Missouri Healthy Eating Active Living (HEAL) Evaluation

Dates: 2016

State: Missouri

Client(s): Missouri Department of Health and Senior Services

Service: Applied Research & Evaluation

Technical Expertise: Aging, Healthy Communities, Maternal and Child Health


Missouri is one of the heaviest states in the country, with 30% of the total population overweight or obese. Obesity is associated with increased risk of a variety of chronic disease like diabetes and stroke, as well as increased mortality. Obesity has been estimated to decrease lifespan by an average of 2-5 years, and leads to significant economic costs to individuals and to the state.

The Missouri Department of Health and Senior Services (MODHSS) established the Healthy Eating Active Living (HEAL) initiative with the goal of reducing obesity and chronic disease, as well as promoting healthy aging. Specifically, HEAL aims to reduce the prevalence of obesity by five percent by 2018. Strategies include capacity building activities to achieve policy and environmental changes that increase access to healthy foods and safe places to be physically active. To achieve the desired outcomes, HEAL is working to increase the following:

  • Missouri Breastfeeding Friendly Worksites;
  • Small retail venues that offer healthy foods;
  • Missouri Live Well Restaurants;
  • Community gardens;
  • Public places that have adopted and implemented nutrition standards for vending/concession on government property (using Eat Smart in parks where appropriate).
Additionally, HEAL aims to increase the number of: shared use agreements and use of facilities; Livable Streets policies; worksites promoting physical activities; and early childhood education (ECE) facilities that are recognized as Missouri Move Smart Centers. Twenty-three Missouri communities will participate in HEAL.

JSI will be evaluating the HEAL initiative to assess its implementation and effectiveness. The primary aim will be to evaluate the reach of project activities (policy and environmental changes to support healthy eating and physical activity) and partners engaged (number, type, and contributions). Secondary aims include evaluating changes in physical activity and healthy eating behaviors resulting from implementation of action plans. This evaluation has the potential to help us understand effective community- and policy-level interventions to reduce obesity and associated chronic disease.