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, MPA
Public 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 Chamber of Commerce
County Manager’s Office Nevada Health Care Coalition
Community Development Join Together Northern Nevada
District Board of Health Truckee Meadows Tomorrow
Library System Chronic Disease Coalition
Parks & Open Space Boys & Girls Club
Public Works Medical Society
Senior Services KNPB
School District
UNR
Cooperative Extension
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)
Washoe County CHANGE
Community-At-Large
Policy
100
90 Environment
80
70
Percentage
60
50
40
30
20
10
0
Physical Nutrition Tobacco Use Chronic Leadership
Activity Disease
Washoe County CHANGE
School District
100
90
80
70
Percentage
60
50
40
30
20
10
0
Policy Environment
Washoe County CHANGE
Youth Serving Organizations - Policy High School
Elementary School
Private School
100
Wellness/Health Center
90 Resource Center
Community-at-large
80
70
60
Percentage
50
40
30
20
10
0
Physical Activity Nutrition Tobacco Use Chronic Disease Leadership Afterschool
Washoe County CHANGE
High School
Youth Serving Organizations - Environment Elementary School
Private School
Health Wellness Center
100 Resource Center
Community-at-large
90
80
70
60
Percentage
50
40
30
20
10
0
Physical Activity Nutrition Tobacco Use Chronic Disease Leadership Afterschool
Washoe County CHANGE
Conclusions
• 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, then
ACHIEVE