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The Steps to a HealthierUS 5-year cooperative agreement program funds States,
cities, and tribal entities to implement chronic disease prevention efforts
focused on reducing the burden of diabetes, overweight, obesity, and asthma and
addressing three related risk factors: physical inactivity, poor nutrition, and
tobacco use.
For FY 2003, the U.S. Department of Health and Human Services (HHS) allocated
$13.6 million to fund 24 communities, including four counties in New York; in FY
2004, HHS allocated $35.8 million to increase funding to the existing 24
communities and to fund an additional 16, for a total of 40 communities.
Project Area
- Broome County: Binghamton (population 200,536).
- Chautauqua County: Jamestown, Dunkirk-Fredonia (population 139,750).
- Jefferson County: Fort Drum, Watertown (population 111,738).
- Rockland County: Ramapo, Nyack (population 286,000).
Target Population
- Preschool, elementary, middle, and high school students; parents;
teachers; school administrators; and school boards.
- Employers and employees in worksites.
- Business and political leaders.
- Racial/ethnic minorities.
- People living below the Federal Poverty Level.
- People living with a disability.
- Health care providers and health care institutions.
- Families living in households with an individual with asthma.
- People with diabetes or prediabetes.
- People age 65 and older.
Steps Activities
Media
- Develop culturally and linguistically appropriate messages on obesity,
diabetes, asthma, nutrition, physical activity, breastfeeding, and tobacco
use.
- Implement social marketing strategies to promote interventions.
- Create awareness of Steps-related chronic diseases and risk factors and
promote Steps to a HealthierNY through television, radio, billboards, Web
sites, and print media.
Policy
Encourage and educate health care providers to implement patient
registries and adhere to appropriate standards of care for patients with
diabetes, asthma, and obesity.
Identify and address environmental and institutional factors in
communities, schools, and worksites that contribute to disease burden and
disparities.
Develop and implement guidelines for providing healthy foods in schools
and worksites.
Collaborate with farmers and farmers' markets to increase access to fruits
and vegetables in communities, schools, and worksites.
Open school buildings and athletic facilities for community walking and
physical activity during nonschool hours.
Develop and implement worksite and community venue breastfeeding policies.
Implement policies requiring physical education classes for all semesters
of high school.
School
Promote the 5 A Day program in school districts through policy changes,
school activities, and communications to community residents.
Conduct asthma education programs for preschool staff, day care providers,
schoolchildren, and sports team coaches.
Train elementary and special education teachers to integrate physical
activity into the classroom.
Implement the Centers for Disease Control and Prevention's School Health
Index assessment and planning guide to identify opportunities to improve
physical activity, healthy food choices, and tobacco-free lifestyle programs.
Create and strengthen school health advisory councils.
Offer financial incentives to schools to implement or enhance nutrition,
physical activity, and tobacco policy and environmental changes.
Conduct school-based physical activity programs.
Establish farm-to-school programs to increase access to locally grown
produce.
Train school nurses on tobacco-use cessation counseling and establish a
system for delivering cessation services to students.
Community
Conduct community physical activity programs and promote the use of
existing resources, such as recreational centers, schools, and parks.
Enlist grocery stores and farmers' markets in promotional campaigns to
highlight the nutritional value of locally grown produce and low-fat dairy
products.
Conduct home-based case management programs for children with asthma,
including identifying environmental triggers and helping families develop
remediation plans.
Offer smoking cessation programs to racial/ethnic minority communities.
Determine factors that impede walkability of communities and make
appropriate environmental improvements.
Screen low-income food stamp recipients by using the American Diabetes
Association risk assessment tool and provide risk-reduction interventions for
those who are at high risk of diabetes.
Conduct weight loss programs in faith-based organizations, communities,
schools, senior centers, health care facilities, and worksites.
Conduct maintenance programs for people who have previously lost weight.
Conduct behavior modification programs for families with overweight
children.
Train low-income and African American mothers to be breastfeeding peer
counselors and link them with new mothers to provide support and education.
Promote the 5 A Day program in grocery stores, in restaurants, and at
community events and venues.
Expand tobacco-use cessation referral systems and provide services.
Host a conference for people with disabilities to make them aware of
physical activity opportunities available to them.
Workplace
Promote the 5 A Day program, farm to you, and farmers' markets at
worksites to increase assess to locally grown produce.
Promote physical activity programs in worksites, including walking
programs and stairwell point-of-decision prompts.
Expand healthy food choices in cafeterias, vending machines, and at
meetings.
Conduct worksite assessments and make sustainable environmental and policy
changes to address identified gaps.
Establish worksite wellness committees.
Health Care
Train health care professionals on standards of asthma care and
self-management.
Establish patient and physician reminder practices that follow current
standards of care for obesity, diabetes, asthma, and tobacco use and expand
self-management education and case management systems.
Offer a variety of continuing medical education programs (through grand
rounds and seminars, on standard of care guidelines and the availability of
community resources on diabetes, obesity, asthma, tobacco, and breastfeeding.
Improve diabetes care through the development of patient registries.
Host a conference for providers on the needs of people with disabilities.
Develop an asthma clinic at a university to better control students'
symptoms and to improve self-management skills.
Educate providers about the ramifications of gaining excessive weight
during pregnancy and provide them with tools for counseling pregnant patients.
Partner with health care plans to promote Steps interventions.
Work with health care plans to provide reimbursement for asthma case
management services.
Evaluation
HHS will provide training and technical assistance to help each Steps
community develop measurable program objectives and specific indicators of
progress and use relevant data to support ongoing program improvement. HHS also
will conduct a national evaluation of the overall program. Existing data
sources, such as the Behavioral Risk Factor Surveillance System and the Youth
Risk Behavior Surveillance System, will be used to identify and measure program
outcomes and assess progress toward program goals.
Community Partners
HHS will provide training and technical assistance to help each Steps
community develop measurable program objectives and specific indicators of
progress and use relevant data to support ongoing program improvement. HHS will
also conduct a national evaluation of the entire program. Existing data sources,
such as the Behavioral Risk Factor Surveillance System and the Youth Risk
Behavior Surveillance System, will be used to identify and measure program
outcomes and assess progress toward program goals.
New York Steps Contact
Cynthia A. Jaconski, M.P.H., C.H.E.S.
Coordinator, Steps to a HealthierNY
NYS Department of Health
150 Broadway
Albany, NY 12204
(518) 474-1222
(518) 473-0642 fax
caj09@health.state.ny.us
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