Healthy Maine Partnerships: policy and environmental changes.

Background: Tobacco settlement funds were used to establish the Healthy Maine Partnerships (HMPs) to reduce tobacco use, increase physical activity, and improve nutrition through local policy and environmental change.

Context: The HMP model is a progressive approach to public health. It provides for coordinated efforts between state and local partners for health promotion and disease prevention. Community coalitions, supported with funding and guidance by the state, are the basis for policy and environmental change.

Methods: The state awarded contracts and provided program guidance to foster policy and environmental change at the local level. The partnerships' efforts were assessed with a retrospective evaluation that consisted of 2 data collection periods conducted using the same tool. A survey booklet containing lists of possible environmental and policy changes was developed and mailed - once in 2005 and once in 2006 - to all 31 local partnership directors and school health coordinators who completed it. Additional data were collected from the local partnerships in the form of narrative reports required by their funder (Maine Center for Disease Control and Prevention).

Consequences: All local partnerships implemented policy or environmental interventions to address tobacco use, physical activity, and nutrition during the period covered by the surveys (July 2002-June 2005 [fiscal years 2003-2005]). Cumulatively, more than 4,600 policy or environmental changes were reported; tobacco use policies represent most changes implemented. A second round of HMP funding has since been secured.

Interpretation: Although the survey methodology had limitations, results suggest that much work has been accomplished by the local partnerships. Plans are to share success stories among partnerships, provide training, and continue to improve the public health infrastructure in Maine.