Examining the role of a community coalition in facilitating policy and environmental changes to promote physical activity: the case of Get Fit Kaua'i.

Community coalitions help to generate policy and environmental changes that address community health problems. This qualitative study examined how one community coalition, Get Fit Kaua'i, catalyzed built environment (BE) policy and infrastructure changes in a rural county in Hawai'i. The purpose was to develop a theory that explained the process by which the community coalition facilitated BE changes to support physical activity. Using a grounded theory approach, semi-structured interviews were conducted with a purposeful sample of 25 stakeholders engaged in the coalition's BE activities. The model to emerge from the coalition interviews consisted of five phases: (1) coalition formation, (2) capacity building, (3) policy development, (4) policy passage, and (5) policy implementation. Community context influenced all of these phases. Although community context limits generalizability, other community coalitions pursuing BE changes can learn from the process of the coalition under study.