Background: Kalihi Valley is a densely populated, low-income community (28,958 residents in approximately 6 square miles) with insufficient sidewalks, bike lanes, and public green space to support regular physical activity for its residents. Kokua Kalihi Valley (KKV), a community health center formed in 1972, sought to improve Kalihi Valley's built environment based on its history of community- and partnership-based preventive health initiatives that have focused on the social determinants of health.
Intervention: Kokua Kalihi Valley used a flexible partnership model and a focus on direct community action to develop an unused 100-acre state park (the Kalihi Valley Nature Park) and establish a bicycle repair and recycling program that mobilized thousands of community volunteers, attracted widespread media coverage, and established a number of innovative programs for active living. Kokua Kalihi Valley and its partners also contributed to the successful passage of a city charter amendment to prioritize Honolulu as a bicycle- and pedestrian-friendly city.
Results: This initiative was successful in reclaiming a substantial amount of land for active living and in stimulating both public governmental support and widespread private community involvement in programs and activities.
Lessons learned: Projects that engaged community members in activities with tangible accomplishment were shown to be most successful.
Conclusions: This initiative showed that community health centers may be uniquely positioned to provide leadership and assume responsibility for cross-sectoral active-living health projects.