HealthyPlaces.org > Healthy Places Framework > Place-based Planning

Place-based Planning

Do features of a place affect people's health behavior choices?
Research has shown that environmental variables can influence how people think and act. In the absence of certain critical elements, the social cognitive theory predicts a decline in motivation, interest, performance, and behavior.

Without at least four critical elements — connection, autonomy, skill building, and healthy norms (C.A.S.H.); it is unlikely that attempts to move people toward healthy behaviors will be successful. Open a new window with descriptions of the critical elements.

The critical elements combined with Barker's behavior-setting theory (Barker, 1968) form the basis of the Healthy Places Framework. According to Barker's behavior-setting theory, individuals with a high degree of responsibility and involvement are key to developing the social and physical environment. We refer to these people as place leaders.

In school settings, place leaders include the person who directs the after school program or the teacher(s) responsible for teaching subjects related to healthy behaviors, such as physical activity and nutrition. Place leaders are key to creating healthy environments. In turn, these environments influence individual psychosocial processes and ultimately advance or hinder efforts to increase the likelihood that students will choose healthy behaviors.

The theories can also be applied in places other than schools and in efforts that target other population groups.

Why is the Healthy Places Framework different?
The framework shifts the focus from program delivery to Healthy Place development. It helps people connect, promote healthy behaviors, and prevent unhealthy behaviors.

People often try to solve problems in isolation. For instance, a community may have a hospital that offers diet and exercise programs to children at-risk for overweight, a nearby school that sponsors a substance abuse prevention program, and an after-school program that teaches conflict management.

Such programs are often costly, have limited reach, and are confusing because they approach problem behaviors in different ways. To maximize effectiveness and reach, resources available to all leaders should be coordinated and applied to develop healthy places that involve children, youth, adults and families. The intent is to give people the opportunity and capacity to make healthy choices in the physical and social environments that matter the most to them.

Why consider the place and its target audience?
The social problems of today cannot be solved by simple solutions delivered in isolation in a top-down fashion. The root causes of social problems must be solved through the difficult yet vital day-to-day efforts of leaders in the places where people live, learn, work and play. However, efforts to build the capacity of these leaders have failed. In fact, top-down strategies intended to raise the capacity of leaders to deliver interventions have led to poor implementation rates (Baranowski and Stables, 2000).

The causes of these poor implementation rates may be due to a lack of resources within the communities to deliver the social program or a lack of capacity of the leaders to adapt rigid programs to meet the needs of the community.

One alternative to the top-down centralized strategy is a decentralized diffusion system (Rogers, 1995) that provides control, autonomy, skill building and healthy norms to the leaders who deliver the intervention locally. The effects of the two approaches could be compared to the differences between the achievements of Habitat for Humanity International (Habitat) versus the Chicago Housing Authority's Cabrini-Green, a low income housing project.

Click here to see a list of Related Publications.