The Washoe County ACHIEVE Community (2010 – 2011)
“Local policies and the physical environment [they create] influence daily
choices that affect our health.” CDC, July 2009
Jennifer M. Hadayia, MPAPublic Health Program Manager
Washoe County Health District
What is ACHIEVE?
• ACHIEVE stands for Action Communities for Health, Innovation, and EnVironmental changE
• Part of the CDC’s Healthy Communities Program launched in 2003
• Five national partners: NACCHO, NACDD, NRPA, SOPHE, and YMCA
• Local implementation of the research showing that policy and environmental change most effectively and equitably improves behaviors related to chronic disease
• A national designation and two-year grant award
• Recognition that Washoe County has the infrastructure and track record for effective policy change to prevent chronic disease
What is ACHIEVE?A nationally-tested program model:
1. CHART. A leadership team of influential policy-makers
2. CHANGE. A CDC-developed policy needs assessment tool measuring ~65 different policies in 5 areas (physical activity, nutrition, tobacco, CDSM, and leadership) in 4 sectors (CBO, worksite, healthcare, schools/district)
3. CAP. A written Community Action Plan outlining policies to be addressed
4. Implementation of proposed policy changes, including at least one Big “P” and one little “p” related to chronic disease risk factors
Washoe County CHART
County Commission
County Manager’s Office
Community Development
District Board of Health
Library System
Parks & Open Space
Public Works
Senior Services
School District
UNR
Cooperative Extension
Chamber of Commerce
Nevada Health Care Coalition
Join Together Northern Nevada
Truckee Meadows Tomorrow
Chronic Disease Coalition
Boys & Girls Club
Medical Society
KNPB
Washoe County CHANGE
• Overall. 15 sites assessed in 4 sectors plus Community-At-Large and School District (June – August 2010)
• Methods. Secondary data review & document archiving; multiple key informant interviews; observational checklists & site-visits
• Scales. Policy (1 to 5); Environment (1 to 5); percent score per module per site (0% to 100%); average and S.D. per sector
• Benchmarks. 60% and over = asset; under 60% = need; low policy + high environment = “low hanging fruit”
• Results. Community-At-Large; School District; and youth-serving entities (schools & CBOs)
0
10
20
30
40
50
60
70
80
90
100
PhysicalActivity
Nutrition Tobacco Use ChronicDisease
Leadership
Per
cent
age
Policy
Environment
Washoe County CHANGE
Community-At-Large
0
1020
30
4050
60
70
8090
100
Policy Environment
Per
cen
tag
eWashoe County CHANGE
School District
0
10
20
30
40
50
60
70
80
90
100
Physical Activity Nutrition Tobacco Use Chronic Disease Leadership Afterschool
Per
cen
tag
e
High SchoolElementary SchoolPrivate School
Wellness/Health CenterResource CenterCommunity-at-large
Washoe County CHANGE
Youth Serving Organizations - Policy
Washoe County CHANGE
0
10
20
30
40
50
60
70
80
90
100
Physical Activity Nutrition Tobacco Use Chronic Disease Leadership Afterschool
Per
cen
tag
e
High SchoolElementary SchoolPrivate SchoolHealth Wellness CenterResource CenterCommunity-at-large
Youth Serving Organizations - Environment
Washoe County CHANGEConclusions
• Nutrition is lowest scoring area overall for CAL; conversely, it is the greatest area of need for the community as a whole.
• District score for policy is higher than environment score (though both exceed benchmark) suggesting inconsistent policy implementation.
• Overall, YSO environment scores exceed policy scores, suggesting the presence of “unofficial” policies and high readiness for codification.
• All YSO physical activity, nutrition, and tobacco environments exceed benchmark, but only about half exceed benchmark for policy. This suggests high readiness for expanding written policies in these areas.
• The afterschool module scored low overall, suggesting another area of need.
Washoe County CAP• Vision. Making Good Health Easy
• Mission. Fill gaps in community-wide nutrition and physical activity policies.
• Goals. (2-year outcomes)
1. Increase the percentage of Washoe County adults who are at a healthy weight. (4% increase)
2. Increase the percentage of Washoe County children who are at a healthy weight. (4% increase)
3. Improve chronic disease prevention infrastructure in Washoe County
Washoe County CAP• Objectives. (1-year outcomes)
1. Customize a model healthy food plan for Washoe County
2. Facilitate worksites and CBOs to adopt a nutrition or physical activity policy using CHANGE selection criteria
3. Incorporate obesity prevention strategies as a priority of the Regional Planning Governing Board
4. Facilitate preschool providers in adopting a wellness policy
5. Facilitate organizations that provide out-of-school-time (OST) in adopting a wellness policy
6. Launch efforts to engage parents and families in promoting child wellness
7. Expand the role of the Chronic Disease Coalition
Washoe County CAP• Tangible Outcomes
1. A healthy food plan for Washoe County
2. Revised Regional Planning Criteria
3. New worksites and CBOs with expanded wellness policies
4. A model Preschool Wellness Policy
5. A model OST Wellness Policy
6. A community engagement initiative for parents and families
7. Expanded Chronic Disease Coalition activities
The Washoe County ACHIEVE Community (2010 – 2011)
For More Information:
Nationally: www.achievecommunities.org
Locally: www.gethealthywashoe.com
Click: Coalition, thenACHIEVE