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County Offices

Clark County Programs

Healthy Steps to Freedom

Alcohol and drug addiction are serious, chronic and relapsing health problems for both women and men of all ages and backgrounds. Leading to physical and mental health problems, substance abuse often precipitates violence, sexually transmitted diseases, unwanted pregnancy, motor vehicle crashes, homelessness, rising health care costs and obesity.

Healthy Steps to Freedom logo

Healthy Steps to Freedom (HSF) targets women and girls in substance abuse settings especially those who find weight issues to be prevalent in their drug use and/or recovery. HSF teaches nutrition, physical activity and body acceptance as a healthy approach to addressing weight and energy concerns. Participants learn about exercise; nutrition; meal planning; food labels and portions; strength activities; calcium intake; and educational programs which address body image disturbances, eating disorders and other poor lifestyle practices.


More than half of clients in treatment for methamphetamine, cocaine and other stimulants are women. Research indicates that women primarily use meth to lose weight and increase energy. Although women sometimes lose a significant amount of weight during their drug use, much of the weight loss is attributed to loss of muscle, bone mass, other vital body tissues and dehydration. They may also experience hair and teeth loss, numerous health problems and broken relationships with family and friends. Additionally, when they stop using drugs, women often experience rapid, unwanted weight gain. The fear of gaining this added weight can lure many back to using stimulant-type drugs, which are known to have quick weight loss effects.

Many women also gain a significant amount of weight while in substance abuse recovery or mental health treatment, due to discontinuation of the stimulant, physical inactivity, poor nutrition and/or prescribed medications. This often leads to feelings of hopelessness and inability to control their weight, which can worsen their mental health status. Some individuals even stop taking prescription medication because of the negative side effects (e.g., weight gain, lethargy).

What Has Been Done:

More than 240 HSF sessions have been conducted since the program’s inception (2007) with over 2,400 adults and 1,000 youth reached. The Healthy Steps to Freedom 10-week program continues to be implemented in the women’s prison and conservation camp as well as substance abuse and mental health recovery centers across Las Vegas (including but limited to: Choices Group, Inc. (Las Vegas & Henderson locations), CC Juvenile Detention Center, Florence McClure Women’s Correctional Center, Jean Conservation Camp, WestCare Nevada — Community Involvement Center and the Women & Children’s Campus). The original HSF curriculum was published in 2009. The 560-page manual contains lesson plans, instructor notes, weekly personal commitment plans and handouts for participants. Currently, this manual is undergoing a 5-year academic revision, with an expected completion date of spring 2018.

In collaboration with the Center for the Application of Substance Abuse Technologies (CASAT), HSF train-the-trainer (TTT) workshops have been conducted in both Las Vegas and Reno since 2009. These workshops offer substance abuse and mental health care providers with continuing education credits and important knowledge and resources to help present the program at their treatment facilities.


Participant Demographics:

HSF program participant’s average age is 34 years old. BMI averages about 28.8 (which is categorized as overweight). Similarly, average body fat percentage is 29.8% (which is classified as concern for unsatisfactory health). Most (80%) of HSF clients have children (average of 2.1 children per client). For those with children under 18, the average age of the youngest child is 5 years old).

Effectiveness of HSF on Health, Body Dissatisfaction, Thin-ideal Internalization, Eating pathology and Weight Concerns:

After program participation, clients reported significant improvement, including:

  • Positive health and nutrition behaviors
  • Greater knowledge about health and nutrition
  • Lower thin-ideals set by society on women
  • Less body dissatisfaction
  • Less symptoms of disordered eating
  • More realistic weight goals
  • Less binge eating symptoms
  • More intuitive eating behaviors
  • Less concern that gaining weight may trigger drug-use relapse
  • Less concern about using drugs to lose weight after leaving treatment

With a demonstrated increase in health knowledge and positive health behavior change along with reductions in eating attitudes, negative body shape and thin-ideal internalization, attrition rates are likely to be higher and hopefully drug relapses will be diminished. After program participation, clients have the skills to improve dietary practices and family meal planning, physical activity, healthy bodies and body image satisfaction. These newly learned lifestyle behaviors, exemplified in the home, have a direct impact on child health and obesity.


  • Center for the Application of Substance Abuse Technologies (CASAT)
  • Choices Group, Inc.
  • Clark County Juvenile Detention Center
  • Nevada Department of Corrections
  • University of Nevada, Las Vegas
  • WestCare Nevada


Lindsay, A. & Velasquez, S. (2009). Healthy Steps to Freedom: A Health and Body Image Curriculum. University Nevada Cooperative Extension (CM-09-02)


  • Lindsay, A., Warren, C., Velasquez S., & Lu, M. (2012). A Gender-Specific Approach to Improving Substance Abuse Treatment for Women: The Healthy Steps to Freedom (HSF) Program. Journal of Substance Abuse Treatment, 43(1), 61-69.
  • Warren, C., Lindsay, A., White, E., Claudat, K., & Velasquez, S. (2012). Weight-related Concerns Related to Drug Use for Women in Substance Abuse Treatment: Prevalence and Relationships with Eating Pathology. Journal of Substance Abuse Treatment 44(5), 494. doi:10.1016/j.jsat.2012.08.222
  • Lindsay, A. (2015). A comparison of beliefs and attitudes about body image, eating and weight between incarcerated and non-incarcerated females. University of Nevada Las Vegas Dissertation. Paper 2557.
  • Lindsay, A. & Velasquez, S. (2012). Nevada Substance Abuse Treatment Providers — Assessing the Needs & Characteristics of Female Clients in Recovery. University of Nevada Cooperative Extension Special Publication SP-12-09, 23 pp.


Anne Lindsay, PhD, Associate Professor, Public Health & Exercise Physiology Specialist,

Programs Program Information

4-H Youth Development

4-H is a community of young people across America learning leadership, citizenship and life skills.

All 4 Kids

University of Nevada Cooperative Extension’s All 4 Kids: Healthy, Happy, Active, Fit program is an interdisciplinary approach to addressing child obesity. Developed by Cooperative Extension faculty from maternal/child nutrition, exercise physiology and child development, the All 4 Kids program helps children meet the Nevada Pre-Kindergarten (Pre-K) Standards while encouraging preschool children and families to practice healthy eating habits and be active every day.

Career Edge: Teens Taking Charge of Their Future! A Workforce Readiness Program

The Career Edge: Teens Taking Charge of Their Future! A workforce readiness program for high school students focused on skill development for workplace and job success. Career Edge helps high school students prepare to get their first "paying" job while working toward their dream job or career. Career Edge provides information and training on interview skills, résumé development, filling out applications, finding job leads and selecting appropriate clothing for the workplace. In addition, many "soft skills" needed in the workplace such as decision-making, teamwork, problem-solving and leadership are integrated throughout the program.

Commercial Landscape Horticulture

Thistles prepared for the “Noxious Weeds and Weed Law” green industry class

Desert Green, Commercial Water Conservation Training

Desert Green is in its eleventh year and is designed to educate commercial clientele in the Green Industry as well as others who have an interest in water conservation issues. A committee representing the industry implements the training. Desert Green is chaired by one industry representative and one UNCE representative. The program is presented once a year, with 36 classes taught in a two-day period. A committee of industry representative reviews evaluations from the previous year to decide future educational direction and topics. During the evaluation process, the program is reviewed, modified and revised according to the needs of the clientele. As part of the marketing of this program, two articles citing the importance of Desert Green appear in regional trade publications.

Expanded Food and Nutrition Education Program (EFNEP)

Exploring Your True Colors: Building an Effective Team & Team Development Course

Team Development Course

Family Storyteller Literacy Program

National award-winning Family Storyteller is a literacy program aimed at encouraging and training parents to play a vital role in the literacy development of their children. Developed by University of Nevada Cooperative Extension (UNCE), KNPB-TV, the Washoe County libraries and Washoe County School District, the statewide program creates an opportunity for parents and young children to interact around literacy and language activities. Family Storyteller is designed especially for families that may have limited language skills and few children’s books at home.

Food for Thoughts, School Garden

University of Nevada Cooperative Extension’s Food for Thoughts Program offers children an alternative site for learning, promotes awareness of the desert environment, demonstrates the geographic sources of their food, and encourages healthy eating and activities.

Fun To Play

University of Nevada Cooperative Extension’s Fun To Play program targets families where, due to the young age, inexperience or limited resources of the parents, young children are placed at-risk for developmental delays and later school difficulties. Fun To Play is a series of weekly infant/child sessions aimed at improving the parenting skills of young parents by increasing the amount of learning activities and interaction they provide their children.

Healing gardens in Las Vegas

University of Nevada Cooperative Extension healing gardens essentially become outdoor sanctuaries for people who are hospitalized as well as their families and the staff that works with them.

Healthy Eating Active Living: Mapping Attributes using Participatory Photographic Surveys (HEAL MAPPS)

Healthy Eating Active Living: Mapping Attributes using Participatory Photographic Surveys (HEAL MAPPS) is a compilation of evidence-based engagement and assessment tools that is used to audit and map community environmental features that support and/or hinder healthful eating and physical activity among community members. The MAPPS method integrates photography, participatory community mapping using global positioning system (GPS) technology, and residents’ voiced perceptions of their community. HEAL MAPPS engages people in community-based participatory research to document attributes of the rural community environment that are perceived by residents as obesity preventing or promoting and assess the local resources and readiness to implement community-level obesity prevention strategies to prevent unhealthy weight gain/overweight and obesity among children and their families.

Healthy Eating on a Budget

The Healthy Eating on a Budget program has been integrated into the TANF Work Readiness workshop as a SNAP-Ed program. The purpose of the 8-lesson series is to provide SNAP recipients with education on healthy nutrition and physical activity practices, food resource management, food safety and food security.

Healthy Steps to Freedom

Alcohol and drug addiction are serious, chronic and relapsing health problems for both women and men of all ages and backgrounds. Leading to physical and mental health problems, substance abuse often precipitates violence, sexually transmitted diseases, unwanted pregnancy, motor vehicle crashes, homelessness, rising health care costs and obesity.

Little Books and Little Cooks

Children scooping soil from a wheelbarrow into a carton

Living With Fire

Be Ember Aware publication

Master Gardeners in Nevada

Master Gardeners provide free, research-based horticulture information to Nevadans. They are volunteers who learn advanced plant science skills from at least 50 hours of classroom instruction by University of Nevada Cooperative Extension (UNCE) professionals. After training, Master Gardeners volunteer a minimum of at least 50 hours a year to pass along their newly acquired knowledge through the media, talks and workshops. They answer phone calls, send out informational materials and develop community gardens.

Nevada Naturalist

University of Nevada Cooperative Extension (UNCE) in collaboration with partnering agencies including Bureau of Land Management, National Park Service, U.S. Fish and Wildlife Service, University of Nevada Las Vegas, Henderson Bird Viewing Preserve, Nevada Department of Wildlife, Springs Preserve, Wetlands Park, Nevada State Museum, and others, has developed a comprehensive environmental education curricula targeting adult learners interested in environmental issues affecting southern Nevada.

Pick a better snack™ (formerly Chefs for Kids)

This evidence-based campaign focuses on building fruit and vegetable consumption in children through healthy snacking. Pick a better snack™ is a monthly, in-school nutrition education program for primary grade children in at-risk elementary schools in Clark and Washoe counties in Nevada. In addition to direct instruction, staff works with school wellness coordinators to build meaningful and sustainable programming to create a well environment in every school.

Statewide Programs *Statewide programs may not be available in all counties

Programs Program Information
Cattlemen’s Update
Food Safety Project
Grow Your Own, Nevada
Herds and Harvest
Invasive Species (Weeds)
Nevada Radon Education Program
Nevada State GEAR UP
Nevada Youth Range Camp
People of the Land
Pesticide Safety Education Program
Riparian and Watershed Assessment and Management
Risk Management
Stronger Economies Together
Weed Prevention and Management