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Steps to a HealthierUS logo Steps Along the Border Initiative, Arizona

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.

For FY 2003, this U.S. Department of Health and Human Services (HHS) program allocated $13.6 million to fund 23 communities, including three counties in Arizona, to implement community action plans to reduce health disparities and promote quality health care and prevention services.

Project Area

Three Arizona–Mexico rural border communities:

  • Cochise County (population 119,281).
  • Santa Cruz County (population 39,590).
  • Yuma County (population 164,942).

Target Population for Steps Interventions

Hispanics/Latinos, people with incomes 200% below the federal poverty level, and people without health insurance.

Proposed Interventions

The proposed interventions build on and expand an existing state and local model, Border Health ¡Si!, which is a comprehensive, community-based project designed to prevent and control diabetes in a high-risk population. The new interventions add obesity and asthma components.


  • Implement social marketing strategies to promote breast-feeding though the Loving Support program.
  • Policy

  • Identify and address environmental and institutional factors that contribute to disease burden and disparities.
  • School-Based

  • Implement CDC’s School Health Index (SHI) self assessment and planning guide for developing physical activity, health eating, and tobacco-free lifestyle program.
  • Collaborate with the Arizona Department of Education to address school policies regarding unhealthy school lunches, inadequate physical activity, and vending machines.
  • Implement comprehensive nutrition and physical activity curricula in schools.
  • Promote clean air asthma initiatives in schools.
  • Community-based

  • Expand existing and successful walking programs, as well as physical activity and nutrition programs implemented by Promotoras, who are lay health workers who conduct culturally relevant outreach and education programs (funded by the Arizona Department of Health Services, Environmental Protection Agency, Health Resources and Services Administration, the University of Arizona, and private foundations). Expand these programs to reach health care providers, students, teachers, school nurses, community members, and residents in their homes and workplaces in the Steps project areas.
  • Workplace

  • Addressed through community-based initiatives.
  • Health Care

  • Partner with local health care providers to address gaps in diabetes and asthma care.
  • 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

    WIC; University of Arizona College of Public Health; Arizona Department of Education; Health Services Advisory Group; Western Growers Association; Cochise County: Cochise County Health Department; University of Arizona Cooperative Extension; Douglas Parks and Recreation; Border Health Foundation; Chiricahua Community Health Centers; Naco School District No. 23; Douglas Unified School District No. 27; Esperanza Community Center; Mexican Consulate; Douglas Police Department; Copper Queen Community Hospital; Women’s Transition Project; Willcox Food Bank; First Southern Baptist Church;  Santa Cruz County: City of Nogales; Santa Cruz County; City of Patagonia; Nogales Unified School District; Santa Cruz County School Superintendent; Santa Cruz Valley Unified School District No.35; Patagonia Unified School District; Southeastern Arizona Area Health Education Center (SEAHEC); Carondelet Health Network; Arizona Association of Community Health Centers; Mariposa Community Health Center; American Lung Association; American Cancer Society; Wilson-Batiz Borderland Food Bank; St. Andrews Episcopal Church; Sacred Heart of Jesus; San Felipe de Jesus, Most Holy Nativity; Produce Association of the Americas; Nogales International; radio Xeny; La Campeona; Nogales Police Department; Boys and Girls Club; Lions Club; Rotary; Headstart/Even Start; United Church Village (subsidized senior housing); Tubac; Patagonia and Nogales Senior Centers; GUIA Public Housing Tenant Association; Yuma County: Somerton City Manager; Campesinos Sin Fronteras; Western Area Health Education Center; Gadsden and Somerton School Districts; City of San Luis and City of Somerton Libraries; Sunset Community Health Center; Yuma County Health Department; Por un Mejor Mañan; San Luis Neighborhood Watch; Gadsden Community Development Board; Promotoras; Yuma County Interfaith Group; City of San Luis and City of Somerton Parks and Recreation Departments; Gowan Company; Factor Sales & Food City; Bajo El Sol; City of San Luis and City of Somerton Police Departments; Yuma County Development Services; Yuma County Public Works; Mexican Consulate; and Cocopah Tribal Council.

    Arizona Steps Contacts

    Nicole L. Olmstead, MPH
    Acting Program Manager
    Arizona Department of Health Services
    Office of Nutrition and Chronic Disease Prevention Services
    150 N. 18th Avenue, Suite 310
    Phoenix, AZ 85042
    (602) 542-1886
    (602) 542-1890 fax

    Sheri Gallager, MS
    Acting Program Manager
    Arizona Department of Health Services
    Office of Nutrition and Chronic Disease Prevention Services
    150 N. 18th Avenue, Suite 310
    (602) 542-1886
    (602) 542-1890 fax

    Note: Steps communities have until May 2004 to finalize their community action plans. Proposed interventions may change accordingly.

    Return to Grantee List