical environment, and policies related to healthy living and to plan improvement strategies. In 2008, with local YMCAs acting as conveners, community assessment teams from six US communities pilot-tested CHLI for cognitive response testing, inter-rater reliability, and implementation feasibility. CHLI was revised to reflect the test results. Results. Pilot analyses demonstrated that the process was feasible, with most questions being interpreted as intended and showing substantial to almost perfect agreement between raters. The final CHLI is being disseminated nationally. Conclusions. Preliminary data illustrate CHLI obtains reliable results and is feasible to implement. CHLI is a promising tool for community-based prevention efforts to draw attention to opportunities for healthy living and create impetus for community changes. (C) 2009 Elsevier Inc. All rights reserved