Cohn: By a show of hands what do you think is the #1 cause of death in women?
These data suggest that the women who are at most risk for heart disease and its potential outcomes are actually least aware of the threat.
Cohn: In the time it has taken for me to read this slide a woman has died of heart attack
I really want stress that only 30% of women experienced chest pain
A very common symptom in women is extreme fatigue. This is tiredness that is so severe that upon waking you feel like you need to go immediately back to sleep.
You can see how it may be easy to dismiss these atypical symptoms but if you have just one that feels unusual don’t make excuses, call 911.
Cohn & Butts - Building Alliances to Improve Heart Health in Harlem
Creating Powerful Alliances for Reducing Disparities inCardiovascular Outcomes in Harlem Mrs. Patricia R. Butts Abyssinian Baptist Church Elizabeth Cohn, RN, DNSc Columbia University
Make a Call-Don’t Miss a Beat• This work is funded under a grant by the NYS Office of Women’s Health Region II• Department of Health and Human Services, Office of Women’s Health.
Project Aims• To develop a set of culturally tailored strategies to educate women and their families about the signs and symptoms of heart attacks.• To raise awareness of medical providers to the alternative presentations of heart attacks in women.• To use social marketing for widespread dissemination of these health messages.• To demonstrate the power of a partnership between faith-based organizations, Schools of Nursing and DHHS.
Four Factor Intervention• Individual: Trained church women in low-tech, high-touch methods. Pocketbook training.• Medical Providers: Huddles; next generation of provides.• Faith-Based/Congregants: Sermons based on CVD information. Original Gospel music and short plays.• Social Marketing: Times Square Jumbotron, Amsterdam news. Jingles.
Review of the morningWhat do you think is the number one cause of death in women in the United States?A. Breast CancerB. Heart DiseaseC. AccidentsD. Lung Cancer
Disparities in CVD• African American women are 40% more likely to have three or more risk factors1 and are significantly more likely to die from heart disease2 when compared to their white counterparts.• Although at increased risk, 60% of African American women lack awareness of the signs and symptoms and the need for a definitive action plan2.• Early recognition and treatment saves lives and improves outcomes. But this depends on identification of the signs and symptoms both by the individual and hospital providers.1. Giardina, et al. (2011). Journal of Womens Health. 20(6): 893-9002. Canto, et al. (2012). JAMA. Feb 22;307(8):813-22.
The Facts A woman suffers a heart attack every minute Even though awareness has increased over the years, women still don’t see personal risk for themselves Women tend to dismiss symptoms leading to poorer outcomes and increased deaths Only about half of women would call 911 if they thought they were having a heart attack Sources: American Heart Association 2008, Sheng et al. 2001 American Heart Association Statistical Update: Heart Disease and Stroke, 2009.Lloyd-Jones D et al. 2009.
Edna’s StoryWhat signs and symptoms can you identify in this story?
Chest Pain Described as “discomfort, ache, pressure, tightness, or fullness” Can last for several minutes or go away and come back This is the “hallmark” sign for heart attacks in men, but one study found that only 30% of women experienced chest pain or discomfort prior to their heart attack
Upper Body Pain Common sites for pain •Chest •Upper back, between the shoulders •Left arm •Shoulder •Neck jaw •Upper stomach Often vague or generalized to a region, if you can point to the pain with one finger, it is less likely that it is a heart attack
Shortness of Breath Difficulty breathing, you may be panting or find yourself trying to take deep breaths Occurs with normal daily activities Can occur with or without chest pain This was reported by half of women experiencing a heart attack
Dizziness Feeling lightheaded or like you may pass out Usually sudden in onset Can be accompanied with severe weakness
Cold Sweats You may suddenly break out into a sweat with cold, clammy skin Can be confused with “hot flashes” of menopause
Nausea May or may not be associated with vomiting May or may not be associated with abdominal pain Often described as “feeling sick to the stomach” Can be mistaken for “a stomach flu”
Fatigue Tiredness that is long-lasting or recurrent Unusual, unexplained, extreme, and sudden in onset May also feel very weak More than half of women experienced marked fatigue prior to the onset of their heart attack
What to do…call 911!If you experience even one of these symptoms that is unusual for you, don’t wait. Call 911!
911 Usage For themselves, 53% of women said that they would call 911 if experiencing the symptoms of a heart attack Only 46% of women would do something other than call 911 – such as take an aspirin, call the doctor or try to drive themselves About 80% said they would call 911 if someone else were having a heart attack Source: Circ Cardiovasc Qual Outcomes Mosca et al. 2010.
Results• We wanted to change those statistics• Both community members and medical personnel who attended the workshops had significantly improved knowledge (p=<0.05) and likelihood of having an action plan and (p=<0.05).• An estimated 10 million women and their families were exposed to the information as measured by Plowshare, an independent social marketing agency.
Does increased knowledgetranslate into increased action?– Measuring the number and types of calls to 911.– Tracking outcomes in women who have presented to Emergency Departments with the signs and symptoms of heart attacks.– Exploring ways of reducing risk factors and preventing heart attacks through greater collaboration of our faith-based organizations and school of nursing.
Collaborative work We have benefited greatly from our collaborative work and invite you to join us in improving health across the nation. Thank firstname.lastname@example.org