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The Steps to a HealthierUS five-year cooperative agreement program
aims to help Americans live longer, better, and healthier lives by reducing the
burden of diabetes, overweight, obesity, and asthma and addressing three related
risk factors — physical inactivity, poor nutrition, and tobacco use.
The FY 2003 Initiative funded 23 communities, including Austin, at a total of
$13.6 million to implement community action plans to reduce health disparities
and promote quality health care and prevention services for every American.
Project Area
- Contiguous geographic area with 20 zip codes in Austin, Texas (population
460,041); 167,000 households.
- 65 elementary schools, 14 middle schools, 13 high schools (student
enrollment 66,597).
- Includes 11 of the city’s 12 Federally Qualified Health Centers (FQHC).
Target Population for Steps Interventions
- Elementary, middle, and high school students; parents; teachers; school
administrators; and school boards.
- Low-income Latino, African-American, and white children and adults.
- Employers and employees in work sites.
- Faith-based organizations and their congregations.
- Clients of City of Austin neighborhood and recreational centers.
- Patients in the City of Austin community health center system.
- Business and political leaders within the community.
Proposed Interventions
Media
- Develop culturally and linguistically appropriate messages on obesity,
diabetes, and asthma prevention and on nutrition, physical activity, and
tobacco use.
- Increase awareness of perceived risks, prevention methods, and available
resources through social marketing messages that integrate of health education
and promotion models (e.g., the Trans-Theoretical Theory, Health Belief Model,
and Social Learning Theory).
- Create awareness of chronic diseases and risk factors and promote Steps to
a Healthier Austin through television and radio news spots, and print media.
Policy
Partner with the Tobacco Free Austin Coalition to implement tobacco
control and prevention education programs to create stronger, enforceable,
smoke-free ordinances.
Work with the American Cancer Society (ACS) to implement policies to
reduce and prevent suffering from tobacco-related illness and reduce health
disparities among minority and medically underserved communities.
Remove foods with low-nutritional value from school campuses.
Work with school boards to advocate for and support daily physical
education classes.
School-Based
Partner with the Austin Independent School District (AISD) to conduct a
needs assessment and gap analysis in order to implement a staff wellness
program.
Implement daily physical education classes (currently occur only three
times per week) in several pilot schools.
Implement Team Nutrition in two high schools, two middle schools, and
eight elementary schools in the intervention area.
Expand the existing student health services model, in which school nurses
perform case-management, to include family risk factor identification and
focus on students at risk for diabetes.
Identify and pilot culturally and linguistically appropriate cooking
classes by expanding partnership with the Sustainable Foods Center and its
Cocina Alegre program.
Partner with the ACS and AISD to garner resources for the Towards No
Tobacco program for all middle schools.
Expand the reach of the American Diabetes Associations (ADA) School Walk
for Diabetes program, an educational fundraising event that teaches children
and adults the benefits of exercise and eating healthy while helping those in
the community affected by diabetes.
Community-Based
Promote and expand local resources and programs, including the Walk Texas
Austin Chapter walking groups, the Sustainable Food Center, ACS education
classes and quit line (tobacco), American Heart Association education classes,
and American Lung Association asthma education programs.
Expand the reach of the ADA community-based programs, such as the Diabetes
Sunday African American /Hispanic Program, a targeted approach to increase
awareness of the seriousness of diabetes, the importance of early detection
and treatment, and the need to make healthy lifestyle choices, coordinate more
events such as the Diabetes Summit of Central Texas to raise awareness about
the seriousness of diabetes and its risk factors.
Work with Austin’s Parks and Recreation Department (PARD) to facilitate
the planning and construction of walking and hiking trails in the intervention
area and promote the use of existing city resources, such as recreational
centers and parks, to increase physical activity.
Establish a new senior fitness program at the Conley-Guerrero Senior
Activity Center and a new fitness program at the Rosewood Recreation Center.
Evaluate effectiveness and expand the program to three additional senior
centers in the next three years.
Review and coordinate program activities at the city’s 18 recreation
centers.
Work with community-based program called OriGENal voice to develop
strategies designed to delay and prevent tobacco-use initiation among middle
school girls.
Create point-of-decision nutrition prompts for intervention area stores
and restaurants.
Workplace
Promote healthy nutritional choices, physical activity, tobacco avoidance
and/or cessation to Austin city and school district employees through ACS’s
web site.
Recruit five intervention-area employers to participate in Steps to a
Healthier Austin wellness programs.
Create point-of-decision prompts in work sites to promote walking and
stair use.
Health Care
Partner with ACS to teach health care providers and staff about
tobacco-use cessation and prevention education that targets low-income
pregnant women and parents of young children who are patients of Community
Health Centers and WIC centers. Implement reminder systems that prompt
providers to assess use.
Organize key community partners to help develop disease management
protocols, implement of evidence-based guidelines, and share best practice
models. A diabetes disease management model will be implemented at the
Rosewood-Zaragosa Community Health Center in the first year. A similar model
will be developed for asthma, in the next two years. These models will later
be expanded to include the entire city health center network.
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 Consortium
Greater Austin Chamber of Commerce, Hispanic Chamber of Commerce, Capital
Area African American Chamber of Commerce, Austin Independent School District,
University of Texas School of Nursing, Huston Tillotson College, Health
Connection, Austin Travis County Mental Health and Mental Retardation, Del Valle
Independent School District, Austin Inter-Faith Alliance, ACS, American Heart
Association, American Lung Association, ADA, Sustainable Food Center–Austin
Community Gardens, Texas Cooperative Extension Service, RunTex, Austin Parks and
Recreation-Natural Resources Division, YMCA, Trust For A Smokefree Texas, Austin
Housing Authority, Health Ministry Team Churches, Capital Metro, El Buen
Samaritano, Trans Texas Alliance, and Texas Department of Health.
Austin Steps Contact
Adolfo Valadez, MD, MPH
Medical Director
Austin/Travis County Health and Human Services Department
RBJ Building
15 Waller Street 4th Floor, Suite 410
Austin, TX 78702
(512) 972-5408
(512) 972-6377 fax
Adolfo.Valadez@ci.austin.tx.us
Note: Steps communities have until May 2004 to finalize their
community action plans. Proposed interventions may change accordingly.
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