1. 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

2. What is ACHIEVE? ACHIEVE stands for Action Communities for Health, Innovation, and EnVironmental changE Part of the CDCs 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

3. 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

4. Washoe County CHART County Commission County Managers 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

5. 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)

6. Washoe County CHANGE Community-At-Large

7. Washoe County CHANGE School District

8. Washoe County CHANGE Youth Serving Organizations - Policy

9. Washoe County CHANGE Youth Serving Organizations - Environment

10. 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.

11. 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

12. 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

13. 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

14. The Washoe County ACHIEVE Community (2010 – 2011) For More Information: Nationally: www.achievecommunities.org Locally: www.gethealthywashoe.com Click: Coalition, then ACHIEVE