Healthy Steps to Freedom: helping women battle addiction
In Nevada’s Florence McClure Women’s Correctional Center in Las Vegas, a maximum security prison, women like Ashley, a 36-year-old mother of two teenage boys, are using their prison time to learn how to address the root causes of what landed them there in the first place. And, unlike most incarcerated men, many women are incarcerated for nonviolent crimes with the underlying catalyst being addiction. Often, the women have used drugs because they, like Ashley, have body image issues or want to lose weight.
Besides body image issues and weight loss, women are also using opioids and methamphetamines to increase their energy, elevate their mood or cope with pain – emotional and physical. The increase in the use of these drugs by women is staggering, Extension Associate Professor Anne Lindsay, a specialist in public health and exercise science, said.
From 1999 to 2015, synthetic opioid-related
Deaths are up 850%
In Nevada, women account for
46% of deaths
due to opiod overdose
From 1999 to 2015, female opioid prescription
Deaths are up 417%
(Male deaths are up 218%)
Lindsay said women in treatment, whether in a treatment center or in a correctional center receiving treatment, need their substance abuse treatment augmented with gender-responsive, health-related programming. Gender-responsive programming is designed based on the lives, strengths and challenges of woman, as opposed to traditional treatment programs designed for men. So, Lindsay developed the Healthy Steps to Freedom Program.
According to Associate Warden Najera at the Correctional Center, the program is a key component in helping to prepare women to re-enter society and to reduce recidivism (returning to prison).
Ashley, who has been at the Correctional Center before, says she has been soaking in as much information as she can this time around to try to prevent returning to prison. She said the program has given her tools to help her achieve the goals she has now set for herself when she gets out.
Healthy Steps to Freedom Program participants experience:
Improved healthy weight perceptions
Improved nutrition and health behaviors
Increases in physical activity
Improved attitudes about eating, binge eating and other disordered eating behaviors
Improved perceived body image and perception of themselves
Positive changes in intuitive eating, eating based on natural hunger and fullness cues
Lindsay is partnering with CASAT, the Center for the Application of Substance Abuse Technologies, at the University to help provide training and support for professionals in the field to facilitate implementation of the program in Nevada, Utah and across the nation. She is also partnering with others in the state to form a coalition to help with gender-responsive core issues that are unique to women.
Understanding each woman's story to help her recover
“These women come from all walks of life, and each has their own story. If we help them address their root causes, they can recover. When I see past participants of our program healthy and with their children, it doesn’t get any better than that.” -Anne Lindsay, Extension associate professor
Extension's Heart & Hope Program works to prevent domestic violence
Our Battle Born state's domestic violence rates are some of the highest in the nation. Associate Professor Jill Baker-Tingey, who is the Extension Educator for Elko County, works to reduce violence in Nevada through her Heart & Hope: Rural Domestic Violence Prevention Program, formerly Heart & Shield. The program was grant-funded for five years and is continuing beyond the grant due to strong community support, including from school counselors, social workers, tribal council and law enforcement.
Through the program, Baker-Tingey and her staff engage small groups of youth and their nonabusive parents with the nine-week Heart & Hope curriculum. The curriculum provides families with experiential learning activities. The experiences are designed to teach the families skills in teambuilding, communication, conflict management, problem solving, emotional literacy and more. In the program, families learn how to strengthen their relationships and break the cycle of violence.
Learn the hard truth about domestic violence
Including answers to questions such as:
- What does domestic violence look like?
- What is the cost of domestic violence?
- Why don't victims just leave?
- Why should I care?
- How can I help?
The program inspires positive behavioral changes in parents and youth:
Parents are better able to stay calm and use positive guidance with their children
Parents are better aware of and attentive to self-care, which improves their ability to care for their children
Youth are better able to name emotions, describe their feelings and generate solutions to solve problems
Parents are are better able to understand their children’s feelings
Growing closer and healthier families
"The different topics helped my family grow closer and healthier together." "Before the program, we did not spend time together as a family. Since we’ve been involved with this program, we have a family activity at least three times a week!" "We are definitely more communicative. When we feel something is wrong, we are able to problem solve. We share affection more on a daily basis, we’re more productive, more understanding and we’re better listeners." -Heart & Hope Program participants
Extension aims to help older adults stay healthy amid COVID-19
The aging population has been particularly at risk since the COVID-19 pandemic erupted earlier last year. Natalie Mazzullo, Extension healthy-aging specialist, has been helping to create a safe and engaging environment for homebound seniors in Nevada.
Mazzullo serves as an action team member for the state’s Nevada COVID-19 Aging Network Rapid Response Team, known as Nevada CAN. Nevada CAN is focused on keeping elders safe from exposure to the virus while ensuring they are well-supplied, have access to medical and social services, and remain free from isolation.
As part of the action teams’ response, Mazzullo helped to coordinate Extension’s support to provide information on where elders in need could access food and to identify volunteers to assist with food delivery.
Since April 2020, Mazzullo and Extension’s healthy-aging team has worked to ensure that some of the most vulnerable and needy elders still have access to resources and activities to aid in their well-being, despite the ongoing pandemic. Year-round, they help develop action plans that promote access and appeal around nutrition and physical activity that are uniquely tailored to the needs of communities where elders live and congregate.
Mazzullo also serves as the assistant director for the Sanford Center for Aging’s Nevada Geriatric Education Center at the University, provides direct oversight for the Nevada Healthy Aging Alliance and sits on various other committees.
Helping Nevada's elders
"I am honored to be part of the Nevada CAN action teams to assist Nevada’s elders with social engagement and food and medication. As a result of Nevada CAN and the efforts of so many compassionate and caring professionals and volunteers, Nevada elders have had the opportunity to become connected with much-needed services." -Extension Specialist Natalie Mazzullo
Nutrition professor helps Nevadans lead healthier lives
Many factors affect how healthy we are now and how healthy we will be in the future. One of the few that we can control and change to improve our health is how we eat.
"A healthy diet is one of the most powerful tools we have to reduce the risk of the leading causes of death and disability," Professor Jamie Benedict, chair of the College's Department of Nutrition, said.
However, much of the information we receive about food and health is misinformation. Armed with bad information, we are less able to make positive changes to our diet. That's where David St-Jules, a registered dietitian and assistant professor with the nutrition department, comes in.
"I’m a public servant," St-Jules said. "I have a responsibility as a state employee and nutrition expert to use my expertise to help improve the health and well-being of the people of Nevada. I don’t gain anything by telling people to eat one thing versus another. I'm just here to help. And that’s my goal."
To help, St-Jules has offered several nutrition programs since joining the College in fall 2019.
Helping the helpers
St-Jules collaborated with local medical professionals, empowering them to use nutrition to manage harmful and costly diet-related conditions once they occur and to prevent them altogether.
For Renown Health, St-Jules provided two rounds of presentations to hospital staff on disease management. One was about kidney failure; the other was about fatty liver disease related to childhood obesity. But in each, St-Jules discussed how the patients' conditions can be managed through diet. About 30 or more doctors, pharmacists, residents and medical students attended each of the two, hour-long talks.
St-Jules also provided two trainings for food and nutrition professionals who have met the strict education and experience requirements to become registered dietitians. A dozen attended each workshop, which together provided about six hours of continuing professional education at no cost. The first workshop was about malnutrition and how to uncover a patient's nutritional needs with a physical exam. The second was about how diet can be used to keep kidney dialysis patients' blood potassium from reaching dangerous levels.
With Hometown Health's HealthyTracks Program, St-Jules provided an hour-long Take a Bite out of Wellness talk for patients and staff. About 80 people attended and learned how to prevent chronic diseases with a healthy diet that includes plant-based foods.
"We don’t yet use the preventative aspects of diet very well in our health care system," St-Jules said. "If you wait until organ failure, end-stage kidney disease, you’ve missed the bulk of the opportunity. By this point, you’re managing severe problems and are unable to reverse them. By doing talks like these, we can reach people with the preventative benefits of nutrition."
Encouraging elders to eat well
St-Jules partnered with the University's Osher Lifelong Learning Institute to develop a two-part Foundations for a Healthy Diet course for elders.
"OLLI is about healthy aging," Kristen Kennedy, Institute executive director, said. "And, good nutrition is necessary for older adults to maintain good health and quality of life. We felt like our members would really benefit from Dr. St-Jules' information."
He offered the course twice in spring 2020 to about 125 people.
"It was a success," Kennedy said. "The information reached a lot of our members who deal with issues such as arthritis, osteoporosis, memory loss, cataracts and changing hormones. Nutrition plays a large role in slowing down or even preventing some of these issues. The class fit perfectly."
Serving those who served
In fall 2020, St-Jules facilitated a joint research symposium for his department and the U.S. Department of Veterans Affairs. The event included about 30 medical and nutrition professionals, and it is expected to foster increased collaboration to better help Nevada's veterans.
"Dr. St-Jules approaches his work with passion and enthusiasm and is always eager to pursue new collaborations,” Benedict said. “His relationships with medical and nutrition professionals throughout northern Nevada are a reflection of this characteristic. The resulting collaborations will ultimately benefit the community at-large.”
Protecting the population
Early in the pandemic, St-Jules published an article on the University’s Nevada Today website to help Nevadans know what to eat to help resist COVID-19. He discussed how to keep immune systems fueled and functioning, and answered common food-related coronavirus questions.
"When faced with the threat of a currently untreatable, potentially fatal disease, it is common for us to look to diet for a potential cure," St-Jules wrote. "Arguably, the best thing that people can do to help combat coronavirus is to follow the evidence-based guidelines for healthy eating."
The piece provided important and accurate information for Nevadans when they needed it most, and was the University's 16th most-viewed article of 2020.
Growing healthy youth
St-Jules developed and recorded a three-part lecture series on Eating for Good Health for the University's Northern Nevada International Center. The Center will use the series to engage youth refugees with health and nutrition information.
Making a difference in people's lives
"We need to focus on all life stages, so I talk to kids and adults. Everyone benefits from having that basic understanding of nutrition. It’s important across the life span. I think there’s a lot of opportunity there to make a difference." -Assistant Professor David St-Jules
Rethink Your Drink Program encourages healthy drinks
When children drink too many sugary drinks, their risk of cavities and obesity increases. They may also miss out on important nutrients found in healthful drinks. Professor Jamie Benedict, chair of the College's Department of Nutrition, has been working to reduce these issues among school-aged children through her Rethink Your Drink Program.
It encourages parents to provide children with healthier drink options, such as water, 100% fruit juice or low-fat milk, instead of offering them soda, sports drinks and other sugary beverages. The program also provides healthcare professionals, including doctors and dentists, with tools and tips they can use to educate patients about healthy drink choices.
The program is offered in collaboration with the College's Extension unit. It's funded by USDA’s Supplemental Nutrition Assistance Program — SNAP. SNAP provides nutrition assistance to people with low incomes.
In 2019 and 2020, Benedict, her nutrition graduates and her Rethink Your Drink Program experts supplied Nevada families with answers to common questions on healthy drink choices, recipes, tips and more:
Should you buy drinks with added electrolytes?
Why is it important to limit 100% fruit juice?
How much water does my family need?
How do I tell if there’s added sugar in my drink?
What are some healthy holiday tips?
Should I buy organic milk for my family?
Are milk alternatives good for my kids?
Are energy drinks bad for children?
Should kids have drinks with caffeine?
How do sugary drinks affect weight?
What are some healthy drinks to drink during quarantine?
How can I help my family make healthier drink choices?
What’s important to know about flavored waters sold in stores?
What's important to know about fruit-flavored drinks?
Fostering healthy Nevada communities
"There is a stage in a child's life when parents have more control over what their children are consuming. This creates an opportunity for parents to have a positive influence that can provide health benefits for their children long into the future." -Professor Jamie Benedict
New SNAP-Ed programming strategy helps Extension serve more than 38,000 people
In recent years, the College’s Extension unit made a strategic change to how it approached Supplemental Nutrition Assistance Program Education (SNAP-Ed) programming. This change brought grant applications and program efforts under one statewide plan that has allowed the program, which aims to improve the health and nutrition of those eligible to receive SNAP benefits, to grow and increase its impact throughout the state. These changes were fully implemented beginning in July 2019, and allowed the program to serve more than 38,000 individuals in the state that fiscal year (July 2019 – June 2020). This was an increase of more than 1,100 compared to the prior fiscal year.
The program uses direct education approaches, such as hosting classes, and indirect education approaches, such as e-newsletters, flyers and social media. Along with the integration of those methods, the restructured approach focuses on helping the community make changes to their policies, environment or operations that promote healthy behaviors and ultimately make healthy choices simple and convenient, increasing long-term impacts. Such approaches include site visits, such as to child care centers, schools or senior centers, and the development of action plans to make such sites more active or to increase healthier food and drink options.
"If we hold a class and 10 people attend, then we’ve reached 10 individuals. But policies and environmental changes have a larger and more long-term impact. If we help implement a change at a senior center, such as promoting healthier menus and organizing walking groups, for example, then we can affect everyone there." -Anne Lindsay, Associate Professor and Extension State Specialist
SNAPping into education early
Through the Healthy Kids, Early Start Program, which is focused on educating preschool-aged children and their parents and teachers, and using policy, systems and environmental approaches, Extension:
The Healthy Kids, Early Start direct education curricula – All 4 Kids and Little Books & Little Cooks – reached 2,124 individuals. All 4 Kids is an eight-week program that includes three 30-minute preschool lessons each week that incorporate dancing to introduce children to specific movements outlined in the Nevada Pre-K Standards. Additionally, the program encourages families to build healthy habits together by completing activities that reinforce the importance of good nutrition and physical activity. The program Little Book & Little Cooks is a seven-week, parent-child series of classes with cooking and reading activities designed to promote healthy dietary patterns among preschool-aged children. In addition, the Healthy Kids Resource Center website received 10,911 page views from 3,574 unique users.
Extension collaborated with school wellness coordinators through the Healthy Kids, Healthy Schools Program and was able to help schools meet their school wellness policy goals, resulting in positive changes in 11 schools throughout the state. The program also reached 5,172 students using other lessons and programs, such as Produce Pick of the Month (formerly Pick a better snack™), Grow Yourself Healthy and Coordinated Approach to Child Health (CATCH) Afterschool lessons. Produce Pick of the Month is a monthly, in-school nutrition education program for primary grade children in high-needs elementary schools in Clark and Washoe Counties that focuses on building fruit and vegetable consumption in children through healthy snacking. Grow Yourself Healthy has a similar goal but takes students into a school garden for hands-on learning. CATCH is an afterschool nutrition education program offered in Washoe County at Reno Housing Authority Community sites.
Graduate of the Pack | Ana Nunez Zepeda
Ana, a recent graduate of the College, teaches nutrition programs to families in Extension's CATCH Programs.
Ana said, "It’s important that there are people doing what I do because we can help our community by teaching them how to have a healthy lifestyle."
SNAPping up healthy activity and food more easily
With effective programming to reach youth in the state previously in place, new strategies to reach adults and the aging population were added to help improve food resource management and consumption of daily fruits and vegetables among SNAP-eligible adults and seniors. These included the Healthy Aging and Healthy Food Systems Programs.
In 2019, the Healthy Aging initiative was developed in partnership with the University's Sanford Center for Aging to increase physical activity and healthy eating among the aging population. As part of this effort, a statewide policy, systems and environmental task force was initiated to improve senior health outcomes and reach across the state. Classes and programs were implemented in senior centers, apartment communities and recreation centers.
These efforts reached 183 adults through the Seniors Eating Well Program, which is a nutrition-education program that includes food demonstrations and educational materials designed to teach older adults how to maintain a healthier lifestyle. Another 141 adults were reached through the initiative's Stay Strong, Stay Healthy Program, which was an eight-week exercise program that incorporates the latest research to help older adults develop the fitness, flexibility and balance that will enable them to live independently. At the same time, wellness champions – individuals representing the organization in the form of residents, staff or community members whose goal is to create change and provide access to healthier lifestyles – were identified at four Clark County apartment communities for seniors with limited resources, and 10 new Stay Strong, Stay Healthy certified instructors were trained through a train-the-trainer model, ensuring that the information will be shared many times over.
Healthy Foods Systems focuses on increasing access to healthy foods, specifically among those using SNAP benefits. Using the Maine Farmers Market Nutrition Education curriculum, Extension developed the SNAP Into Farm Fresh Foods Program to raise awareness among limited-resource adults and families in Clark, Lyon and Washoe Counties about using their SNAP benefits at farmers markets, with an overall goal of increasing their daily consumption of fruits and vegetables. The program's direct and indirect education efforts about the use of SNAP benefits at farmers markets reached 1,670 participants across 23 sites.
"I am pleased that Nevada's SNAP-Ed plan includes support for healthy food systems programming," Assistant Professor and Public Health Nutritionist Aurora Buffington said. "The way we treat people, manage resources, and accomplish the activities needed to bring food from farm to table and beyond influences the health of our residents not only physically, but economically and socially. Our programming is designed to help make the healthy choice the easy choice, and I am proud of the work our teams have been able to accomplish."
The effort to increase the use of SNAP benefits at farmers markets included systems and environmental changes, such as developing promotional banners and posters to raise awareness and establishing a central terminal booth to accept SNAP benefits, removing a common barrier for vendors at markets. This booth was staffed by Extension to provide support to the participating farmers market, share nutritious recipes and other healthy information, and gather data to prove its value and so it could be replicated at other farmers markets. Extension staff also provide technical assistance to farmers market managers who want to become authorized to accept SNAP benefits. As the administrative burden can be a potential barrier for accepting SNAP benefits, Extension is working with market managers and vendors to develop solutions to ensure that individuals and families with limited resources have access to healthy options.
Lindsay, Buffington and their teams plan to continue moving forward with the new strategy and are developing more projects to help all Nevadans stay healthy.
Making an impact in communities throughout the state
"We have the ability to make an impact because Extension has community roots and connections throughout the state, including all rural counties." -Associate Professor and Extension State Specialist Anne Lindsay
Extension program helps Nevadans avoid exposure to cancer-causing gas
Extension’s Radon Education Program, led by Program Director Susan Howe, offers free short-term radon test kits to Nevadans each year in January and February. The test kits are available at Extension offices and partnering locations statewide.
Radon is a naturally occurring, radioactive gas that is colorless, odorless and tasteless. It comes from the ground and can accumulate in homes, raising the risk of lung cancer. The U.S. Environmental Protection Agency estimates 21,000 Americans die each year from radon-caused lung cancer, killing more people than secondhand smoke, drunk driving and house fires.
In Nevada, one in four homes tested show radon concentrations at or above the EPA action level. According to experts, living in a home with radon concentrations at the action level poses a similar risk of developing lung cancer as smoking about half a pack of cigarettes a day.
The risk of radon-caused lung cancer can be reduced. A simple three-day test can determine if a house has a radon problem, and winter is an ideal time to test a home for radon. If radon problems are found, they can be fixed.
Tests indicate Lincoln County residents at greater risk of exposure to radon
Historically, residents of Lincoln County knew about and experienced the dangers of radiation in the form of hazardous fallout from the Nevada Test Site, but an even bigger radiation hazard exists today whose source is natural and comes from below, rather than being manmade and falling from above.
Data from Extension's Nevada Radon Education Program indicates that 1 in 3 homes in Lincoln County have radon levels that are unhealthy. This is above average for Nevada. Residents should test their homes for radon.
If a home is determined to be unsafe due to elevated radon levels, it can be fixed by either hiring experts or by doing-it-yourself.
Preventing radon exposure during quarantine
"More of us are working and attending online meetings and webinars in our homes than ever before due to the COVID-19 pandemic. This change is potentially increasing our exposure to a radioactive gas that can enter and accumulate in any building. Testing for radon is easy, and you can test your own home using a radon test kit from the Nevada Radon Education Program." -Program Director Susan Howe