Professional Documents
Culture Documents
Healthy Hearts
Reducing Cardiovascular Disease one
woman at a time!
Natasha Dang
Esha Fletcher
RFP
#3
Healthy People
Overarching Goal:2020
Improve cardiovascular health
and quality of life through prevention, detection,
and treatment of risk factors for heart attack and
stroke; early identification and treatment of heart
attacks and strokes; and prevention of repeat
cardiovascular events.
Mission
Statement
The Open Minds and Healthy Heart Programs in
Connecticut are committed to providing quality,
cardiovascular-related preventative services to
minority women and their families. Our
dedicated team of professionals strive to
provide the community with knowledge and
resources, along with instilling confidence and
motivation to pursue a holistically healthy life.
Program Goals
Background
Few unsettling stats:
CVD kills nearly 50,000 African-American
women annually
Of African-American women ages 20 and
older, 49% have heart diseases
Only 1 in 5 African-American women
believes she is personally at risk
Only 52% percent of African-American
women are aware of the signs and
symptoms of a heart attack
Program
Objectives
Goal-Setting
Theory
Five Principles:
Clarity, Challenge, Commitment, Feedback,
Task Complexity
The goal setting theory will be pushed
because it challenges the participants to set
meaningful and challenging goals. Dr. Edwin
Locke, the creator of the goal setting theory
found that setting clear goals and giving
feedback, motivates people.
Concept
Definition
Application
Clarity
Challenge
Commitment
Feedback
Task Complexity
Health Belief
Model
Concept
Definition
Application
Perceived
Susceptibility
Perceived
Severity
Perceived
Benefits
Perceived
Barriers
Cues to Action
Strategies to activate
readiness
Self-Efficacy
Explanation Plan
Process
3 year program
Held in churches (6 intervention, 4 control)
16-week intervention (3 in a year)= 2 years of interventions
Intervention groups meet twice/week
90 mins sessions- weekly educational topic, homework
assignments, 30 mins physical activity, devotional, weekly scripture
and discussion
Lottery, drawings and prize giveaways
Weekly checking of vitals
Weekly emails sent out to remind participants to exercise & work w/
prayer partners
Lessons on signs and symptoms of CVD
Design &
Measurement
Tools
Design
Tools
Weekly Meetings
Overview
Weekly Topics
Weekly Handouts
Program Budget
Staff
Esha- $65,000/yr
Andrea- $65,000/yr
Natasha- $65,000/yr
Nurse- $40/hr
Dietitian- $30/hr
Recruitment/Marketing
Flyers, Newspaper, Radio- $100
Materials
Pedometers- $1.50 each
sheet
Resistance Bands- $9 each
sheet
Food Journals- $5 each
Posters/Visuals- $16
Biometric Screenings
Health Screenings- $25
Other
Cooking Classes (food, utensils)- $90/week
Marketing
Social Media- Facebook, Twitter, Instagram,
Blog
Church Bulletin- every Sunday
YWCA (Young Women's Christian Association)
Newspaper
Doctors
Church Website
Sources of
Funding
One
Love,
One
Heart
Natasha Dang
Program
Rationale
CVD is the #1 killer on the top ten leading causes
The Intervention
To reduce the risk of CVD
of high-risk minority
women by increasing
physical activity and
prolonging the
maintenance a healthy
weight through
community-based sites
Trans-Theoretical
Model
Stages of change
All participant volunteers at contemplative stage
or higher
Material tailored to each participant
Studies show that it is time consuming, but
effective
MATCH Model
Phase 6
Health
Status
(Morbidity
,
Mortality,
&
Wellness)
Phase 5
Evaluation
Phase 1
Health
Goal
Selection
Phase 4
Implementa
tion
Phase 2
Interventi
on
Planning
Phase 3
Developm
ent
Overarching goals:
awareness and knowledge of PA and diet,
prevalence of risk factors and CVD, and mortality &
morbidity from CVD, maintenance of weight loss
Priority population:
High-risk, postmenopausal, minority women of lowsocioeconomic status
Behaviors/Environmental Factors associated with
Time restraints
current health status:
Safety Concern
High salt/fat/sugar intake in diet
Lack of transportation
Smoking
Obesity
Physical Inactivity
Phase 2: Intervention
Planning
Target of intervention actions:
Individual Level: Behavioral change influences actions
or habits
Organizational Level: Members of a community are
influenced by their organizational leaders and residents
Community Level: Individuals learn by practices and
norms in the community
Intervention Actions:
Morbidity, mortality, and wellness are changed by the
use of facilitation, activities, resources, practices, and
education
Program Objectives
At the end of the program:
At least 90% of the participants will have increased
awareness for the risk factors of heart disease
At least 50% of the program volunteers will participate in
monthly health screenings.
There will less than a 30% attrition rate
The number of participants who integrate an exercise
routine into their daily life will be statistically significant (p
<0.05)
Health screenings post-intervention will determine that at
least 20% of the participants will be less at risk for CVD
Program Objectives
At the end of the program:
100% of all participants will have learned at least one
cooking skill that can be used daily
At least 20% of the participants will eat a diet with less fat
content from the start at baseline
At least 80% of the participants will complete the posttest
Phase 3: Program
Development
Program Components:
STEP 1
STEP 2
STEP 3
STEP 4
January 1st
2015
July 1st 2015
October 2nd
2015
January 1st
2016
January 2nd
2016
July 1st 2017
6 Month
Interval
3 Month Interval
3 Month Interval
18 Month
Interval
Program
Planning,
Community
Counseling
Maintenance
Sessions
Program
Evaluation
Phase 3: Program
Development
Phase 4:
Implementation
Supportive Evidence:
Participants view positive support from others and
active opposition to cultural norms as critical for
maintenance
Strategies are set in place to maintain lost weight if
participants struggle
Focus groups aided maintenance of healthy weight
Strategies:
Multifaceted approach to intervention
Medically Trained Personnel
Social media and social support
Evaluation Plan
Process:
ROI: $5.60 for every dollar spent over five years
Treatment costs much higher than implementing a
health promotion program
Satisfaction Ratings by participants
Summative:
A questionnaire or survey is used to measure
knowledge/awareness of CVD related risk factors via
posttest
Post intervention health screening to identify the same
risk factors from baseline
Outcome Evaluation:
A questionnaire will be administered at a 5-year and
Program Design
STEP 1
STEP 2
STEP 3
STEP 4
6 Month Interval
3 Month Interval
3 Month Interval
18 Month Interval
Program Planning,
Development, and
Recruitment
Community
Counseling Sessions
Maintenance Sessions
Program Evaluation
and Write-Up
Lectures, cooking
classes, lowmoderate physical
activity, health
demonstrations,
videos, field trips to
grocery stores,
fitness centers,
restaurants, tracking
food intake
Measurement Tools
Anthropometric Data [Scales, BP cuff,
measurement tape]
Height, weight, waist circumference, BMI, BP
Biochemical Data [Lab Reports]
Lipid panels (blood cholesterol), Metabolic
panels (sodium)
Surveys/Questionnaires before, during, and after
intervention (follow-up)
Reports from focus groups and social media
Cooking equipment
Abridged Financial
Budget
Marketing Strategies
1. E-mail
2. Formal Letters to Org.
leaders
3. Social Media
a. Facebook
b. Instagram
4. Program Website
5. Advertisements to the public
(newspapers, online)
Funding Opportunities
1. The Myocarditis Foundation
Supports an investigator proposing innovative basic, clinical or
translational research projects relevant to the etiology,
pathophysiology, diagnosis, treatment epidemiology and/or
prevention of myocarditis [CHF].
2. The American Heart Association
Research broadly related to cardiovascular function and
disease and stroke, or to related clinical, basic science,
bioengineering or biotechnology, and public health problems,
including multidisciplinary efforts.
Funding Opportunities
3. Centers for Disease Control & Prevention
This FOA will support effective implementation of existing
policy, systems and environmental improvements, and offers
opportunities for communities to take comprehensive action to
address risk factors contributing to the most common and
debilitating chronic conditions. These risk factors include
tobacco use and exposure, poor nutrition, physical inactivity,
and lack of access to chronic disease prevention, risk
reduction and management opportunities.
4. Prevention and Public Health Funds
This Funding Opportunity Announcement (FOA) supports
implementation of population-wide and priority population
References
Questions?
Andrea DePetris
Program Goals
1. Increase awareness and knowledge of CVD among
parishioners throughout CT
2. Lower CVD risk profiles of parishioners
3. Increase overall levels of physical activity (PA) among
parishioners
4. Increase levels of motivation and self-efficacy among
participants
5. increase knowledge about nutrition and healthy eating
Program Objectives
1. 90% of participants in the active intervention groups will attend at least one
of the two weekly sessions.
2. 100% of participants in the active intervention groups will participate in the
angel motivation for walking program.
3. There will be significant, positive improvements of at least 3 of the 13 CVD
physiological outcomes for at least 60% of participants in the active
intervention group
(weight, BMI, waist circumference, body fat %, SBP, DBP, LDL-C, energy
intake,
4. At least 60% of participants with a BMI 25 will lose 5% of their body weight
by the end of the 16 week standard intervention.
5. Reported levels of self-efficacy for physical activity will improve for 100% of
participants
6. 95% of participants in the active intervention sessions will fill out satisfaction
surveys after each session
Bopp et. al 2009; Dodani and Fields 2010; Yanek et al. 2001)
Behavior Theory
Social Cognitive Theory
- Interpersonal level theory
- Reinforcement
- direct reinforcement (ex: verbal praise, weight loss, increased
energy levels)
- vicarious reinforcement (ex: family spotlight, angels)
- self-reinforcement (ex: returning walking logs and increasing
steps, healthy treat/ activity, lottery entry)
- Self-efficacy
- performance attainment (ex: skill building & exercise mastery)
- vicarious experiences (ex: observing peers, church leaders,
exemplars)
- verbal persuasion (ex: peers, angels, PT, educators, church
leaders)
- emotional arousal (ex: interpreting ones emotional state with
(McKenzie, PT)
Neiger, and Thackery 2009)
Planning Model 1
Health Belief Model
-
http://en.wikipedia.org/wiki/File:The_Health_Belief_Model.pdf
Planning Model 2
PRECEDE-PROCEED Model
-
PRECEDE
PROCEED
Program Design
Year 1:
establish community expert panels, obtain informed consent, focus groups, pilot intervention in both a rural
and urban setting
cluster large, active churches in CT by region & select participating churches randomly
randomly assign churches to intervention (6) and comparison groups (4)
Year 2:
Intervention and Comparison groups
health fair (screening, baseline data collection)
one day church retreats (small groups going to stations): motivational sessions, intro. to nutritional
education, intro to PA, focus groups, light yoga, massage, review of results from baseline screenings with
nutritionist, discussion of barriers to PA, intro. to angel program and angel pairings
handout pedometers: collect one weeks worth of data
Year 3: (3 months)
health fair and data collection, focus groups, interviews, fidelity checklists, analysis of results
health fair and data collection, focus groups, interviews, fidelity checklist
Measurement Tools
Medical Materials: calibrated digital scale, bioelectrical
impedance tool, tape measure, sphygmomanometer,
UConn laboratory, pedometers
Health History: demographic form, medical history packet
Questionnaires: the Physical Activity Readiness
Questionnaire, the Block Food Questionnaire, the SelfEfficacy for Exercise Questionnaire, the Behavioral RIsk
Factor Surveillance Survey Questionnaire (general health
status and access questions), the Yale Physical Activity
Survey, the Center for Epidemiological StudiesDepression, the Social Support for Diet and Exercise
Questionnaires, the Physical Activity Enjoyment Scale
Bopp et. al 2009; Resnicow et al. 2002; Yanek et al. 2001)
Program Budget
Marketing Strategies
(Parishioners)
Church Website
Church Bulletin (pastor plugs, weekly health newsletter)
Weekly Angel phone calls
Family video camera footage shared on church projector
Nourishing the Soul cookbook
CD & Poster dissemination
Partnerships with local bodegas, health food stores, supermarkets, and
restaurants
Social Media- Facebook, Twitter, Instagram
Marketing Strategies
(Stakeholders)
References
Bopp, M., Wilcox, S., Laken, M., Hooker, S. P., Parra-Medina, D., Saunders, R., ... & McClorin, L. (2009). 8 Steps to Fitness: a faithbased, behavior change physical activity intervention for African Americans. Journal of physical activity & health, 6(5), 568.
Dodani, S., & Fields, J. Z. (2010). Implementation of the Fit Body and Soul, a Church-Based Life Style Program for Diabetes
Prevention in High-Risk African Americans A Feasibility Study. The Diabetes Educator, 36(3), 465-472.
McKenzie, J. F., Neiger, B. L., & Thackera, R. (2009). Planning, Implementing, And Evaluating Health Promotion Programs: A
Primer Author: James F. McKenzie, Brad L.
Resnicow, K., Jackson, A., Braithwaite, R., DiIorio, C., Blisset, D., Rahotep, S., & Periasamy, S. (2002). Healthy Body/Healthy
Spirit: a church-based nutrition and physical activity intervention. Health Education Research, 17(5), 562-573.
http://en.wikipedia.org/wiki/File:The_Health_Belief_Model.pdf
Yanek, L. R., Becker, D. M., Moy, T. F., Gittelsohn, J., & Koffman, D. M. (2001). Project Joy: faith based cardiovascular health
promotion for African American women. Public health reports, 116(Suppl 1), 68.
https://www.goredforwomen.org/home/live-healthy/
http://www.mindtools.com/pages/article/newHTE_87.htm
http://www.utwente.nl/cw/theorieenoverzicht/theory%20clusters/health%20communication/health_belief_model/
Woods G, Levinson AH, Jones G, Kennedy RL, Johnson LC, Tran ZV, Gonzalez T, Marcus AC. The Living Well by Faith Health and
wellness program for African Americans: an exemplar of community-based participatory research. Ethn Dis. 2013
Spring;23(2):223-9
Questions?