Identify two behavioral risk factors for chronic disease and two evidence-based community interventions to address them.

• A. High sugar intake and sleep duration; interventions: sugar tax and midnight running clubs.
• B. Excessive screen time and high fiber intake; interventions: screen time bans and more fiber classes.
• C. Tobacco use and physical inactivity; interventions: community-based cessation programs and physical activity promotion.
• D. Alcohol moderation and hydration; interventions: hydration campaigns and water bottle giveaways.

Answer: (C)

Two behavioral risk factors for chronic disease that public health efforts commonly target are tobacco use and physical inactivity. Smoking damages the heart, blood vessels, lungs, and many organs, driving cardiovascular disease, cancers, and respiratory illnesses. Not getting enough physical activity increases the risk of obesity, type 2 diabetes, heart disease, and some cancers. The two evidence-based community interventions that best address these risks are: helping people quit tobacco through community-based cessation programs, which provide counseling, peer support, and access to cessation medications; and promoting physical activity through community-level efforts that create opportunities and motivation to be active—such as organized exercise programs, walking groups, and creating safe spaces and environments that encourage movement. These approaches are supported by strong evidence showing they improve quit rates and raise overall activity levels, reducing chronic disease risk at the population level.

The other options mix factors and interventions that don’t align as clearly with well-established community strategies. For example, while high sugar intake is a dietary risk factor, a sugar tax is a broad policy tool and the proposed intervention here isn’t a proven, routine community activity; high fiber intake is generally protective, not paired with an inappropriate choice like excessive screen time. Hydration is not a primary behavioral risk factor in the same way, and hydration campaigns or giveaways don’t directly target the main behaviors that drive chronic disease risk.