Abstract

Steps to Health King County (Steps KC; Seattle, Washington) was one of 40 community-level initiatives funded in 2003 as part of the Steps to a HealthierUS initiative. Steps KC goals included reducing the impact of chronic diseases through a compre-hensive, coordinated approach and reducing health disparities due to chronic illness. Steps KC intervention activities took place on two levels: the overall Steps KC collaborative and individual funded programs. Collaborative-level activities included policy and systems change initiatives and efforts to better integrate the funded-program organizations. The funded programs ranged from group health promotion programs to intensive case management. Steps KC was successful in creating a large, diverse community collaborative and funding 14 separate programs that reached approximately 8,000 community residents with medium- and high-intensity programs of demonstrated effectiveness. Systems change initiatives within school districts and government agencies led to a greater institutional emphasis on health promotion and on partnership with communities to address health inequities. Keywords chronic disease prevention, community coalitions, community-based initiatives, participatory evaluation, organizational change, policy change, systems change Promoting behavioral changes to prevent chronic illness