The Awards are a component of STEPS to a HealthierUS, a DHHS initiative that advances President Bush's goal of helping Americans live longer, better, and healthier lives. Nine awards were given among the seven categories listed below.

2006 Awardees (Click on programs for summary description)

Faith-based and/or community-based

The Glorifying Our Spiritual & Physical Existence for Life (G.O.S.P.E.L)
Montgomery County Department of Health & Human Services, Wheaton, MD

Health Care Delivery

Clinton Family Health Center
Clinton Family Health Center/Rochester General Hospital, Rochester, NY

Healthy Workplace - Large Employer (greater than 500 employees)

Perdue Health Improvement Program
Perdue Farms, Salisbury, MD

Washoe County School District Wellness Program
Washoe County School District, Reno, NV

Healthy Workplace - Small Employer (500 or less employees)

Step Up for Wellness
Hudson River HealthCare, Peekskill, NY

Non-Profit

Active Start
The OASIS Institute, St. Louis, MO

Public Sector

CATCH Program
University of Texas School of Public Health, Houston, TX

Healthy Hawaii Initiative
University of Hawaii, Hawaii Department of Health, and the Hawaii Department of Education, Honolulu, HI

Schools (K-12)

Alhambra Unified School District Nutrition Network
Alhambra Unified School District, Alhambra, CA

Summaries

Program Area: Faith-based and/or Community-based Initiatives

Program Title:
The Glorifying Our Spiritual & Physical Existence for Life (G.O.S.P.E.L)

Organization:
Montgomery County Department of Health & Human Services

Location:
Wheaton, MD

The G.O.S.P.E.L Program is a faith-based program managed by the Montgomery County Department of Health & Human Services, in collaboration with the Black Minister's Conference of Montgomery County. The program was developed to increase knowledge and awareness among African Americans regarding health disparity issues, especially those related to tobacco. Through a collaborative effort between the Office of Health Promotion and Substance Abuse Prevention and the Black Minister's Conference, the G.O.S.P.E.L. program reaches eleven African American churches and has a team of twenty-three community outreach workers. The outreach team meets monthly to discuss ongoing activities, introduce new topics, receive presentations from speakers on relevant topics, and to distribute resource materials. Trainings are periodically offered for the outreach team to enhance their skills and bring additional resources to the community. Together the team presented multiple health symposiums; conducted individual and group outreach impacting well over 5,000 people; and distributed a wide variety of health resource materials. In addition, the G.O.S.P.E.L. program developed creative interactive teaching tools, such as F.A.I.T.H. Bingo and Smoking Jeopardy, to help program development and motivate the community. Larger scale events included: the Brown Bag Event (pharmacy awareness and doctor-patient communication) and three Heart Health Symposiums. Activities resulting from partnerships included: the Walkways program, the Health Freedom Walk, and a Nutrition Challenge. The program partnered with the Uniformed Services University Center for Health Disparities to conduct an evaluation component. An abstract of the data collected in the first administration of the survey was presented at the Society for Behavioral Medicine and is available upon request.

Program Area: Health Care Delivery

Program Title:
Clinton Family Health Center

Organization:
Clinton Family Health Center/Rochester General Hospital

Location:
Rochester, NY

The Clinton Family Health Center (CFHC) is a Community Health Center located in the heart of the northeast sector of Rochester, NY. The population of this particular portion of the city faces enormous obstacles, including poor health. Thirty-five percent of the residents live in poverty and nearly 50% of those under the age of 18 are poor. In such circumstances, emergency room visits replace primary care visits. Faced with the dilemma of rising emergency room use and growing health disparities in the northeast sector of Rochester, in 2003 CFHC undertook an ambitious and aggressive approach to completely redesigning its delivery system with prevention in mind. The redesign involved six major areas of change over a two year period of time: 1) Team formation - Teams consisted of a provider, nurse and secretary. All patient care and patient matters were handled by that team; 2). Open Access - All patients requesting care get a same-day appointment-regardless of the person's ailment or request; 3). Chronic Care Model - All elements of the Institute for Healthcare Improvement's Chronic Care Model were instilled into daily practice; 4) Chronic Disease Prevention Plan - The Partnership for Prevention action plan for chronic disease prevention was embedded into daily practice; 5) Group Medical Visits - Providers began seeing patients with chronic illnesses in groups of 10 for their routine follow-up appointment. After all the "mechanics" of the visit were completed (vital signs, refills, etc.) there was a built-in educational time for behavioral risk reduction; 6) Data tracking - First by paper and pencil, and later by computer data base, to include: patient's Hemoglobin A1c, blood pressure, LDL-cholesterol, attendance, and overall sense of well being were tracked. The results of the project have been astonishing. Before the project, only 50% of scheduled patients showed for their appointments. Open Access scheduling produced a "show rate" of 95%. There has been a 24% decline in all emergency room visits, and an astonishing 30% decrease in the number of CFHC patients going to the emergency room for non-urgent care. The number of diabetics on their goal Hemoglobin A1C and LDL-cholesterol has nearly doubled; the average Hemoglobin A1C of target population diabetics has dropped from 8.5 to 7.4.

Program Area: Healthy Workplace - Large Employer

Program Title:
Perdue Health Improvement Program

Organization:
Perdue Farms

Location:
Salisbury, MD

Perdue Farms is the third largest poultry company in the United States, with 22,000 employees. Perdue is a leading innovator for health practices in the poultry industry, targeting an employee population that, under most circumstances, would be difficult to reach with first class health care. Perdue's Health Improvement Program focuses on meeting the challenges that come with a target audience that is, for many reasons, often underserved. Participation in the Health Improvement Program is defined by voluntarily being measured by health promotion specialists for 20 modifiable health risk factors, including: Blood Pressure; Exercise Status (self-reported); Height and Weight (BMI); Total Cholesterol and LDL-cholesterol; Tobacco Use (determined by a blood cotenine), with continuous follow-up at intervals of four to six weeks. To get a baseline on the most important drivers of healthcare costs, Perdue nurses measured each participating employee for the20 health risk factors. An example of how the Program encourages risk factor reduction is shown in the following: a male employee is screened for 20 different health risks. Perdue's proprietary computer program determines his four most dangerous health risks. The Health Improvement specialist invites him to select the two that concern him most. If he's most concerned about weight and blood pressure, the specialist coaches him on diet and exercise, directs him to the 40% of Perdue cafeteria menu items that are low-fat and low-sodium, and encourages him to use the on-site walking path. To address health issues at the earliest, least costly, most easily treated stage, Perdue has on-site medical clinics that provide free preventive screenings, plus primary and certain specialty care services. The employee will return for additional coaching and medical follow-up at 4 to 6 week intervals. Results have been dramatic: in the 2004 - 2005 time period, statistically significant risk reduction in blood pressure, weight, tobacco use, exercise and dietary intake was demonstrated. Independent evaluations of data demonstrated overall cost savings (net of program costs) of $161 per individual. These savings do not include reduction in time away from work, worker turnover, or any other indirect or consequential costs.

Program Area: Healthy Workplace - Large Employer

Program Title:
Washoe County School District Wellness Program

Organization:
Washoe County School District

Location:
Reno, NV

The Washoe County School District (WCSD) operates 91 schools spread over a county larger than the state of Delaware. The WCSD Wellness Program targets all 8,800 employees, retirees, and spouses covered under the District's health plan. Each year, over the past 13 years, completion of the annual screening form (Good Health Incentive Program) ranges from 93 - 95% of eligible members (~8,800 employees, retirees and spouses). The total annual voluntary program enrollment (7-8 different programs per year) outside the annual screening has steadily increased since 2000. As of June 2006, the totals had reached 21,849. The program's sole purpose is to reward healthy behavior adherence. An annual physical is heavily promoted, as it builds the vital patient-physician relationship and engages members with individuals that can properly diagnose and treat chronic diseases and high risk factors. All members and spouses have a $40 per month contribution into the Wellness Program, which can be reduced to zero by engaging in appropriate health actions each year (related to ideal blood pressure, tobacco use, and body mass index). This "Good Health Incentive Program" is in place to help members help themselves. It is the member's responsibility to complete this program each year and take health actions if needed. Voluntary participation in four to eight week programs that are fun, educate, engage, and empower members throughout the year is the engine that is driving a cultural shift towards health and well-being in the district and returning millions of dollars in savings. Recent research published, Prev Med. 2005 Feb;40(2):131-7, shows a $15.60 ROI for these programs. A 2003 analysis showed that wellness participants were 26% more likely to be in the lowest quartile of healthcare costs. The most recent analysis from 2001 through 2004 indicated a 7% reduction in the average dollar claim and fewer overall claims for wellness participants. The 2005 analysis will be completed shortly. A functional internet interface moves the behavior change process from the traditional "one-on-one" to a much more cost effective "one-on-thousands" without difficult and costly administrative barriers.

Program Area: Healthy Workplace - Small Employer

Program Title:
Step Up for Wellness

Organization:
Hudson River HealthCare

Location:
Peekskill, NY

The Step Up for Wellness program is open to employees and Board members of Hudson River HealthCare (HRHCare), a network of 12 federally qualified health centers (FQHCs), located in both urban and rural areas. HRHCare's staff and Board reflect the diverse communities served, with a Board that is 65% minority and a staff that is 49% minority-primarily African American and Hispanic. The goal of the Step Up for Wellness Program is to encourage employees to make choices that improve their health. Hudson River HealthCare established the "Step Up For Wellness" program in 2004. The program increases employees' knowledge of basic health outcomes and improves their lifestyle choices and health behaviors. The two major components of "Step Up for Wellness" are: 1) Process Component: Accumulating Activity Points - The incentive program consists of a variety of health and wellness activities that are assigned a point value. Points are accumulated during the year, and at project year end, they are summed to determine level of success, as well as level of financial award, and 2) Outcome Component: Achieving Healthy Results - As participants progress through the activity steps and their health improves, they are given credit for moving toward and/or meeting nationally accepted indicators of health and wellness, such as: blood pressure (less than or equal to 135/85); BMI (less than 25); cholesterol level (200 or less); and smoking status (no smoking). One of the unique aspects of the program is the use of peer Health Coaches to assist employees in setting and reaching goals. Each participant is assigned a Coach, and given a pedometer and tracking booklet covering a 12-week period. Progress is tracked monthly by the Coaches. HRHCare further facilitated participant progress toward goals by initiating walking clubs at various sites and offering workshops on health related topics.

Program Area: Non-Profit

Program Title:
Active Start

Organization:
The OASIS Institute

Location:
St. Louis, MO

Active Start is a two-part "Active Living Every Day" program that consists of: 1) a 20-week physical activity behavior change class, and 2) ExerStart for Lay Leaders, a beginning level exercise class taught by older adults. Active Start was designed to respond to the Center for Disease Control and Prevention's Guide to Community Preventive Services, which provides recommendations for population-based interventions to improve physical activity. The program's overall goal is to increase physical activity and improve functional fitness levels among sedentary, underserved older adults by offering the classes in neighborhood senior centers. Enrollees (low income older adults in Los Angeles) are screened prior to participation to determine their current activity and fitness levels. Taking the project to older adults where they live and training volunteers who are their peers to facilitate the classes, ensures the participants have a neighborhood community setting-where they are comfortable-and have strong social support. Weekly activities include one-hour of behavior change instruction and 90 minutes of light-moderate physical activity resulting in 20 hours of behavior change instruction and 30 hours of physical activity. Senior center staff and older adult volunteers are trained to facilitate Active Start as lay leaders. Approximately 67% are senior center staff and 33% are older adult volunteers. A replication toolkit is in development to explain the process of which OASIS has been successful in implementing the program. Participants have increased their minutes of weekly physical activity. They have also shown improvements in overall mental and physical wellness and self-efficacy for physical activity. Preliminary comparisons between the raw scores on the Senior Fitness Test before and after the twenty weeks indicate that most participants showed improvements on at least three of the six Senior Fitness Test measures.

Program Area: Public Sector

Program Title:
CATCH Program

Organization:
University of Texas School of Public Health

Location:
Houston, TX

CATCH (originally, the Child and Adolescent Trial for Cardiovascular Health) is a multi-component, multi-year coordinated school health promotion program designed to decrease fat, saturated fat, and sodium in children's diets, increase physical activity, and prevent tobacco use. At the completion of the trial, CATCH succeeded in producing lasting changes in dietary and physical activity behaviors in the targeted population (at the time, third to fifth graders). Currently CATCH (the Coordinated Approach to Child Health) is a breakthrough obesity prevention program that focuses on improving school environments to increase student physical activity and healthy dietary practices. The program's primary purpose is to create healthy children and healthy school environments. The CATCH Texas staff achieves this goal by implementing effective coordinated school health programming (CSHP)-using CATCH, in every school in Texas. CATCH is a coordinated school health program which builds an alliance of parents, teachers, child nutrition personnel, school staff, and community partners to teach children and their families how to be healthy for a lifetime. The four CATCH components-Go For Health Classroom Curriculum, CATCH Physical Education, Eat Smart School Nutrition Guide, and family Home Team activities-reinforce positive healthy behaviors throughout a child's day and make it clear that good health and learning go hand in hand. Successful implementation of CATCH requires that every school is educated in the need for and benefits of CATCH. In addition, every school is trained to implement all components of CATCH. Logistical support is provided before and during the implementation process. New and revised CATCH products, training programs, and advocacy networks are developed to effectively support the institutionalization of CATCH in all schools. Recently the Houston Endowment granted 2.4 million dollars for CATCH implementation in all 400+ Harris County elementary schools, potentially reaching another half million Texas children. It is estimated that 1,911 Texas schools have adopted and implemented the program reaching a potential of 900,000-elementary schoolchildren.

Program Area: Public Sector

Program Title:
Healthy Hawaii Initiative

Organization:
University of Hawaii, Hawaii Department of Health, and the Hawaii Department of Education

Location:
Honolulu, HI

The Healthy Hawaii Initiative is the only long-term, statewide program to implement a social ecological approach to reduce obesity, increase physical activity, and improve nutrition. The collaboration between the state department of health, state department of education, and the University of Hawaii provide a true multidisciplinary setting to develop and test interventions. The goal of the Healthy Hawaii Initiative (HII) is to increase the years of healthy life for all people of Hawaii and reduce existing health disparities among ethnic groups in Hawaii. The goal is addressed by creating sustainable changes that promote health lifestyles, in particular through nutrition and physical activity promotion. Interventions are targeted at the individual, social, and environmental level and use a variety of channels. Several evidenced-based programs, including the 1% or less low-fat milk campaign, have been successfully adapted and culturally tailored to Hawaii's population to facilitate behavior change. Between 2000 and 2006, HHI interventions were divided into four main delivery channels: 1) community-based interventions, 2) school-based interventions, 3) public education, and 4) professional education. These channels focused on a variety of different strategies to effect behavior change. The evaluation design was developed using the CDC's 7-step model for evaluating physical activity programs. The evaluation is divided into long-term (10-20 years), intermediate (5-10 years) and short-term (2-5 years) indicators. Long term outcomes focus on health conditions significantly related with physical inactivity and poor nutrition, such as stroke and cardiovascular disease mortality and diabetes prevalence. Behavioral data results are showing positive trends. No leisure time physical activity in adults decreased by 7.2% from 25.5% in 1999 to 18.3% in 2003. Over the same time period, the percentage of adults eating five or more servings of fruit/vegetables a day also increased by 5.2% from 22.4% to 27.6%. The rate of overweight and obese adults decreased by 0.2%-the rest of the U.S., the median of overweight and obese increased by 3.0%. In 2003, Hawaii ranked first among the 50 states in percentage of people who where neither overweight nor obese, fifth in fruit and vegetable consumption, and 17th in adequate leisure time physical activity.

Program Area: Schools. K-12

Program Title:
Alhambra Unified School District Nutrition Network

Organization:
Alhambra Unified School District

Location:
Alhambra, CA

Alhambra Unified School District Nutrition Network supports students in building healthy lifestyle habits. Nutrition education is provided through interactive learning, classroom instruction and cooking, increasing physical activity, and developing strategies to overcome barriers to a healthy diet-thus empowering students to make behavioral changes. The primary target audience is Grades PreK-12 students and their families of low income, less than 180% poverty level (identified by 50% or more of students receiving free/reduced priced meals at school sites). The ethnicity of the district is comprised of approximately 48% Asian Pacific Islander, 42% Hispanic, 10% Other (White, African American, Native American). The program has a strong commitment to ensure that the needs of all students are met. The Nutrition Network reaches all grades Pre-K through 12th. Special needs children are provided nutrition education instruction, including the provision of sign language interpretation where needed. Nutrition activities are incorporated into all curricular areas such as language arts, math, social studies, and science. The Nutrition Network is district-wide at all elementary and high school locations. Nutrition Network develops lessons and disseminates standards-based curricula that guides youths to develop self efficacy towards making healthier choices and being physically active. The entire Alhambra Unified School District community is committed to Nutrition Network. Results indicated a statistically significant increase in preferences for fruit and vegetable consumption and an increase in student self efficacy skills. Behavioral changes included student increased ability to ask their families to provide healthy food choices for home, i.e., fruits, vegetables, and 100% juice. In addition, there was an increase in students helping to prepare a salad/vegetable items at home, as well as choosing fruits and vegetables for a snack.