Department of Community and Cultural Psychology, University of Hawai'i at Mānoa, 2530 Dole St, Honolulu, HI, 96822, USA.
Office of Public Health Studies, University of Hawaii at Manoa, 1960 East West Road, Honolulu, HI, 96822, USA.
BMC Public Health. 2020 Jan 31;20(1):141. doi: 10.1186/s12889-019-8078-1.
The Healthy Hawai'i Initiative was created in 2000 with tobacco settlement funds as a theory-based statewide effort to promote health-supporting environments through systems and policy change. Still active today, it is imbedded explicitly in a multi-sectoral, social ecological approach, effectively striving to build a culture of health before this was the name for such an ambitious effort.
From interviews with key informants, we analyze two decades of the Healthy Hawai'i Initiative (HHI) in the context of the Robert Wood Johnson Foundation (RWJF) Culture of Health Action Framework (CHAF). We list HHI accomplishments and examine how the Initiative achieved notable policy and environmental changes supportive of population health.
The Healthy Hawai'i Initiative started with an elaborate concept-mapping process that resulted in a common vision about making "the healthy choice the easiest choice." Early on, the Initiative recognized that making health a shared value beyond the initial stakeholders required coalition and capacity building across a broad range of governmental and nonprofit actors. HHI coalitions were designed to promote grassroots mobilization and to link community leaders across sectors, and at their height, included over 500 members across all main islands of the state. Coalitions were particularly important for mobilizing rural communities. Additionally, the Initiative emphasized accessibility to public health data, published research, and evaluation reports, which strengthened the engagement to meet the shared vision and goals between diverse sector partners and HHI. Over the past two decades, HHI has capitalized on relationship building, data sharing, and storytelling to encourage a shared value of health among lawmakers, efforts which are believed to have led to the development of health policy champions. All of these factors combined, which centered on developing health as a shared value, have been fundamental to the success of the other three action areas of the CHAF over time.
This evidence can provide critical insights for other communities at earlier stages of implementing broad, diverse, multifaceted system change and fills a key evidence gap around building a culture of health from a mature program in a notably multicultural state.
健康夏威夷倡议于 2000 年成立，资金来自烟草和解协议，旨在通过系统和政策变革，在全州范围内推广有利于健康的环境，这是一个基于理论的全州性努力。该倡议至今仍在积极开展，它明确嵌入到多部门、社会生态方法中，在这种雄心勃勃的努力还没有一个名称之前，就有效地努力建立一种健康文化。
我们对健康夏威夷倡议（HHI）进行了 20 年的分析，这些分析是在罗伯特·伍德·约翰逊基金会（RWJF）健康文化行动框架（CHAF）的背景下进行的。我们列出了 HHI 的成就，并研究了该倡议如何实现了支持人口健康的显著政策和环境变化。
健康夏威夷倡议始于一个精心策划的概念映射过程，该过程产生了一个共同的愿景，即“让健康选择成为最容易的选择”。早期，该倡议认识到，要让健康成为超越最初利益相关者的共同价值观，需要在广泛的政府和非营利行为者之间建立联盟和能力建设。HHI 联盟旨在促进基层动员，并在各部门的社区领袖之间建立联系，在其鼎盛时期，全州有超过 500 名成员。联盟对于动员农村社区尤为重要。此外，该倡议强调了公共卫生数据、研究报告和评估报告的可及性，这加强了不同部门合作伙伴与 HHI 之间实现共同愿景和目标的参与度。在过去的 20 年里，HHI 一直致力于建立关系、分享数据和讲故事，以鼓励立法者树立健康的共同价值观，人们相信这导致了健康政策拥护者的发展。所有这些因素的结合，都集中在将健康发展为共同价值观，这对 CHAF 的其他三个行动领域的成功起到了至关重要的作用。
这些证据可以为其他处于实施广泛、多样化、多方面系统变革早期阶段的社区提供重要的见解，并填补了在一个明显多元文化的州从成熟项目中建立健康文化的关键证据空白。
