Contact Information

Steps to a Healthier Cleveland

The Steps Program funds states, cities, and tribal entities to implement community-based chronic disease prevention efforts that are focused on reducing the burden of obesity, diabetes, and asthma and addressing three related risk factors: physical inactivity, poor nutrition, and tobacco use.

Project Area:

• Entire City of Cleveland, Ohio; population 478,403

Demographics of Project Area:

• 51% of residents are African American
• 31% of residents live below the federal poverty line
• 47% of children live in poverty
• There are some 65,000 students in the Cleveland Municipal School District
• 20% of Clevelanders are 55 years of age and older
• Cleveland is home to some 117 identified ethnic groups
• Cleveland has 36 distinct neighborhoods

Target populations for Steps interventions:

• The entire City of Cleveland, Ohio will be targeted to include racial and ethnic minorities; low-income persons; those living in at-risk neighborhoods; and the medically underserved.

Lead Agency:

• The Cleveland Department of Public Health (CDPH)

Steps Activities:

Media/Communications

• Create and effective and efficient internal communications plan that includes Steps branding and staff development.
• Incorporate public service announcements (PSA’s) into the already existing morning announcements in all schools. 
• Leverage resources and enhance existing social marketing campaigns to address improved nutrition and physical activity.  Messages will be expanded to include tobacco use and exposure as well as asthma.
• Design and revise collateral pieces to expand the Cleveland Steps message through billboards, city kiosks, press releases, websites, fact sheets, and special programming.
• Create program-area specific toolkits.

Policy

• Adopt competitive food policies in select K–8 and high schools.
• Promote smoke-free worksites and public places; promote and educate on clean indoor air/smoke free Cleveland legislation.
• Advocate for changes in the built environment to support health behavior improvements, such as a completed Tow Path, new bike lanes, and worksite vending machine improvements.
• Enforce tobacco-free school environments.   

School-based

• Expand the “Open Airways” and “Tools for Schools” asthma programs into additional schools.
• Implement a sports and asthma education program for coaches and teachers.
• Expand SHOUT youth tobacco prevention programs into intervention schools.
• Reduce diabetes and obesity through enhanced nutrition education, diabetes management for school personnel, and expanding the “Grab n Go” breakfast program.
• Improve the nutritional quality of food and beverage options served in schools.
• Increase lunch time physical activities, including school pedometer competitions.

Community-based

• Use GIS mapping to assess healthy food, physical activity outlets, and smoke-free environments.
• Create and distribute maps of intervention neighborhoods.
• Implement “Safe Routes to School” program citywide.
• Create additional community gardens and introduce the practice/concept of gleaning and market gardens.
• Place healthy recipes in local supermarkets.
• Provide bicycle racks to all intervention schools.
• Promote and support selected local sporting and health events.

Worksite

• Expand and enhance workplace wellness programs to include asthma, smoking cessation and clean indoor air policy.
• Expand direct services to Cleveland Municipal School District staff.
• Support and expand the “Healthy Cleveland Business Council” through outreach to Cleveland-based businesses, thereby, expanding worksite wellness programs in more businesses throughout Cleveland.
• Promote walking and biking clubs, starting with Downtown Cleveland businesses.
• Engage providers and insurers in discussion on policy changes, including lowering premiums for companies with worksite wellness programs.

Healthcare Provider Education (HCPs)

• Identify and engage local health care providers into the CCBH “DIET” (Dietitians Involved in Education and Training) Program to provide trainings in the areas of prevention and management of pediatric obesity and related chronic diseases.
• Offer random chart audits for physicians to assess the prevalence of pediatric    obesity and related chronic diseases among patients ages 3–18.
• Use toolkits as incentives that provide literacy appropriate and culturally diverse educational materials, resources, and references for the health care providers and their patients on obesity, diabetes, asthma, physical activity, nutrition and tobacco use and exposure. 
• Support the Annual Asthma Educator’s Institute.

Community Health Workers (CHWs)

• Continue to develop a formal network of Community Health Workers.
• Provide continuing education to enhance proficiency.
• Increase referrals to healthcare providers.
• Increase screenings for diabetes, asthma, hypertension, etc.
• Engage faith-based community leaders as CHWs.

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 progress toward program goals. 

Partners:

American Cancer Society; American Diabetes Association; American Heart Association; American Lung Association/Greater Cleveland Asthma Coalition; Anthem Blue Cross Blue Shield in Ohio; ASIA, Inc.; Case Western Reserve University; The Center for Community Solutions; City of Cleveland; City Year; ClearChannel Communications; Cleveland.com; Cleveland Municipal School District; Cleveland Neighborhood Development Corporation; Cuyahoga Community College; Cuyahoga County Board of Health; Diabetes Association of Greater Cleveland; El Barrio, Inc.; EcoCity Cleveland; Environmental Health Watch; Kaiser Permanente of Ohio; Kent State University’s Urban Design Center; ParkWorks; Medical Mutual of Ohio; MetroHealth Medical System; Mt. Sinai Health Care Foundation; Neighborhood Family Practice; Neighborhood Progress, Inc.; Northeast Ohio Neighborhood Services; Ohio Department of Health/Healthy Ohioans; The Ohio State University Extension – Cuyahoga County; Saint Luke’s Foundation of Cleveland; QualChoice/University Hospitals; Slavic Village Development/Active Living by Design; Sherman Consulting LLC; The Sherwin-Williams Company; St. Vincent Charity Hospital; United Pastors in Mission; WellCorp; YMCA of Greater Cleveland. 

Page last reviewed: May 2, 2008
Page last modified: August 13, 2007
Content source: Division of Adult and Community Health, National Center for Chronic Disease Prevention and Health Promotion