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The Evolution of the Steps Program, 2003-2010

This figure depicts a map of the United States and shows where the Steps communities are located. The state-coordinated small cities and rural communities were Washington (Chelan, Douglas, and Okanogan Counties; Clark County; Colville Confederated Tribes; and Thurston County); Arizona (Cochise, Santa Cruz, and Yuma Counties and the Tohono O’odham Tribe); Colorado (Mesa, Pueblo, Teller, and Weld Counties); Minnesota (City of Minneapolis, Rochester-Olmsted County, St. Paul-Ramsey County, and the City of Willmar); Alabama (the River Region and Southeast Alabama); Pennsylvania (Fayette, Luzerne, and Tioga Counties); and New York (Broome, Chautauqua, Jefferson, and Rockland Counties). The large cities and urban communities were Seattle-King County, Washington; Santa Clara County, California; Salinas-Monterey County, California; Austin-Travis County, Texas; San Antonio-Bexar County, Texas; New Orleans, Louisiana; DeKalb County, Georgia; St. Petersburg-Pinellas County, Florida; Tampa-Hillsborough County, Florida; Cleveland, Ohio; Philadelphia, Pennsylvania; and Boston, Massachusetts. The tribes and tribal entities were Southeast Alaska Regional Health Consortium, AK; Cherokee Nation Health Services Group, OK; and the Intertribal Council of Michigan (Bay Mills Indian Community, Grand Traverse Bands of Ottawa & Chippewa Indians, Hannahville Indian Community, Huron Potawatomi Indian Community, Keweenaw Bay Indian Community, Little Traverse Bay Band of Odawa Indians, Saginaw Chippewa Indian Tribe, and the Sault Ste. Marie Tribe of Chippewa Indians), Michigan.

Figure 1. The Steps program map of communities by categories of eligibility.

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The Steps model depicts the association between Steps risk factors and chronic disease focus; use of community coalitions, partnerships, leveraged funds, and resources; implementation of policy, systems, and environmental (PSE) change strategies across all sectors of the population that lead to policies, county and city ordinances, and changes at the systems and environmental level to create sustainable change.

Figure 2. The Steps model.

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The opinions expressed by authors contributing to this journal do not necessarily reflect the opinions of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions.

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