Shaping healthier futures: community-level impact of the Alberta Healthy Communities Approach

Introduction Built environment initiatives that change the physical places in which people live, work and play offer an approach to preventing cancer and chronic diseases. The purpose of this study was to evaluate the effectiveness of the Alberta Healthy Communities Approach Phase II (AHCA II), a community-based approach to creating healthy environments within and across rural communities and addressing modifiable health behaviours to prevent and reduce cancer and chronic disease. Methods Nineteen rural communities participated in AHCA II. Data collected with and by community members included two pre- and postimplementation assessment tools and postimplementation focus groups and surveys. Qualitative and quantitative data sources were triangulated to determine community-level outcomes and impacts. Results The evaluation found three key outcomes and impacts of the AHCA: supportive (built) environments for health; community wellness culture; and community capacity. These intersecting categories demonstrate the positive effects of healthy community initiatives on improving the built environment and supporting health behaviours such as healthy eating, physical activity, ultraviolet radiation protection and tobacco reduction. Conclusion In addition to improving supportive environments for health, the AHCA facilitated cultural changes and improved community capacity within and across rural communities in Alberta. Each of these components is required to support long-term behaviour changes that promote health and prevent cancer and chronic disease. While these results are encouraging, time and additional evaluations are required to determine whether behavioural changes are sustained and result in reduced rates of cancer and chronic disease.