title: Implementing the ACHIEVE model to prevent and reduce chronic disease in rural Klickitat County, Washington.
abstract: BACKGROUND
  In the United States, 133 million people live with 1 or more chronic diseases, which contribute to 7 of 10 deaths annually. To prevent and reduce the prevalence of chronic diseases, the National Association of County and City Health Officials (NACCHO) provided technical assistance and funding to 33 local health departments in Washington State, including the Klickitat County Health Department (KCHD), to implement the Action Communities for Health, Innovation, and Environmental Change (ACHIEVE) model.
  
  
  OBJECTIVE
  Klickitat County residents experience higher rates of obesity and overweight than people living in urban areas in the state. KCHD applied the ACHIEVE model to accomplish 2 objectives: 1) to engage the community in community health assessment, action plan development for chronic disease prevention, and implementation of the plan and 2) to work with targeted sectors to promote worksite wellness and to establish community gardens and bicycling and walking trails.
  
  
  METHODS
  KCHD convened and spearheaded the Healthy People Alliance (HPA) to complete a community assessment, develop a community action plan, implement the plan, and evaluate the plan's success.
  
  
  RESULTS
  KCHD, working with HPA, accomplished all 5 phases of the ACHIEVE model, expanded a multisector community coalition, developed Little Klickitat River Trail and 3 community gardens, and created and promoted a worksite wellness toolkit.
  
  
  CONCLUSIONS
  Assistance and training that NACCHO provided through ACHIEVE helped the KCHD engage nontraditional community partners and establish and sustain a community coalition.
authors.affiliation: National Association of County and City Health Officials, 1100 17th St, NW, 7th Fl, Washington, DC 20036, USA. lhorne@naccho.org
authors.forename: Laura
authors.initials: L
authors.lastname: Horne
authors.forename: Katie
authors.initials: K
authors.lastname: Miller
authors.forename: Sandra
authors.initials: S
authors.lastname: Silva
authors.forename: Lori
authors.initials: L
authors.lastname: Anderson
mesh_terms: D000124:Achievement; D002391:Catchment Area, Health; D002908:Chronic Disease / Q000191:economics / Q000208:ethnology / Q000517:prevention & control*; D018672:Community Health Planning / Q000458:organization & administration*; D017281:Cost of Illness; D006265:Health Care Coalitions; D017048:Health Care Costs / Q000706:statistics & numerical data / Q000639:trends; D006293:Health Promotion / Q000379:methods / Q000458:organization & administration; D054624:Health Status Disparities; D040361:Healthy People Programs; D006801:Humans; D020380:Needs Assessment; D017063:Outcome Assessment, Health Care / Q000379:methods; D011314:Preventive Health Services / Q000191:economics / Q000379:methods*; D012424:Rural Population; D014861:Washington