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Approaches undertaken by the Food & Fitness (F&F) community partnerships demonstrate that engaging community residents in the process of creating systems change strengthens the ability of neighborhoods, organizations, and institutions to foster and sustain those changes over time. The F&F partnerships were established to increase access to locally grown food and safe places for physical activity for children and families in communities with inequities across the United States. A critical focus of this initiative has been to use community-determined approaches to create changes in policies, infrastructures, and systems that will lead not only to change but also to sustainable change that positively influences health equity. During the 9 years of the initiative, lessons were learned about the fundamental elements that built the foundation for success across all partnership work. Data were extracted from the systems and policy change tracking forms related to efforts for all F&F sites over the entire implementation period (2009-2016). Documentation related to both the process and outcomes of the efforts were qualitatively analyzed to determine factors related to success. The following factors have emerged from our analyses and uncover a deeper understanding of what actions and factors were critical for the work: focus of the work over time, capacity built in the partnerships, and sustainability of the work and outcomes.