Our Blog

Begin with the End in Mind

By Sarah Strunk on September 5th, 2014

In The Seven Habits of Highly Effective People, Habit 2 is beginning with the end in mind, envisioning what you can’t see but wish to happen. Author Stephen Covey notes, “Begin with the End in Mind means to begin each day, task or project with a clear vision of your desired direction and destination, and then continue by flexing your proactive muscles to make things happen.”

Over the past few weeks, we’ve celebrated the culmination of our work on Healthy Kids, Healthy Communities (HKHC), a five-year, $33.4 million childhood obesity prevention initiative supported by the Robert Wood Johnson Foundation (RWJF). In writing and reviewing final reports, sharing lessons learned and thinking about the future, I’ve been reflecting on Covey’s Habit 2. What end were we envisioning when we launched HKHC? Did we achieve it? And what happens next?

While planning HKHC in late 2007, obesity rates were accelerating at an alarming pace, particularly among children of color. Experts discussed the complexity of this issue, with growing recognition of the need for multi-faceted solutions. They understood that this epidemic, which had been brewing for decades, wouldn’t be eradicated overnight.

Together with RWJF, Active Living By Design identified some ambitious goals for HKHC:

  1. Support at least 100 local communities to address active living and healthy eating through policies, systems and environmental change strategies.
  2. Implement and grow a comprehensive learning network to develop local capacity and leadership.
  3. Publish case studies and community profiles to document lessons learned and successes that other communities can replicate.
  4. Collaborate with state and national partners to help build a broader movement to achieve sustainable change.

With experienced staff in place, a logic model that resonated with researchers and practitioners alike, and hundreds of communities that demonstrated great interest in this work, we were ready to go. And then reality hit. The Great Recession of 2008 led to a significant reduction in funding for HKHC, and we cut in half the number of communities we originally envisioned serving. Locally, many communities experienced significant increases in poverty, unemployment and violence, which diverted resources—as well as residents’ and leaders’ attention—from childhood obesity. The Tea Party movement swept through many parts of the country, compromising city councils’, county commissions’ and state legislatures’ ability to collaborate effectively on issues viewed by some as solely a personal or parental responsibility. At the federal level, corporations became people, preemption bills stifled or banned local innovation altogether, and the political gridlock experienced locally also hit Washington, DC, with a vengeance.

This could have wreaked havoc on our “begin with the end in mind” vision. But there was good news, too. The healthy communities movement received an infusion of new resources thanks to the American Reinvestment and Recovery Act and, later, Community Transformation Grants. Sophisticated web-based resources such as Community Commons and County Health Rankings & Roadmaps brought robust vehicles for networking and valuable data to everybody’s fingertips, not just to funded grantees. First Lady Michelle Obama’s Let’s Move! campaign made fitness and healthy eating cool, and provided energy and motivation in our communities, homes, schools and places of workshop. And though the greatly-anticipated tax on sugar-sweetened beverages and cap on portion sizes remained elusive, we learned a lot about effective advocacy strategies from diverse and courageous leaders in Philadelphia, Telluride, the Navajo Nation and New York City.

Isn’t this how change happens? Even with a clear vision and the flexing of proactive muscles, it’s messy. It’s unpredictable. It’s disruptive. It’s simultaneously frustrating and exhilarating. And it can be extremely rewarding, as we’ve experienced with HKHC.

Although formal evaluation results won’t be released until early 2015, there’s no question that HKHC had an impact, both on the ground and in the field writ large. In total, HKHC communities implemented 2,183 policy and environmental changes to prevent childhood obesity and leveraged another $141 million to support their initiatives on the ground. HKHC initiatives created greater capacity in communities, frequently moving them far beyond the initial scope of the grant. Local governments took on greater roles to improve health conditions for low-income children and families. Resident involvement in policy making increased. Elected officials became champions of healthy communities. Likewise, local HKHC project staff frequently transitioned to more influential roles, becoming elected officials and members of appointed commissions.  We have many reasons to be proud! You can read more about HKHC’s accomplishments, specific success stories and lessons learned in our new publication, Growing a Movement: Healthy Kids, Healthy Communities Final Report.

Recent reports suggest that childhood obesity levels have levelled off, and that’s encouraging. Yet despite these advances, significant barriers and disparities remain—especially for poor families and children of color. For example, although young children in Charleston, WV will eat better and be more physically active in childcare centers as a result of the policy wins achieved through HKHC, those same children will graduate to elementary schools that struggle to simultaneously achieve educational standards, meet nutritional guidelines in the lunchroom and offer safe walking environments for students.

I believe, however, that the HKHC communities are in a much better position to address these challenges than they were prior to receiving this funding. A depth of capacity now exists as an outcome of the investment. Technical assistance, peer learning, experience and persistence enabled project staff and partners to continue making improvements in the quality of life of their communities that will be sustained for years to come.

We’re grateful to the many community leaders and partners with strong visions who joined us in this legacy-building work. As we observe National Childhood Obesity Awareness Month through the end of September, I hope you’ll think about ways you can help spread the word, take action to reverse childhood obesity and create healthier communities for everyone. What is the end that you have in mind, and how can we work toward achieving it together?

Sarah Strunk

Strategic Advisor

Healthy communities networker, integrator and distance runner on the go.