Steps to a HealthierUS logo ¡Salud! Salinas Steps to Health


2004

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 the city of Salinas in Monterey County, California; 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

  • City of Salinas in Monterey County, California (population 415,800); Salinas is a federal Health Professional Shortage and Medically Underserved Area.

Target Population
  • Low-income Latinos and Whites.
  • Adults and seniors at risk of or diagnosed with diabetes and asthma.
  • Children diagnosed with asthma and diabetes.
  • Obese and overweight individuals of all ages.
  • Agricultural employers and employees.
  • Church leaders and congregational members.
  • Fast food and taqueria (taco stand) restaurant owners and customers.
  • Clinic staff and patients.
  • School staff.
  • School-age children.

Steps Activities

Media

  • Develop a social marketing and implementation plan focusing on obesity, diabetes, and asthma.
  • Develop and test key messages in English and Spanish.
  • Develop a local Steps Web site on the Monterey County Health Department Web site for use by intermediaries, such as churches, agricultural employers, and schools.
  • Develop resource toolkits for use by intermediaries for intervention implementation.
  • Develop a local heroes initiative that includes digital stories highlighting community members who have taken steps to prevent or reduce the burden of asthma, obesity, or diabetes. 

Policy

  • Eliminate soft drink sales on school campuses and at school-related events, at youth-serving organizations, at churches, and at agricultural employer sites.
  • Eliminate fast food sales or offer healthier alternatives on school campuses and in agricultural employer cafeterias.
  • Open school playgrounds and outdoor sports fields to the public during non-school hours.
  • Increase structured activities that promote physical activity at schools and youth-serving organizations.
  • Encourage churches and agricultural employers to adopt policies to improve nutrition and increase physical activity.
  • Encourage low-fat, healthy food choices at church-related events, at agricultural employer potlucks, and during classroom celebrations at schools.
  • Prohibit smoking within 20 feet of all entrances and windows at private buildings and agricultural employer sites.
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    School

  • Implement Open Airways for Schools for elementary-age schoolchildren with asthma.
  • Increase healthy food options and physical activity opportunities for elementary, middle, and high school students (including high-risk independent study and continuation high school students).
  • Increase tobacco-use cessation awareness by promoting the California Smoker's Helpline.
  • Provide training for teachers and school staff on how to recognize and deal with a child who may be experiencing an asthma attack.
  • Establish School Health Advisory Councils to implement the School Health Index and make policy recommendations to promote healthy lifestyles for students.
  • Promote October Walk a Child to School Week.
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    Community

  • Restaurants: Partner with fast food franchises and taquerias to offer and promote healthy food choices, including special meal options for people with diabetes; initiate a chronic disease awareness program for customers by displaying and distributing posters and brochures; offer on-site diabetes and risk assessments; and introduce toys that promote physical activity.
  • Senior Centers: Introduce healthy food choices and physical activity programs; expand diabetes screening, referral, and education; develop and implement culturally appropriate weight loss program in Spanish and English; and work with social service agencies to offer on-site enrollment for health insurance coverage and food assistance programs in senior centers.
  • Churches: Integrate health behavior themes with spiritual messages in church activities. Accompany themes with diabetes screenings, referrals, health risk appraisals, healthy food, and physical activity interventions, including walking clubs.
  • Community Education: Train neighborhood leaders as health promoters to provide educational workshops on asthma and diabetes; expand programs to increase physical activity and healthy food choices; improve screening, referral, and self-management of asthma, diabetes, and obesity; and convene town hall meetings.
  • After-School Programming: Implement programming for youth and their families in local community settings to increase physical activity and improve nutrition.
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    Workplace

  • Expand healthy food choices in cafeterias, vending machines, and field catering trucks.
  • Expand diabetes screenings and referrals.
  • Initiate smoking cessation by promoting the California Smokers' Helpline.
  • Provide referrals to social and health services.
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    Health Care

  • Work with community health care systems to establish patient and physician reminder practices that follow current standards of care for obesity, diabetes, and asthma.
  • Expand self-management education (individual or group sessions) and case management systems for patients who are diabetic, have asthma, or are overweight or obese.
  • Improve medical care access for patients who are asthmatic, diabetic, or obese.
  • Provide training on standards of care for clinic physicians and staff.
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    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 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.

    Community Partners

    American Lung Association of the Central Coast, Central Coast Alliance for Health, Clinica de Salud del Valle de Salinas, Educational Message Services, Inc., Prevention Institute, Diabetes Care Center, Center for Community Advocacy, Monterey County Area Agency on Aging, Monterey County Health Department Clinical Services Division, Monterey County Office of Education, Monterey County Health Consortium, Natividad Medical Center, California State University Monterey Bay, Stanford University, Public Health Institute, Regional Diabetes Collaborative of the Central Coast, Nutrition and Fitness Coalition of the Central Coast, Coalition for a Tobacco-Free Monterey County, Salinas Ministerial Association, Agricultural Growers and Shippers, Spanish Television Media, American Cancer Society, American Heart Association, Salinas Valley Memorial Healthcare System, Monterey County Ministerial Association, Monterey County Insurance Group, and Agriculture Growers/Shippers Association. 

    Salinas Steps Contact

    John P. Snider, M.P.H., M.P.A.
    Director, Community Health Division
    Monterey County Health Department
    1270 Natividad Road
    Salinas, CA 93906
    (831) 755-4529
    (831) 751-9015 fax
    sniderj@co.monterey.ca.us

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