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The CRI-MEZCOPH Healthy Steps for Families Demonstration Project was developed to help parents become better role models for their children around issues related to health and wellness. With chronic diseases such as diabetes and heart disease posing a clear and immediate threat to children, more needs to be done to help children begin their lives by taking steps toward developing healthy eating and exercising habits. This project aims to influence children’s behavior where it is first learned, in the home. We provide parents with strategies that help them to become healthier role models. These strategies include walking more, playing outside with their children, cooking with less fat, and ensuring fruits and vegetables are part of every meal. When parents adopt those practices, they are building a foundation for a healthier life for themselves and for their children. This foundation of healthy habits makes for healthy parents and provides children with a blueprint for healthy living that can last a lifetime and lead to a long-term reductions in chronic disease.

This demonstration project consists of 12 two-and-a-half-hour interactive sessions where parents of Head Start children participate in physical activities, hands-on cooking demonstrations, attend health education sessions, and join walking groups. All project components are grounded in the best practices of health literacy. They are easy to understand, interactive, and appropriate to the cultural and linguistic abilities of the participants.

Our Partner
The Healthy Steps for Families Demonstration Project is implemented in collaboration with the Canyon Ranch Center for Prevention and Health Promotion (CRCPHP) at MEZCOPH. The CRCPHP focuses on interventions to prevent chronic disease through community action to change behavior, policy, and the environment. Research and programming through the center seeks to contribute to the reduction of health disparities and improve the health status of multiethnic communities primarily in the U.S.- Mexico border region.

Community-based Collaborating Agencies
CRI and the CRCPHP believe it is important that this demonstration project work directly with community organizations that serve the families of Tucson. A natural place to locate families and children are in early care and education settings. One such setting is Head Start, a federal preschool program serving low-income children up to age five. Head Start includes education, health, nutrition, and social service outreach to parents. Child Parent Centers, Inc. is the Head Start grantee for southeastern Arizona and has been a part of this program from the beginning. We have implemented this program with their families at several Head Start locations in Tucson, AZ.

The Pima Community College and Cochise College family literacy programs work with Head Start to provide literacy, language, and parent education as well as parent-child activities for Head Start families. Family Literacy provides classes for parents of Head Start children and other families in Tucson and is a natural setting for the Healthy Steps for Families program.

Program Curriculum
The Healthy Steps for Families Demonstration Project uses the Pasos Adelante (Steps Forward) Spanish language curriculum. Pasos Adelante is an adaption of the National Institute of Health’s, National Heart Lung and Blood Institute’s Su Corazon, Su Vida (Your Heart, Your Life) curriculum that was designed to enhance chronic disease prevention and control in an older population. Pasos Adelante was first adapted, piloted, and evaluated in border communities of Southern Arizona. The curriculum was further adapted to include parenting issues related to food and physical activity and to target a younger population in Tucson as part of the CRI-MEZCOPH Healthy Steps for Families Demonstration Project.

Program Evaluation
CRI and MEZCOPH developed, implemented, and are currently evaluating this community-based intervention to ensure that the demonstration project measurably improves the health and wellness of families in Southern Arizona. Early evaluation data indicate significant drops in BMI and waist size. Two factors that are related to chronic disease risk reduction. These healthy gains are the result of the healthy changes they are making in their own lives and are providing healthy examples for their children as well.

Adult participants in the Healthy Steps for Families Demonstration Project are evaluated via questionnaires, lab results, and physical measures to help assess the program’s outcomes. The evaluation of the CRI-MEZCOPH Healthy Steps for Families Demonstration Project will provide a solid foundation for future project growth and useful information that will help to develop future demonstration projects.

Program Launch
The CRI-MEZCOPH Healthy Steps for Families Demonstration Project was launched in August, 2007 with a collaborative needs and assets assessment conducted with Child Parent Centers Inc. This assessment identified significant challenges and opportunities for working with local Head Start families, specifically a need for health-literate programming focusing on the prevention of chronic diseases.

In January 2008, at the request of Child Parent Centers, the CRI-MEZCOPH partnership completed a 12-week worksite intervention with Child Parent Centers' leadership and administrative staff. This provided an opportunity for the leadership and staff of Child Parent Centers to learn about the concepts of chronic disease prevention that are the foundation for the CRI-MEZCOPH Healthy Steps for Families Demonstration Project.

The demonstration project launched its first 12-week session targeted at parents in October, 2008. During this first phase of the CRI-MEZCOPH Healthy Steps for Families Demonstration Project, many participants reported sharing recipes and health information with their families as well as making simple changes in their daily choices, such as reducing consumption of sugary drinks or choosing healthier fats.

What's Happening Today
We are currently in our second full year of programming and working to strengthen the program and ensure continued success. During the summer of 2009, we worked closely with Family Literacy to adapt the curriculum to meet the needs of the adult education environment, including development of health vocabulary and expanding the timeline to allow the curriculum to match their academic schedule.

In early 2009 we expanded the training component and invited Head Start and Family Literacy staff to Canyon Ranch for a Health and Wellness Workshop. We also developed a peer leader program for the families who participated in the program last year. This allows parents who are repeat participants in the program to learn new skills around facilitation and peer mentoring and help support those who are participating in the program for the first time.

In addition to the refinement of ongoing programs in Tucson, AZ, we have expanded to the border community of Douglas to build upon the success generated by promotoras (community health educators) who have been working there for many years. In Douglas, we are serving parents at two Head Start facilities as well as integrating into an additional Family Literacy program housed at the Cochise Community College as part of their adult education initiatives. Since the initial launch in fall of 2008, the CRI-MEZCOPH Healthy Steps for Families Demonstration Project has collectively served over 100 parents and grandparents and impacted the lives of nearly 300 children.

Next steps
The evaluation data collected at all sites are currently being analyzed and will be used to inform next steps. CRI and MEZCOPH are working with leadership and instructors at Family Literacy and Head Start to determine the best way to ensure future sustainability of the demonstration project within their organizations. With an eye towards expansion, we will continue to investigate ways this program can grow sustainably. We will also continue to adapt the program based on the evaluation outcomes in order to better understand and meet the needs of participants.


Partnership photographs:



Children at the Southside Tucson Head Start Center play together while their mothers participate in the Healthy Steps for Families Demonstration Project. The program is focused on helping mothers to be healthy role models for their children. (February 2009, Tucson, Arizona)




The Healthy Steps for Families Demonstration Project provided the opportunity for parents to learn about disease prevention and how to teach their children healthy habits. (February 2009, Tucson, Arizona)




Healthy Steps for Families Demonstration Project participants teach their children about the importance of exercise. Each Healthy Steps for Families program session contains a physical activity component.
(February 2009, Tucson, Arizona)




CRI-MEZCOPH Healthy Steps for Families Demonstration Project participants get hands-on experience preparing healthy meals that are shared by all. A new recipe was tried at each session, and participants were encouraged to bring in their own recipes to adapt to include healthier ingredients.
(November 2008, Tucson, Arizona)




Healthy Steps for Families Demonstration Project participants from the Family Literacy program graduate the 12-week course.
(April 2009, Tucson, Arizona)