Contact Information

Steps to a Healthier New York

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.

New York Project Area

• Broome County: Binghamton (population 200,536).
• Chautauqua County: Jamestown, Dunkirk-Fredonia (population 139,750).
• Jefferson County: Fort Drum, Watertown (population 111,738).
• Rockland County: Ramapo, Nyack (population 286,000).

Target Population of Steps Interventions

• Preschool, elementary, middle, and high school students; parents; teachers; school administrators; and school boards.
• Employers and employees in worksites.
• Business and political leaders.
• Racial/ethnic minorities.
• People living below the federal poverty line.
• People living with a disability.
• Health care providers and health care institutions.
• Families living in households with an individual with asthma.
• People with diabetes or pre-diabetes.
• People 65 years of age and older.

Steps Interventions

Media

• Develop culturally and linguistically appropriate messages on obesity, diabetes, asthma, nutrition, physical activity, breastfeeding, and tobacco use.
• Implement social marketing strategies to promote interventions.
• Create awareness of Steps related chronic diseases and risk factors and promote Steps to a HealthierNY through television, radio, billboards, websites, and print media.

Policy

• Encourage and educate health-care providers to implement patient registries and adhere to appropriate standards of care for patients with diabetes, asthma, and obesity.
• Identify and address environmental and institutional factors in communities, schools, worksites and churches that contribute to disease burden and disparities.
• Develop and implement guidelines for providing healthy foods in schools and worksites.
• Collaborate with farmers and farmers markets to increase access to fruits and vegetables in communities, schools, and worksites.
• Open school buildings and athletic facilities for community walking and physical activity during non-school hours.
• Develop and implement worksite and community venue breastfeeding policies.
• Note: See additional policy-related interventions under school-based, community-based, workplace, and health care categories.

School-Based

• Promote the 5 A Day program in school districts through policy changes, school activities, and communications to community residents.
• Conduct asthma education programs for preschool staff, day care providers, school children, and athletic coaches.
• Train elementary and special education teachers to integrate physical activity into the classroom.
• Implement CDC’s School Health Index assessment and planning guide to identify opportunities to improve physical activity, healthy food choices, and tobacco-free lifestyle programs.
• Create and strengthen district level School Health Advisory Councils and Healthy School Teams.
• Offer financial incentives to schools to implement or enhance nutrition, physical activity, and/or tobacco policy and environmental changes.
• Offer ALA’s Open Airways programs in elementary schools.
• Conduct school-based physical activity programs.
• Institute farm to school programs to increase access to locally grown produce to school districts.
• Train school nurses on cessation counseling and establish a system for delivering cessation services to students.
• Train school personnel to work with families of children who are overweight.
• Establish staff wellness programs in school districts.

Community-Based

• Conduct community physical activity programs and promote the use of existing resources, such as recreational centers, schools, and parks.
• Enlist grocery stores and farmers markets in promotional campaigns to highlight the nutritional value of locally grown produce and low-fat dairy.
• Establish mechanisms for insurance reimbursement for home-based case management programs for children with asthma.
• Determine factors that impede walkability of communities and make appropriate environmental improvements.
• Screen low-income food stamp recipients using the ADA risk assessment tool and provide risk reduction interventions for those who are at high risk for diabetes.
• Conduct weight loss programs in faith-based organizations, communities, schools, senior centers, healthcare facilities, and worksites.
• Conduct maintenance programs for individuals who have previously lost weight.
• Conduct behavior modification programs for families with overweight children.
• Train low-income and African American mothers to be breastfeeding peer counselors and link them with new moms to provide support and education.
• Promote the 5 A Day program in grocery stores, restaurants, and at community events and venues.
• Expand tobacco-use cessation referral systems and provide services.
• Modify restaurant menus to increase healthy food options.

Workplace

• Promote the 5 A Day program, farm to you, and farmers markets at worksites to increase access to locally grown produce. 
• Promote physical activity programs in worksites including walking programs and stairwell point-of-decision prompts.
• Expand healthy food choices in cafeterias, vending machines, and at meetings.
• Conduct worksite assessments and make sustainable environmental and policy changes to address identified gaps.
• Establish worksite wellness committees.

Health Care

• Train health care professionals on standards of asthma care and self-management.
• Establish patient and physician reminder practices that follow current standards of care for obesity, diabetes, asthma, and tobacco use and expand self-management education and case management systems.
• Offer a variety of continuing medical education programs through grand rounds, seminars, and office detailing on standard of care guidelines and availability of community resources on diabetes, obesity, asthma, tobacco, and breastfeeding.
• Improve diabetes care through the development of patient registries.
• Develop an asthma clinic at a university to better control students’ symptoms and to improve self-management skills.
• Educate providers about the ramifications of gaining excessive weight during pregnancy and provide them with tools to council pregnant patients.
• Partner with health care plans to promote Steps interventions.
• Work with health care plans to provide reimbursement for asthma case management services.

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

Departments of education, health, social services, and transportation; various other government agencies; school district personnel; Board of Cooperative Education Services (BOCES); health care providers; health plans; national and local health organizations; faith-based organizations; private sector participants; YMCAs; chambers of commerce; chronic disease and breast-feeding coalitions; cooperative extensions; academic institutions; county executives and other county government personnel; offices for the aging; rural health networks; youth bureaus; Boys and Girls clubs; WIC programs; business community; transit authorities; organizations assisting people with disabilities; prenatal/perinatal councils; alcohol and substance abuse councils; teacher training centers; family resource centers; child and adult food care programs; Head Starts; day care and preschool providers; and environmental resource agencies.

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