Objective: The purpose of this overview was to summarize evidence about the effectiveness of community-based healthy communities projects within the scope of public health practice in Canada.

Methods: A search of published and unpublished literature resulted in the retrieval of 308 articles. Each article was reviewed by a primary reader for relevance and a subset was reviewed by a secondary reader. Agreement between the two raters was high (kappa = 0.8). Two raters assessed the quality of the projects using the following criteria; a) adequate description of the project, b) rationale for project given, c) planning and action phases described, d) information gathering and analysis phases described, e) conclusions supported by data.

Results: A total of fourteen articles were relevant to healthy community initiatives. 'Validity' or quality assessment criteria included description of project, rationale for project, planning and action phases, information gathering and analysis. Using these criteria, four projects were judged to be strong, two moderate, and eight weak. Action strategies used most often in the projects included: mass media, lobbying, health campaigns, workshops, health centres and counselling. Characteristics of the populations involved included both rural and urban settings, low socioeconomic status, and moderate to high risk levels of behaviour.

Discussion: Positive outcomes included community wide awareness of project and project activities, significant participation by community in planned activities, implementation of strategies into multiple locations (schools, worksites, restaurants), increased level of health care utilization, weight loss, and development of community coalitions and planning structures. Recommendations for community based practice were made.