Heart to Heart- A Heart Disease Screening Program for Women This PP was created for a community concepts nursing graduate class. This program has not been implemented.
EOA2016: Taking Stock: 2016 Health Profile & Well-Being ReportsPIHCSnohomish
During the 2nd breakout session at Edge of Amazing 2016, Jody Early, PhD (UW Bothell School of Nursing & Health Services) and Elizabeth Parker, PhD (Snohomish Health District) discussed results from the PIHC Health & Well-Being Monitor & the Health Districts latest profile of health in Snohomish County.
Dr Samantha Smith delivered this presentation at an ESRI conference tilted ‘Health and social care supply and resource allocation planning in Ireland' on 24 September 2019.
There were two reports launched at the event. They can be read here:
‘An analysis of the effects on Irish hospital care of the supply of care inside and outside the hospital’
https://www.esri.ie/publications/an-analysis-of-the-effects-on-irish-hospital-care-of-the-supply-of-care-inside-and
‘Geographic profile of healthcare needs and non-acute healthcare supply in Ireland’
https://www.esri.ie/publications/geographic-profile-of-healthcare-needs-and-non-acute-healthcare-supply-in-ireland
Photos from the conference are available to view on the ESRI website here: https://www.esri.ie/events/health-and-social-care-supply-and-resource-allocation-planning-in-ireland
EOA2016: Taking Stock: 2016 Health Profile & Well-Being ReportsPIHCSnohomish
During the 2nd breakout session at Edge of Amazing 2016, Jody Early, PhD (UW Bothell School of Nursing & Health Services) and Elizabeth Parker, PhD (Snohomish Health District) discussed results from the PIHC Health & Well-Being Monitor & the Health Districts latest profile of health in Snohomish County.
Dr Samantha Smith delivered this presentation at an ESRI conference tilted ‘Health and social care supply and resource allocation planning in Ireland' on 24 September 2019.
There were two reports launched at the event. They can be read here:
‘An analysis of the effects on Irish hospital care of the supply of care inside and outside the hospital’
https://www.esri.ie/publications/an-analysis-of-the-effects-on-irish-hospital-care-of-the-supply-of-care-inside-and
‘Geographic profile of healthcare needs and non-acute healthcare supply in Ireland’
https://www.esri.ie/publications/geographic-profile-of-healthcare-needs-and-non-acute-healthcare-supply-in-ireland
Photos from the conference are available to view on the ESRI website here: https://www.esri.ie/events/health-and-social-care-supply-and-resource-allocation-planning-in-ireland
New CVS Health Poll Reveals That A Majority of U.S. Women Are Unaware of Thei...CVS Health
Results from a new national poll, commissioned by CVS Health (NYSE: CVS), reveal that while American women are increasingly aware of the dangers of heart disease and recognize it as the #1 killer of women, few acknowledge their personal risk factors that contribute to heart disease. Learn more: https://cvs.co/2s2OT0C
Using Measurement to Improve Performance: Insights from ScorecardsThe Commonwealth Fund
A presentation given by Eric Schneider and
Douglas McCarthy of The Commonwealth Fund to the Utah State Legislature – Health and Human Services Committee on
August 23, 2017.
If you’re ready to fight for your best life, then you’re ready for the
Wellness 101 Warrior Program!
An annual wellness membership including 14 valuable benefits including massage & chiropractic treatments, nutrition and fitness assessments, wellness coaching, concierge service, event tickets and much more!
What does wellness mean to you? When it comes to your health do you know the numbers that can save your life? Sandy will use tools to assess your risk for disease and inspire you to make healthier choices to achieve wellness.
It is not necessary (although desirable) to know everything about the natural history of a disease to initiate preventive measures. Often times, removal or elimination of a single known essential cause may be sufficient to prevent a disease. The objective of preventive medicine is to intercept or oppose the "cause" and thereby the disease process. The epidemiological concept permits the inclusion of treatment as one of the modes of intervention.
New CVS Health Poll Reveals That A Majority of U.S. Women Are Unaware of Thei...CVS Health
Results from a new national poll, commissioned by CVS Health (NYSE: CVS), reveal that while American women are increasingly aware of the dangers of heart disease and recognize it as the #1 killer of women, few acknowledge their personal risk factors that contribute to heart disease. Learn more: https://cvs.co/2s2OT0C
Using Measurement to Improve Performance: Insights from ScorecardsThe Commonwealth Fund
A presentation given by Eric Schneider and
Douglas McCarthy of The Commonwealth Fund to the Utah State Legislature – Health and Human Services Committee on
August 23, 2017.
If you’re ready to fight for your best life, then you’re ready for the
Wellness 101 Warrior Program!
An annual wellness membership including 14 valuable benefits including massage & chiropractic treatments, nutrition and fitness assessments, wellness coaching, concierge service, event tickets and much more!
What does wellness mean to you? When it comes to your health do you know the numbers that can save your life? Sandy will use tools to assess your risk for disease and inspire you to make healthier choices to achieve wellness.
It is not necessary (although desirable) to know everything about the natural history of a disease to initiate preventive measures. Often times, removal or elimination of a single known essential cause may be sufficient to prevent a disease. The objective of preventive medicine is to intercept or oppose the "cause" and thereby the disease process. The epidemiological concept permits the inclusion of treatment as one of the modes of intervention.
Presentation by Janet S. Wright, MD, FACC, Executive Director, Million Hearts Initiative, Centers for Disease Control and Prevention and Centers for Medicare and Medicaid Innovation Center
Hypertension Education and Screening In Urban African American Churches by Dawn M. Aycock, PhD, RN, ANP-BC
Assistant Professor at Georgia State University.
Alcohol and Regional Drug Trends in Region 8, information about the demographics, statistics from the 2014 Texas School Survey and signs and symptoms of substance abuse
The goal of this webinar is to educate physicians and healthcare professionals about hospice eligibility and benefits for patients with advanced cardiac disease (ACD) who have a prognosis of ≤6 months. Through evidence-based data and a review of case studies, attendees understand the benefits of advance care planning, complex modalities for high-acuity cardiac patients, how to manage symptoms, address pain and provide comfort and dignity near the end of life.
Effects of a Community Population Health Initiative onBlood .docxgidmanmary
Effects of a Community Population Health Initiative on
Blood Pressure Control in Latinos
James R. Langabeer II, PhD, EdD; Timothy D. Henry, MD, FACC; Carlos Perez Aldana, MS; Larissa DeLuna; Nora Silva, MPA;
Tiffany Champagne-Langabeer, PhD, RD
Background-—Hypertension remains one of the most important, modifiable cardiovascular risk factors. Yet, the largest minority
ethnic group (Hispanics/Latinos) often have different health outcomes and behavior, making hypertension management more
difficult. We explored the effects of an American Heart Association–sponsored population health intervention aimed at modifying
behavior of Latinos living in Texas.
Methods and Results-—We enrolled 8071 patients, and 5714 (65.7%) completed the 90-day program (58.5 years �11.7; 59%
female) from July 2016 to June 2018. Navigators identified patients with risk factors; initial and final blood pressure (BP) readings
were performed in the physician’s office; and interim home measurements were recorded telephonically. The intervention
incorporated home BP monitoring, fitness and nutritional counseling, and regular follow-up. Primary outcomes were change in
systolic BP and health-related quality of life. Using a univariate paired-samples pre–post design, we found an average 5.5% (7.6-
mm Hg) improvement in systolic BP (139.1 versus 131.5, t=10.32, P<0.001). Quality of life measured by the European quality of
life 5-dimension visual analog scale improved from 0.79 to 0.82 (t=31.03, P<0.001). After multivariate regression analyses,
improvements in quality of life and overall body mass index were significantly associated with reductions in systolic BP.
Conclusions-—A noninvasive, population health initiative that encourages routine engagement in patients’ own BP control was
associated with improvements in systolic BP and quality of life for this largely Latino community. (J Am Heart Assoc. 2018;7:
e010282. DOI: 10.1161/JAHA.118.010282.)
Key Words: blood pressure measurement/monitoring • ethnicity • hypertension • population
H ypertension remains a major but modifiable risk factorfor cardiovascular disease (CVD) and stroke in the
United States. It is estimated that the hypertension preva-
lence rates based on current guidelines affect 46% of the
population, or nearly 115 million adults in the United States
alone.1 The American Heart Association (AHA) established
strategic impact goals aimed at reducing CVD and stroke
deaths by 20% by the year 2020.2 The strategy introduced a
concept for cardiovascular health that is characterized by 7
metrics known as “Life’s Simple 7.”3 These metrics focus on
the patient’s self-engagement in monitoring their health and
key measures and emphasizes 4 health behaviors and 3
health factors, including blood pressure (BP) reduction.
Cardiovascular health has been shown to have ethnic and
racial variation due to genetic, culture, nutritional, socioeco-
nomic, and other factors.4,5 Hispanic and Latino people
(Latinos) compose the largest ...
Effects of a Community Population Health Initiative onBlood .docxtoltonkendal
Effects of a Community Population Health Initiative on
Blood Pressure Control in Latinos
James R. Langabeer II, PhD, EdD; Timothy D. Henry, MD, FACC; Carlos Perez Aldana, MS; Larissa DeLuna; Nora Silva, MPA;
Tiffany Champagne-Langabeer, PhD, RD
Background-—Hypertension remains one of the most important, modifiable cardiovascular risk factors. Yet, the largest minority
ethnic group (Hispanics/Latinos) often have different health outcomes and behavior, making hypertension management more
difficult. We explored the effects of an American Heart Association–sponsored population health intervention aimed at modifying
behavior of Latinos living in Texas.
Methods and Results-—We enrolled 8071 patients, and 5714 (65.7%) completed the 90-day program (58.5 years �11.7; 59%
female) from July 2016 to June 2018. Navigators identified patients with risk factors; initial and final blood pressure (BP) readings
were performed in the physician’s office; and interim home measurements were recorded telephonically. The intervention
incorporated home BP monitoring, fitness and nutritional counseling, and regular follow-up. Primary outcomes were change in
systolic BP and health-related quality of life. Using a univariate paired-samples pre–post design, we found an average 5.5% (7.6-
mm Hg) improvement in systolic BP (139.1 versus 131.5, t=10.32, P<0.001). Quality of life measured by the European quality of
life 5-dimension visual analog scale improved from 0.79 to 0.82 (t=31.03, P<0.001). After multivariate regression analyses,
improvements in quality of life and overall body mass index were significantly associated with reductions in systolic BP.
Conclusions-—A noninvasive, population health initiative that encourages routine engagement in patients’ own BP control was
associated with improvements in systolic BP and quality of life for this largely Latino community. (J Am Heart Assoc. 2018;7:
e010282. DOI: 10.1161/JAHA.118.010282.)
Key Words: blood pressure measurement/monitoring • ethnicity • hypertension • population
H ypertension remains a major but modifiable risk factorfor cardiovascular disease (CVD) and stroke in the
United States. It is estimated that the hypertension preva-
lence rates based on current guidelines affect 46% of the
population, or nearly 115 million adults in the United States
alone.1 The American Heart Association (AHA) established
strategic impact goals aimed at reducing CVD and stroke
deaths by 20% by the year 2020.2 The strategy introduced a
concept for cardiovascular health that is characterized by 7
metrics known as “Life’s Simple 7.”3 These metrics focus on
the patient’s self-engagement in monitoring their health and
key measures and emphasizes 4 health behaviors and 3
health factors, including blood pressure (BP) reduction.
Cardiovascular health has been shown to have ethnic and
racial variation due to genetic, culture, nutritional, socioeco-
nomic, and other factors.4,5 Hispanic and Latino people
(Latinos) compose the largest .
Latinos in the U.S. and Northeast Florida: A Health Overview
Feb. 25, 2005
This is part 1 of an 8 part series of seminars on Hispanic Health Issues brought to you by the University of North Florida’s Dept. of Public Health, College of Health, a grant from AETNA, and the cooperation of Duval County Health Department.
Navigating Challenges: Mental Health, Legislation, and the Prison System in B...Guillermo Rivera
This conference will delve into the intricate intersections between mental health, legal frameworks, and the prison system in Bolivia. It aims to provide a comprehensive overview of the current challenges faced by mental health professionals working within the legislative and correctional landscapes. Topics of discussion will include the prevalence and impact of mental health issues among the incarcerated population, the effectiveness of existing mental health policies and legislation, and potential reforms to enhance the mental health support system within prisons.
Antibiotic Stewardship by Anushri Srivastava.pptxAnushriSrivastav
Stewardship is the act of taking good care of something.
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
WHO launched the Global Antimicrobial Resistance and Use Surveillance System (GLASS) in 2015 to fill knowledge gaps and inform strategies at all levels.
ACCORDING TO apic.org,
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
ACCORDING TO pewtrusts.org,
Antibiotic stewardship refers to efforts in doctors’ offices, hospitals, long term care facilities, and other health care settings to ensure that antibiotics are used only when necessary and appropriate
According to WHO,
Antimicrobial stewardship is a systematic approach to educate and support health care professionals to follow evidence-based guidelines for prescribing and administering antimicrobials
In 1996, John McGowan and Dale Gerding first applied the term antimicrobial stewardship, where they suggested a causal association between antimicrobial agent use and resistance. They also focused on the urgency of large-scale controlled trials of antimicrobial-use regulation employing sophisticated epidemiologic methods, molecular typing, and precise resistance mechanism analysis.
Antimicrobial Stewardship(AMS) refers to the optimal selection, dosing, and duration of antimicrobial treatment resulting in the best clinical outcome with minimal side effects to the patients and minimal impact on subsequent resistance.
According to the 2019 report, in the US, more than 2.8 million antibiotic-resistant infections occur each year, and more than 35000 people die. In addition to this, it also mentioned that 223,900 cases of Clostridoides difficile occurred in 2017, of which 12800 people died. The report did not include viruses or parasites
VISION
Being proactive
Supporting optimal animal and human health
Exploring ways to reduce overall use of antimicrobials
Using the drugs that prevent and treat disease by killing microscopic organisms in a responsible way
GOAL
to prevent the generation and spread of antimicrobial resistance (AMR). Doing so will preserve the effectiveness of these drugs in animals and humans for years to come.
being to preserve human and animal health and the effectiveness of antimicrobial medications.
to implement a multidisciplinary approach in assembling a stewardship team to include an infectious disease physician, a clinical pharmacist with infectious diseases training, infection preventionist, and a close collaboration with the staff in the clinical microbiology laboratory
to prevent antimicrobial overuse, misuse and abuse.
to minimize the developme
ICH Guidelines for Pharmacovigilance.pdfNEHA GUPTA
The "ICH Guidelines for Pharmacovigilance" PDF provides a comprehensive overview of the International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use (ICH) guidelines related to pharmacovigilance. These guidelines aim to ensure that drugs are safe and effective for patients by monitoring and assessing adverse effects, ensuring proper reporting systems, and improving risk management practices. The document is essential for professionals in the pharmaceutical industry, regulatory authorities, and healthcare providers, offering detailed procedures and standards for pharmacovigilance activities to enhance drug safety and protect public health.
The dimensions of healthcare quality refer to various attributes or aspects that define the standard of healthcare services. These dimensions are used to evaluate, measure, and improve the quality of care provided to patients. A comprehensive understanding of these dimensions ensures that healthcare systems can address various aspects of patient care effectively and holistically. Dimensions of Healthcare Quality and Performance of care include the following; Appropriateness, Availability, Competence, Continuity, Effectiveness, Efficiency, Efficacy, Prevention, Respect and Care, Safety as well as Timeliness.
Leading the Way in Nephrology: Dr. David Greene's Work with Stem Cells for Ki...Dr. David Greene Arizona
As we watch Dr. Greene's continued efforts and research in Arizona, it's clear that stem cell therapy holds a promising key to unlocking new doors in the treatment of kidney disease. With each study and trial, we step closer to a world where kidney disease is no longer a life sentence but a treatable condition, thanks to pioneers like Dr. David Greene.
The Importance of Community Nursing Care.pdfAD Healthcare
NDIS and Community 24/7 Nursing Care is a specific type of support that may be provided under the NDIS for individuals with complex medical needs who require ongoing nursing care in a community setting, such as their home or a supported accommodation facility.
India Clinical Trials Market: Industry Size and Growth Trends [2030] Analyzed...Kumar Satyam
According to TechSci Research report, "India Clinical Trials Market- By Region, Competition, Forecast & Opportunities, 2030F," the India Clinical Trials Market was valued at USD 2.05 billion in 2024 and is projected to grow at a compound annual growth rate (CAGR) of 8.64% through 2030. The market is driven by a variety of factors, making India an attractive destination for pharmaceutical companies and researchers. India's vast and diverse patient population, cost-effective operational environment, and a large pool of skilled medical professionals contribute significantly to the market's growth. Additionally, increasing government support in streamlining regulations and the growing prevalence of lifestyle diseases further propel the clinical trials market.
Growing Prevalence of Lifestyle Diseases
The rising incidence of lifestyle diseases such as diabetes, cardiovascular diseases, and cancer is a major trend driving the clinical trials market in India. These conditions necessitate the development and testing of new treatment methods, creating a robust demand for clinical trials. The increasing burden of these diseases highlights the need for innovative therapies and underscores the importance of India as a key player in global clinical research.
One of the most developed cities of India, the city of Chennai is the capital of Tamilnadu and many people from different parts of India come here to earn their bread and butter. Being a metropolitan, the city is filled with towering building and beaches but the sad part as with almost every Indian city
CHAPTER 1 SEMESTER V - ROLE OF PEADIATRIC NURSE.pdfSachin Sharma
Pediatric nurses play a vital role in the health and well-being of children. Their responsibilities are wide-ranging, and their objectives can be categorized into several key areas:
1. Direct Patient Care:
Objective: Provide comprehensive and compassionate care to infants, children, and adolescents in various healthcare settings (hospitals, clinics, etc.).
This includes tasks like:
Monitoring vital signs and physical condition.
Administering medications and treatments.
Performing procedures as directed by doctors.
Assisting with daily living activities (bathing, feeding).
Providing emotional support and pain management.
2. Health Promotion and Education:
Objective: Promote healthy behaviors and educate children, families, and communities about preventive healthcare.
This includes tasks like:
Administering vaccinations.
Providing education on nutrition, hygiene, and development.
Offering breastfeeding and childbirth support.
Counseling families on safety and injury prevention.
3. Collaboration and Advocacy:
Objective: Collaborate effectively with doctors, social workers, therapists, and other healthcare professionals to ensure coordinated care for children.
Objective: Advocate for the rights and best interests of their patients, especially when children cannot speak for themselves.
This includes tasks like:
Communicating effectively with healthcare teams.
Identifying and addressing potential risks to child welfare.
Educating families about their child's condition and treatment options.
4. Professional Development and Research:
Objective: Stay up-to-date on the latest advancements in pediatric healthcare through continuing education and research.
Objective: Contribute to improving the quality of care for children by participating in research initiatives.
This includes tasks like:
Attending workshops and conferences on pediatric nursing.
Participating in clinical trials related to child health.
Implementing evidence-based practices into their daily routines.
By fulfilling these objectives, pediatric nurses play a crucial role in ensuring the optimal health and well-being of children throughout all stages of their development.
Global launch of the Healthy Ageing and Prevention Index 2nd wave – alongside...ILC- UK
The Healthy Ageing and Prevention Index is an online tool created by ILC that ranks countries on six metrics including, life span, health span, work span, income, environmental performance, and happiness. The Index helps us understand how well countries have adapted to longevity and inform decision makers on what must be done to maximise the economic benefits that comes with living well for longer.
Alongside the 77th World Health Assembly in Geneva on 28 May 2024, we launched the second version of our Index, allowing us to track progress and give new insights into what needs to be done to keep populations healthier for longer.
The speakers included:
Professor Orazio Schillaci, Minister of Health, Italy
Dr Hans Groth, Chairman of the Board, World Demographic & Ageing Forum
Professor Ilona Kickbusch, Founder and Chair, Global Health Centre, Geneva Graduate Institute and co-chair, World Health Summit Council
Dr Natasha Azzopardi Muscat, Director, Country Health Policies and Systems Division, World Health Organisation EURO
Dr Marta Lomazzi, Executive Manager, World Federation of Public Health Associations
Dr Shyam Bishen, Head, Centre for Health and Healthcare and Member of the Executive Committee, World Economic Forum
Dr Karin Tegmark Wisell, Director General, Public Health Agency of Sweden
2. • In 2013, Lafayette County had a higher mortality rate for
diseases of the heart than the state of Arkansas and the
nation. (Centers for Disease Control and Prevention,
National Center for Health Statistics, 2015).
• According to the CDC Wonder database (2015), 11
women (ages 35-85+) died in Lafayette County related to
heart disease in 2013.
• The CDC reports “Heart disease is the leading cause of
death for women in the United States” (2015).
Why Heart to Heart ?
3. Lafayette County Demographics
Population (2013)
◦ 7,252 (6.98% decrease from 2010)
• Southernmost part of Arkansas bordering Louisiana
• Four towns: Bradley, Buckner, Lewisville, and Stamps
Characteristics (2103)
◦ High school graduate or higher (77.5%)
◦ Caucasian (61.1%)
◦ African American (37.1%)
◦ Persons 65 year and over (21.5%)
◦ Median age 65
◦ Women (51.7%)
◦ Median household income:$29,732 (State, $40,768)
◦ Persons below poverty level (24%)
5. Lafayette County Resources
• Schools
• County School District;
• Elementary School in Lewisville, and High School in Stamps
• Churches
• First Methodist Church in Lewisville
• First Presbyterian Church in Stamps
• Parks/Recreational Facilities
• Conway Cemetery State Park
• Maya Angelou City Park
• Community Resources/Centers
• Cooperative Extension Service 4-H
6. Lafayette County Medical Resources
• Health Resources
• CABUN Rural Health Services (8 counties in rural southern
Arkansas)
• Southwest Arkansas Counseling and Mental Health Center
• AR State Dept. of Health
• Health Resources lacking in Lafayette County but nearby
• Magnolia Regional Medical Center (Columbia County)
• Dentists available in Hope (Hempstead Co), Magnolia
(Columbia Co), and Texarkana (Miller Co)
7. Lafayette County Health Disparities
• Health Disparities (2013)
higher mortality rate for diseases of the heart than
Arkansas and the US
lower mortality rate from malignant neoplasms than
Arkansas and the US
lower mortality rate from ischemic heart disease than
Arkansas and the US
8. US Arkansas Lafayette County
Total population 316,128,839 2,959,373 7,252
MORTALITY RATES PER 100,000 POPULATIONS, 2013
US Arkansas Lafayette County
TYPES OF DEATHS RATE (NUMBER) RATE (NUMBER) RATE (NUMBER)
Diseases of the Heart 193.31 (611,105) 249.28 (7377) 330.94 (24)
Malignant Neoplasms 185.01 (584,881) 225.99 (6688) 179.26 (13)
Ischemic Heart Disease 117.11 (370,213) 147.19 (4356) 17.19 (15)
SELECTED POPULATION DATA FOR
U.S., ARKANSAS, and LAFAYETTE COUNTY, 2013
9. Community Assessment
of Lafayette County
• Community Diagnosis
• Increased risk of heart disease among adult women in
Lafayette County related to uncontrolled hypertension,
hyperlipidemia, and current smokers as evidenced by a
high mortality rate from diseases of the heart.
10. Healthy People 2020 Goal
Heart Disease
• Goal: 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 (USDHHS, 2015).
11. Healthy People 2020 Objectives
SHORT TERM Objectives – Heart Disease
1. “HDS-4 Increase the proportion of adults who have had their blood pressure
measured within the preceding 2 years and can state whether their blood
pressure was normal or high” (USDHHS, 2015).
2. “HDS-8 Reduce the mean total blood cholesterol levels among adults”
(USDHHS, 2015).
3. “HDS-17 Increase the proportion of adults aged 20 years and older who are
aware of the symptoms of and how to respond to a stroke” (USDHHS, 2015).
12. Targeted Health Issue
Heart Disease
• In 2013, Lafayette County had a higher mortality rate for
diseases of the heart (330.94) than Arkansas (249.28) and
the US (193.31) (Centers for Disease Control and
Prevention, National Center for Health Statistics, 2015).
• The U. S. Preventive Services Task Force (USPSTF)
recommends that all adults aged 18 and older be screened
for hypertension. (Blood Pressure in Adults, 2015).
13. Target Population
• The target population will be women ages 35-65 living
in Lafayette County who agree to participate in the
program.
• According to the CDC Wonder database (2015), 11
women (ages 35-85+) died in Lafayette County related to
heart disease in 2013.
• To prevent premature adult deaths, heart disease
preventative measures need to be taught to young adults.
14. Behavioral Objective # 1
• “HDS-4 Increase the proportion of adults who have had their
blood pressure measured within the preceding 2 years and can
state whether their blood pressure was normal or high”
(USDHHS, 2015).
• Objective 1: Within 6 months of implementing Lafayette
County’s “Heart to Heart” Heart Disease Screening Program
for Women, 90% of participants will be able to state what
their last blood pressure readings were and if the blood
pressure was normal or high.
15. Behavioral Objective # 2
• “HDS-12 Increase the proportion of adults with hypertension
whose blood pressure is under control” (USDHHS, 2015).
• Objective 2: Within 12 months of implementing Lafayette
County’s “Heart to Heart” Heart Disease Screening Program
for Women, 80% of participants ages 35-65 with hypertension
will have normalized blood pressure readings in provider
medical records.
16. Behavioral Objective # 3
• “HDS-8 Reduce the mean total blood cholesterol levels
among adults” (USDHHS, 2015).
Objective 3: After the completion of the program, Lafayette County’s
“Heart to Heart” Heart Disease Screening Program for Women
participants ages 35-65 will see a 25% decrease in their total
cholesterol level."
17. Behavioral Objective # 4
• “TU-1 Reduce tobacco use by adults” (USDHHS, 2015).
Objective 4: After the completion of the program, Lafayette
County’s “Heart to Heart” Heart Disease Screening Program for
Women, participants ages 35-65 will see a 35% reduction in tobacco
use.
18. Program Interventions
• Baseline Blood Pressure Screen - refer to PCP if indicated
• Baseline Cholesterol Level - refer to PCP if indicated
• Smoking Assessment – refer to Quit line if indicated
• Provide Educational Materials to the target population about ways to
decrease the risk of heart disease, such as exercise, dietary modifications,
and smoking cessation
• Sign up target population for email groups to be provide periodical heart
healthy educational materials from the American Heart Association
• Recheck Blood Pressure and Cholesterol at 6 and 12 months
19. Resources
• Finances:
• Community Sponsors
• Business Owners to invest
• Write Grants
• Facilities:
• The Cooperative Extension Service
• CABUN Rural Health Clinic
• AR Health Department in Lewisville
• Team members:
• APRN
• RN’s and LPN’s
• Administrative Personnel
• Community members
20. Recruitment
• The target population will be women ages 35-65 living in
Lafayette County who agree to participate in the program
to reach them advertisement is key!
• Ads in local newspaper, on TV, and radio
• Social media (Facebook, Twitter, Instagram)
• Fliers at all medical clinics and health department
• Post information on Lafayette County website
• Fliers at local banks, post office and library
• Word of mouth via nurses and providers
21. Evaluation Plan — 6 Steps
• Step 1 Engage the Stakeholders: stakeholders include the
target population, program facilitators/board members, and
myself.
• Step 2 Describe the program: to improve cardiovascular
health and quality of life through prevention, detection, and
treatment of risk factors for heart attack and stroke;
• Step 3 Evaluation design: quantitative study design to
measure the number of participants who will be able to state
blood pressure readings, have normalized BPs, reduced
cholesterol levels and reduction in tobacco use.
22. Evaluation Plan cont.
• Step 4 Gathering Evidence: Nurses complete screenings
with strict documentation LPN’s: BPs, lab draws, smoking
assessment. RN’s: education to participants APRN’s:
interpret data, make recommendations, full health history.
Administrative: email databases to send educational
materials.
• Step 5 Justifying Conclusion: analysis and interpretation of
data discussed before data collection begins.
• Step 6 Ensuring Use and Lessons Learned: Formal report
along with meeting of stakeholders.
23. Summary
• Lafayette County has a higher mortality rate for diseases of the
heart than the state of Arkansas and the nation.
• With this low-cost program, we can see a reduction in heart
disease risk factors in just 12 months!
• By reducing risk factors, we will see a decrease in mortality rates
for those living in Lafayette County.
• Teamwork is key for a successful Heart to Heart Program!
24. References
• Blood Pressure in Adults: Screening. U.S. Preventive Services Task Force. July 2015. http://www.uspreventiveservicestaskforce.org/Page
/Document/UpdateSummaryFinal/blood-pressure-in-adults-hypertension-screening
• CABUN Rural Health Services - Providing Healthcare for All in Arkansas. (2015). Retrieved September 2, 2015, from http://www.cabun.org
• Center for Disease Control and Prevention. (2015). Women and Heart Disease Fact Sheet. Retrieved September 16, 2015, from
http://www.cdc.gov/dhdsp/data_statistics/fact_sheets/fs_women_heart.htm
• Centers for Disease Control and Prevention. (2011). Program Performance and Evaluation Office. Retrieved from Centers for Disease Control
and Prevention: http://www.cdc.gov/eval/steps/index.htm
• Centers for Disease Control and Prevention, National Center for Health Statistics. Underlying Cause of Death 2013 on CDC WONDER Online
Database, released 2015. Data are from the Multiple Cause of Death Files, 2013, as compiled from data provided by the 57 vital statistics
jurisdictions through the Vital Statistics Cooperative Program. Accessed at http://wonder.cdc.gov/ucd-icd10.html on Sep 7, 2015 10:57:09 PM
• Conway Cemetery State Park. (2015). Retrieved September 2, 2015, from https://en.wikipedia.org/wiki/Conway_Cemetery_State_Park
• Health Unit Details. (2015). Retrieved September 2, 2015, from
http://www.healthy.arkansas.gov/programsServices/localPublicHealthOffices/Pages/huDetails.aspx?show=Lafayette County Health Unit -
Lewisville
• James, P. A., Oparil, S., Carter, B. L., Cushman, W. C., Dennison-Himmelfarb, C., Handler, J., ... & Ortiz, E. (2014). 2014 evidence-based
guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee
(JNC 8). Jama, 311(5), 507-520.
• Lafayette County, Arkansas. (2015). Retrieved August 30, 2015, from https://en.wikipedia.org/wiki/Lafayette_County,_Arkansas#Demographics
25. References cont.
• Lafayette County, Arkansas Extension Office. (2015). Retrieved September 3, 2015, from http://www.uaex.edu/counties/lafayette/
• Lafayette County School District. (2015). Retrieved September 1, 2015, from http://www.lcscougars.org
• Magnolia Regional Medical Center. (2015). Retrieved September 2, 2015, from http://magnoliarmc.org
• Maya Angelou City Park. (2015). Retrieved September 3, 2015, from http://www.arkansas.com/attractions/detail/maya-angelou-city-
park/96650/
• McKenzie, J., Neiger, B., & Thackeray, R. (2013). Planning, implementing, evaluating health promotion programs: A Primer (6th ed.). San
Francisco, CA: Pearson Benjamin Cummings.
• Occupations in Lafayette County, Arkansas. (2015). Retrieved September 17, 2015, from
http://statisticalatlas.com/county/Arkansas/Lafayette-County/Occupations
• Southwest Arkansas Counseling and Mental Health Center. (2015). Retrieved September 2, 2015, from http://www.swacmhc.com
• U.S. Department of Health and Human Services. (2012). About healthy people. Retrieved from http://www.healthypeople.gov/2020/topics
objectives/topic/heart-disease-and-stroke
• U.S. Department of Health and Human Services. (2015). About healthy people. Retrieved from http://www.healthypeople.gov/2020/topics-
objectives/topic/heart-disease-and-stroke
• United States Census Bureau. (2015). Retrieved September 2, 2015, from http://quickfacts.census.gov/qfd/states/05/05073.html
Editor's Notes
In 2013, Lafayette County had a higher mortality rate for diseases of the heart (330.94) than Arkansas (249.28) and the US (193.31) (Centers for Disease Control and Prevention, National Center for Health Statistics, 2015). I chose to identify a heart disease goal from Healthy People 2020 to help met this disparity in Lafayette County based on the statistics reported that there is a higher mortality rate for heart disease in this county.
The Center for Disease Control and Prevention (CDC) reports “Heart disease is the leading cause of death for women in the United States (2015). In the United States, 292,188 women died from heart disease in 2009 (CDC, 2015). According to the CDC Wonder database (2015), 11 women (ages 35-85+) died in Lafayette County related to heart disease in 2013.
To improve cardiovascular health of residents in Lafayette county, a heart disease risk factor screening program will be established. The target population will be women aged 35-65.
Lafayette County is in the southernmost part of Arkansas bordering Louisiana. There are four towns located in this county; Bradley, Buckner, Lewisville, and Stamps. The townships are Baker (most of Stamps), French, Hadley (Buckner, small part of Stamps), La Grange (small part of Lewisville), Mars Hill, Roane (Bradley), Russell, Steel (most of Lewisville), and Walker Creek (Lafayette County, Arkansas, 2015).
The US Census Bureau reports an estimated 2014 population to be 7,111. This is down 134 from the year before and down over 500 since 2010 when the last census was conducted. As of the 2013 US Census Population Estimates Program (PEP), the county is 61.2% white, 37.1% Black with the remaining 2% being Hispanic. 51.5% of the population is female. 89% of people living in Lafayette County have lived in their home for at least one year or longer. The median income is $29,732 with 24% below the poverty level (United States Census Bureau, 2015).
High school graduate or higher, percent of persons age 25+, 2009-2013 EDU635213 77.5% 83.7%
Bachelor's degree or higher, percent of persons age 25+, 2009-2013 EDU685213 10.7%
Persons 65 years and over
http://statisticalatlas.com/county/Arkansas/Lafayette-County/Occupations
http://statisticalatlas.com/county/Arkansas/Lafayette-County/Occupations
Occupations in Lafayette County, Arkansas. (2015). Retrieved September 17, 2015, from http://statisticalatlas.com/county/Arkansas/Lafayette-County/Occupations
Schools
Lafayette County has a county school district with schools in both Lewisville and Stamps. The Elementary School is located in Lewisville, also the county seat of Lafayette County. The Lafayette County High School is located in Stamps (Lafayette County School District, 2015).
Parks
Lafayette County is home to the Conway Cemetery State Park, a historical park to honor the late James Sevier Conway’s former cotton plantation and his final resting place. Mr. Conway was the first governor of the great state of Arkansas serving from 1836-1840 (Conway Cemetery State Park, 2015).
The city of Stamps is home to a city park honoring the late poet Maya Angelou. She is most known for her work titled I Know Why the Caged Bird Sings. The city of Stamps is the childhood home of Mrs. Angelou and was depicted in her autobiography (Maya Angelou City Park, 2015).
Community resources
There are very few community resources available for residents of Lafayette County. The most used resource is the Arkansas State Dept. of Health in Lewisville. At the health until they are able to provide communicable disease investigation, intervention and prevention, voter registration, environmental health studies, family planning, STD testing and treatment, immunizations, in home personal care services, maternity care, TB prevention, WIC and women’s health (Health Unit Details, 2015).
The Cooperative Extension Service in Lafayette County is located in Lewisville. Through the extension service, they are able to help improve the well being of the residents through education regarding agriculture, 4-H, healthy living, and community development (Lafayette County, Arkansas Extension Office, 2015).
Churches
First Methodist Church (Lewisville, Arkansas)
First Presbyterian Church (Stamps, Arkansas)
Medical Facilities
The Magnolia Regional Medical Center in Magnolia, Arkansas (Columbia, County) is the closest hospital to Lafayette County. The hospital that is city owned operates 49 beds. In 2010, the hospital underwent significant renovations on the 76-year-old building. The hospital services obstetric, neonatal, pediatric, adult and geriatric patients (Magnolia Regional Medical Center, 2015).
CABUN Rural Health Services is a non-profit corporation that was developed to proved care to residents of 8 counties in rural south and southwestern Arkansas.
The Lewisville Family Practice Center is the CABUN owned clinic that operates just down the street from the Health Unit (CABUN Rural Health Services, 2015).
Southwest Arkansas Counseling and Mental Health Center provides mental health services to the residents of Lewisville and Lafayette County. The clinic is located on the same street and the Health Unit and the Family Practice Center (Southwest Arkansas Counseling and Mental Health Center, 2015).
References
CABUN Rural Health Services - Providing Healthcare for All in Arkansas. (2015). Retrieved September 2, 2015, from http://www.cabun.org
Conway Cemetery State Park. (2015). Retrieved September 2, 2015, from https://en.wikipedia.org/wiki/Conway_Cemetery_State_Park
Health Unit Details. (2015). Retrieved September 2, 2015, from http://www.healthy.arkansas.gov/programsServices/localPublicHealthOffices/Pages/huDetails.aspx?show=Lafayette County Health Unit - Lewisville
Lafayette County, Arkansas. (2015). Retrieved August 30, 2015, from https://en.wikipedia.org/wiki/Lafayette_County,_Arkansas#Demographics
Lafayette County, Arkansas Extension Office. (2015). Retrieved September 3, 2015, from http://www.uaex.edu/counties/lafayette/
Lafayette County School District. (2015). Retrieved September 1, 2015, from http://www.lcscougars.org
Magnolia Regional Medical Center. (2015). Retrieved September 2, 2015, from http://magnoliarmc.org
Maya Angelou City Park. (2015). Retrieved September 3, 2015, from http://www.arkansas.com/attractions/detail/maya-angelou-city-park/96650/
Southwest Arkansas Counseling and Mental Health Center. (2015). Retrieved September 2, 2015, from http://www.swacmhc.com
United States Census Bureau. (2015). Retrieved September 2, 2015, from http://quickfacts.census.gov/qfd/states/05/05073.html
Medical Facilities
The Magnolia Regional Medical Center in Magnolia, Arkansas (Columbia, County) is the closest hospital to Lafayette County. The hospital that is city owned operates 49 beds. In 2010, the hospital underwent significant renovations on the 76-year-old building. The hospital services obstetric, neonatal, pediatric, adult and geriatric patients (Magnolia Regional Medical Center, 2015).
CABUN Rural Health Services is a non-profit corporation that was developed to proved care to residents of 8 counties in rural south and southwestern Arkansas.
The Lewisville Family Practice Center is the CABUN owned clinic that operates just down the street from the Health Unit (CABUN Rural Health Services, 2015).
Southwest Arkansas Counseling and Mental Health Center provides mental health services to the residents of Lewisville and Lafayette County. The clinic is located on the same street and the Health Unit and the Family Practice Center (Southwest Arkansas Counseling and Mental Health Center, 2015).
The most used resource is the Arkansas State Dept. of Health in Lewisville. At the health until they are able to provide communicable disease investigation, intervention and prevention, voter registration, environmental health studies, family planning, STD testing and treatment, immunizations, in home personal care services, maternity care, TB prevention, WIC and women’s health (Health Unit Details, 2015).
References
CABUN Rural Health Services - Providing Healthcare for All in Arkansas. (2015). Retrieved September 2, 2015, from http://www.cabun.org
Conway Cemetery State Park. (2015). Retrieved September 2, 2015, from https://en.wikipedia.org/wiki/Conway_Cemetery_State_Park
Health Unit Details. (2015). Retrieved September 2, 2015, from http://www.healthy.arkansas.gov/programsServices/localPublicHealthOffices/Pages/huDetails.aspx?show=Lafayette County Health Unit - Lewisville
Lafayette County, Arkansas. (2015). Retrieved August 30, 2015, from https://en.wikipedia.org/wiki/Lafayette_County,_Arkansas#Demographics
Lafayette County, Arkansas Extension Office. (2015). Retrieved September 3, 2015, from http://www.uaex.edu/counties/lafayette/
Lafayette County School District. (2015). Retrieved September 1, 2015, from http://www.lcscougars.org
Magnolia Regional Medical Center. (2015). Retrieved September 2, 2015, from http://magnoliarmc.org
Maya Angelou City Park. (2015). Retrieved September 3, 2015, from http://www.arkansas.com/attractions/detail/maya-angelou-city-park/96650/
Southwest Arkansas Counseling and Mental Health Center. (2015). Retrieved September 2, 2015, from http://www.swacmhc.com
United States Census Bureau. (2015). Retrieved September 2, 2015, from http://quickfacts.census.gov/qfd/states/05/05073.html
SELECTED POPULATION DATA FOR U.S., ARKANSAS, and LAFAYETTE COUNTY, 2013
U.S.
Arkansas
Lafayette County
Total Population
316,128,839
2,959,373
7,252
MORTALITY RATES PER 100,000 POPULATIONS, 2013
U.S.
Arkansas
Lafayette County
TYPES OF DEATH
RATE (NUMBER)
RATE (NUMBER)
RATE (NUMBER)
Malignant Neoplasms
185.01 (584,881)
225.99 (6688)
179.26 (13)
Diseases of the Heart
193.31 (611,105)
249.28 (7377)
330.94 (24)
Ischemic Heart Disease
117.11 (370,213)
147.19 (4356)
17.19 (15)
SOURCE OF RAW DATA: Centers for Disease Control and Prevention, National Center for Health Statistics. Underlying Cause of Death 2013 on CDC WONDER Online Database, released 2015. Data are from the Multiple Cause of Death Files, 2013, as compiled from data provided by the 57 vital statistics jurisdictions through the Vital Statistics Cooperative Program. Accessed at http://wonder.cdc.gov/ucd-icd10.html on Sep 7, 2015 10:57:09 PM
Summary Statement:
In 2013, Lafayette County had a lower mortality rate from malignant neoplasms (179.26) than Arkansas (225.99) and the US (185.01).
In 2013, Lafayette County had higher mortality rate for diseases of the heart (330.94) than Arkansas (249.28) and the US (193.31).
In 2013, Lafayette County had a lower mortality rate from ischemic heart disease (17.19) than Arkansas (147.19) and the US (117.11).
References
Centers for Disease Control and Prevention, National Center for Health Statistics. Underlying Cause of Death 2013 on CDC WONDER Online Database, released 2015. Data are from the Multiple Cause of Death Files, 2013, as compiled from data provided by the 57 vital statistics jurisdictions through the Vital Statistics Cooperative Program. Accessed at http://wonder.cdc.gov/ucd-icd10.html on Sep 7, 2015 10:57:09 PM
Diseases of the Heart
ICD–10 codes I00–I09, I11, I13, I20–I51)
Acute rheumatic fever (I00-I02)
Chronic rheumatic heart diseases (I05-I09)
I11 Hypertensive heart disease
I13 Hypertensive heart and chronic kidney disease
Ischemic heart diseases (I20-I25)Pulmonary heart disease and diseases of pulmonary circulation (I26-I28)
I30 Acute pericarditis
I31 Other diseases of pericardium
I32 Pericarditis in diseases classified elsewhere
I33 Acute and subacute endocarditis
I34 Nonrheumatic mitral valve disorders
I35 Nonrheumatic aortic valve disorders
I36 Nonrheumatic tricuspid valve disorders
I37 Nonrheumatic pulmonary valve disorders
I38 Endocarditis, valve unspecified
I39 Endocarditis and heart valve disorders in diseases classified elsewhere
I40 Acute myocarditis
I41 Myocarditis in diseases classified elsewhere
I42 Cardiomyopathy
I43 Cardiomyopathy in diseases classified elsewhere
I44 Atrioventricular and left bundle-branch block
I45 Other conduction disorders
I46 Cardiac arrest
I47 Paroxysmal tachycardia
I48 Atrial fibrillation and flutter
I49 Other cardiac arrhythmias
I50 Heart failure
I51 Complications and ill-defined descriptions of heart disease
120-125 Ischemic Heart Disease
Acute Myocardial Infarction
I21-I22
Other Acute Ischemic Heart Dis.
I24
Other forms of Chronic Ischemic Heart Disease
I20, I25
Atherosclerotic Cardiovascular Disease, so described
I25.0
All Other Forms of Chronic Ischemic Heart Disease
I20, I25.1-I25.9
References
Centers for Disease Control and Prevention, National Center for Health Statistics. Underlying Cause of Death 2013 on CDC WONDER Online Database, released 2015. Data are from the Multiple Cause of Death Files, 2013, as compiled from data provided by the 57 vital statistics jurisdictions through the Vital Statistics Cooperative Program. Accessed at http://wonder.cdc.gov/ucd-icd10.html on Sep 7, 2015 10:57:09 PM
http://www.healthdata.org/sites/default/files/files/county_profiles/US/County_Report_Lafayette_County_Arkansas.pdf
http://www.healthy.arkansas.gov/stats/county_health_data/lafayette.pdf
The Institute for Health Metrics and Evaluation (IHME) at the University of Washington analyzed the performance of all 3,143 US counties or county-equivalents in terms of alcohol use, life expectancy at birth, smoking prevalence, obesity, physical activity, and poverty using novel small area estimation techniques and the most up-to-date county-level information.
http://www.healthy.arkansas.gov/programsServices/healthStatistics/Brfss/Documents/CountyHealthSurveys/Adult/LafayetteCounty2003BRFSSReport.pdf
23.7% female smokers 2012
In 2013, female life expectancy was in the worst 25% of all counties at 77.7 years, while male life expectancy was in the worst 10% of all counties at 69.6 years. This compares to the national average of 81.2 years for females and 76.5 years for males.
● Changes over the period from 1985 to 2013 were in the middle-performing 50% of all counties for females and in the worst-performing 10% of all counties for males, with females having an increase of 1.1 years and males having an increase of 1.8 years. The national average was an increase of 3.1 years for females and an increase of 5.5 years for males.
In 2013, Lafayette County had a higher mortality rate for diseases of the heart (330.94) than Arkansas (249.28) and the US (193.31) (Centers for Disease Control and Prevention, National Center for Health Statistics, 2015). I chose to identify a heart disease goal from Healthy People 2020 to help met this disparity in Lafayette County based on the statistics reported that there is a higher mortality rate for heart disease in this county.
The Center for Disease Control and Prevention (CDC) reports “Heart disease is the leading cause of death for women in the United States (2015). In the United States, 292,188 women died from heart disease in 2009 (CDC, 2015). According to the CDC Wonder database (2015), 11 women (ages 35-85+) died in Lafayette County related to heart disease in 2013.
To improve cardiovascular health of residents in Lafayette county, a heart disease risk factor screening program will be established. The target population will be women aged 35-65.
Healthy People Health Disparity #1: Heart Disease
Heart Disease
Goal: 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 (USDHHS, 2015).
Short Term Objectives
1. “HDS-4 Increase the proportion of adults who have had their blood pressure measured within the preceding 2 years and can state whether their blood pressure was normal or high” (USDHHS, 2015).
2. “HDS-8 Reduce the mean total blood cholesterol levels among adults” (USDHHS, 2015).
3. “HDS-17 Increase the proportion of adults aged 20 years and older who are aware of the symptoms of and how to respond to a stroke” (USDHHS, 2015).
U.S. Department of Health and Human Services. (2015). About healthy people. Retrieved from http://www.healthypeople.gov/2020/topics-objectives/topic/heart-disease-and-stroke
Heart Disease
Goal: 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 (USDHHS, 2015).
Long Term Objectives
1. “HDS-1 (Developmental) Increase overall cardiovascular health in the U.S. population” (USDHHS, 2015).
2. “HDS-2 Reduce coronary heart disease deaths” (USDHHS, 2015).
3. “HDS-3 Reduce stroke deaths”. (USDHHS, 2015).
U.S. Department of Health and Human Services. (2012). About healthy people. Retrieved from http://www.healthypeople.gov/2020/topics-objectives/topic/heart-disease-and-stroke
References
U.S. Department of Health and Human Services. (2012). About healthy people. Retrieved from http://www.healthypeople.gov/2020/topics-objectives/topic/heart-disease-and-stroke
Center for Disease Control and Prevention. (2015). Women and Heart Disease Fact Sheet. Retrieved September 16, 2015, from http://www.cdc.gov/dhdsp/data_statistics/fact_sheets/fs_women_heart.htm
Centers for Disease Control and Prevention, National Center for Health Statistics (2015). Underlying Cause of Death 2013 on CDC WONDER Online Database, released 2015. Data are from the Multiple Cause of Death Files, 2013, as compiled from data provided by the 57 vital statistics jurisdictions through the Vital Statistics Cooperative Program. Accessed at http://wonder.cdc.gov/ucd-icd10.html on Sep 7, 2015 10:57:09 PM
Centers for Disease Control and Prevention, National Center for Health Statistics (2015). Underlying Cause of Death 2013 on CDC WONDER Online Database, released 2015. Data are from the Multiple Cause of Death Files, 2013, as compiled from data provided by the 57 vital statistics jurisdictions through the Vital Statistics Cooperative Program. Accessed at http://wonder.cdc.gov/ucd-icd10.html on Sep 15, 2015 11:32:09 PM
U.S. Department of Health and Human Services. (2012). About healthy people. Retrieved from http://www.healthypeople.gov/2020/topics-objectives/topic/heart-disease-and-stroke
U.S. Department of Health and Human Services. (2015). About healthy people. Retrieved from http://www.healthypeople.gov/2020/topics-objectives/topic/heart-disease-and-stroke
Using the CDC Wonder database (2015), I was able to determine the leading cause of death of Lafayette County Older Adult (65 and older) residents. Diseases of the heart are the leading cause of death for this target population. This ICD 10 group includes acute and chronic rheumatic fever, hypertensive heart disease, hypertensive heart disease and chronic kidney disease, and ischemic heart diseases (I20-I25). Ischemic heart disease diagnoses include pulmonary heart disease, pericarditis, endocarditis, valve disorders, valvular endocarditis, myocarditis, cardiomyopathy, AV and left bundle branch block, cardiac arrest, atrial fibrillation, other arrhythmias, heart failure and complications of heart disease. To prevent these older adult deaths, you need to begin preventative measures earlier. Therefore, to improve cardiovascular health of residents in Lafayette County, the target population will be women aged 35-65. According to the CDC Wonder database (2015), 11 women (ages 35-85+) died in Lafayette County related to heart disease in 2013.
An important screening intervention that can be performed at every patient contact is high blood pressure screening. The U. S. Preventive Services Task Force (USPSTF) recommends that all adults aged 18 and older be screened for hypertension (HTN). This screening applies only to those without a hypertension diagnosis previously. This screening recommendation is graded A which means that there is substantial benefit if the service is provided (Blood Pressure in Adults, 2015).
The USPSTF recommendations state “HTN should be diagnosed only after 2 or more elevated readings on at least 2 visits over a period of 1 to several weeks (2015).” There is not a recommended screening interval, but it easily completed with every patient contact. According to the panel members appointed to the Eighth Joint National Committee (JNC 8), hypertension is one of the most preventable and important contributors to disease and death. There have been blood pressure goals established for general population (no chronic kidney disease (CKD) or diabetes) and those patients with CKD and diabetes. General population patients 60 and older should have a BP goal of <150/<90 and those younger than 60 should have a BP goal of <140/<90. Any age patient with CKD or diabetes should have a goal of <140/<90 (James et. al, 2014).
References
Blood Pressure in Adults: Screening. U.S. Preventive Services Task Force. July 2015. http://www.uspreventiveservicestaskforce.org/Page /Document/UpdateSummaryFinal/blood-pressure-in-adults-hypertension-screening
Center for Disease Control and Prevention. (2015). Women and Heart Disease Fact Sheet. Retrieved September 16, 2015, from http://www.cdc.gov/dhdsp/data_statistics/fact_sheets/fs_women_heart.htm
Centers for Disease Control and Prevention, National Center for Health Statistics (2015). Underlying Cause of Death 2013 on CDC WONDER Online Database, released 2015. Data are from the Multiple Cause of Death Files, 2013, as compiled from data provided by the 57 vital statistics jurisdictions through the Vital Statistics Cooperative Program. Accessed at http://wonder.cdc.gov/ucd-icd10.html on Sep 7, 2015 10:57:09 PM
James, P. A., Oparil, S., Carter, B. L., Cushman, W. C., Dennison-Himmelfarb, C., Handler, J., ... & Ortiz, E. (2014). 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). Jama, 311(5), 507-520.
Using the CDC Wonder database (2015), I was able to determine the leading cause of death of Lafayette County Older Adult (65 and older) residents. Diseases of the heart are the leading cause of death for this target population. This ICD 10 group includes acute and chronic rheumatic fever, hypertensive heart disease, hypertensive heart disease and chronic kidney disease, and ischemic heart diseases (I20-I25). Ischemic heart disease diagnoses include pulmonary heart disease, pericarditis, endocarditis, valve disorders, valvular endocarditis, myocarditis, cardiomyopathy, AV and left bundle branch block, cardiac arrest, atrial fibrillation, other arrhythmias, heart failure and complications of heart disease. To prevent these older adult deaths, you need to begin preventative measures earlier. Therefore, to improve cardiovascular health of residents in Lafayette County, the target population will be women aged 35-65. According to the CDC Wonder database (2015), 11 women (ages 35-85+) died in Lafayette County related to heart disease in 2013.
An important screening intervention that can be performed at every patient contact is high blood pressure screening. The U. S. Preventive Services Task Force (USPSTF) recommends that all adults aged 18 and older be screened for hypertension (HTN). This screening applies only to those without a hypertension diagnosis previously. This screening recommendation is graded A which means that there is substantial benefit if the service is provided (Blood Pressure in Adults, 2015).
The USPSTF recommendations state “HTN should be diagnosed only after 2 or more elevated readings on at least 2 visits over a period of 1 to several weeks (2015).” There is not a recommended screening interval, but it easily completed with every patient contact. According to the panel members appointed to the Eighth Joint National Committee (JNC 8), hypertension is one of the most preventable and important contributors to disease and death. There have been blood pressure goals established for general population (no chronic kidney disease (CKD) or diabetes) and those patients with CKD and diabetes. General population patients 60 and older should have a BP goal of <150/<90 and those younger than 60 should have a BP goal of <140/<90. Any age patient with CKD or diabetes should have a goal of <140/<90 (James et. al, 2014).
References
Blood Pressure in Adults: Screening. U.S. Preventive Services Task Force. July 2015. http://www.uspreventiveservicestaskforce.org/Page /Document/UpdateSummaryFinal/blood-pressure-in-adults-hypertension-screening
Center for Disease Control and Prevention. (2015). Women and Heart Disease Fact Sheet. Retrieved September 16, 2015, from http://www.cdc.gov/dhdsp/data_statistics/fact_sheets/fs_women_heart.htm
Centers for Disease Control and Prevention, National Center for Health Statistics (2015). Underlying Cause of Death 2013 on CDC WONDER Online Database, released 2015. Data are from the Multiple Cause of Death Files, 2013, as compiled from data provided by the 57 vital statistics jurisdictions through the Vital Statistics Cooperative Program. Accessed at http://wonder.cdc.gov/ucd-icd10.html on Sep 7, 2015 10:57:09 PM
James, P. A., Oparil, S., Carter, B. L., Cushman, W. C., Dennison-Himmelfarb, C., Handler, J., ... & Ortiz, E. (2014). 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). Jama, 311(5), 507-520.
U.S. Department of Health and Human Services. (2015). About healthy people. Retrieved from http://www.healthypeople.gov/2020/topics-objectives/topic/heart-disease-and-stroke
U.S. Department of Health and Human Services. (2015). About healthy people. Retrieved from http://www.healthypeople.gov/2020/topics-objectives/topic/heart-disease-and-stroke
U.S. Department of Health and Human Services. (2015). About healthy people. Retrieved from http://www.healthypeople.gov/2020/topics-objectives/topic/heart-disease-and-stroke
U.S. Department of Health and Human Services. (2015). About healthy people. Retrieved from http://www.healthypeople.gov/2020/topics-objectives/topic/heart-disease-and-stroke
APRNs – To develop the pamphlets and email topics to provide to the participants
To also provide treatment, as needed
Nurses – to assist with vital sign checks and blood draws at the health fair and home health agencies
One home health nurse to be the evaluator of the program
Administrative Personnel— to handle email and general paperwork duties throughout the program
Supplies needed will be:
Blood pressure monitors from local doctor’s offices/health department (No cost)
Test tubes and laboratory fees (Paid for by grants and sponsorship)
Paper and ink for pamphlets (Paid for by grants and sponsorship)
Email (free)
Centers for Disease Control and Prevention. (2011). Program Performance and Evaluation Office. Retrieved from Centers for Disease Control and Prevention: http://www.cdc.gov/eval/steps/index.htm
McKenzie, J., Neiger, B., & Thackeray, R. (2013). Planning, implementing, evaluating health promotion programs: A Primer (6th ed.). San Francisco, CA: Pearson Benjamin Cummings.
This framework uses 6 steps: engaging stakeholders, describing the program, focusing the evaluation design, gathering credible evidence, justifying conclusions, and ensuring use and shared lessons learned (Centers for Disease Control and Prevention, 2011).
Step 1 is to engage the stakeholders, which is “those involved in the program, those served or affected by the program, and the primary users of the evaluations results” (McKenzie, 2013). For the Heart to Heart program the stakeholders are the target population, program facilitators/board members, and myself.
The next step, step 2, is to describe the program. McKenzie (2013) states that this sets the frame of reference for the rest of the evaluation. Included in this step are the mission, goals, and objectives of the program (Centers for Disease Control and Prevention, 2011). For the Heart to Heart program, the goal is to 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 through increasing the number of adults who have had their blood pressure measured within the preceding 2 years and can state whether their blood pressure was normal or high and to increase the proportion of adults with hypertension whose blood pressure is under control. These objectives are key for the Heart to Heart program to be beneficial to the target population of women ages 35-65 living in Lafayette County who agree to participate in the program.
Step 3 is focusing on the evaluation design which involves making sure that those in the program development have used the resources appropriately and efficiently. For this step it is best to formulate a research question and determine the type of design that is going to be used (Centers for Disease Control and Prevention, 2011). For the Heart to Heart program, a Quantitative study design is the best fit, since we will be measuring the number of participants will be able to state what their last blood pressure readings were and if the blood pressure was normal or high and the number of participants ages 35-65 with hypertension will have normalized blood pressure readings in provider medical records.
Centers for Disease Control and Prevention. (2011). Program Performance and Evaluation Office. Retrieved from Centers for Disease Control and Prevention: http://www.cdc.gov/eval/steps/index.htm
McKenzie, J., Neiger, B., & Thackeray, R. (2013). Planning, implementing, evaluating health promotion programs: A Primer (6th ed.). San Francisco, CA: Pearson Benjamin Cummings.
Step 4 is gathering credible evidence, which involves deciding measurement indicators, quality, quantity, and the logistics for collecting the evidence. This step requires a lot of organization to keep the data needed for measuring the evidence (Centers for Disease Control and Prevention, 2011). For the Heart to Heart program, this will require all parties to be involved, especially the nurses who are completing the screenings. Documentation will play a critical role in this step. The duties of the personnel involved in the Heart to Heart program will be listed in detail prior to implementation. LPN’s will be asked to complete blood pressure monitoring via sphygmomanometer, lab draws for cholesterol screenings, and smoking screenings. RN’s will be asked to complete the educational portion of the program, including follow up education for those with further questions. RN’s will also be asked to assist the LPN’s if the screening process becomes extremely busy as to avoid having any patient wait longer than set by the stakeholders. APRN’s will interpret the data collected by the LPN’s and RN’s and make recommendations based on this data. The APRN’s will also be completing a full health history with a focus on cardiovascular health history. Administrative staff will create email databases based on the recommendations of APRN’s in order to send the appropriate educational materials.
Step 5 entails justifying conclusion, which compares the evidence against five elements: “standards, analysis/synthesis, interpretation, judgment and recommendations.” (Centers for Disease Control and Prevention, 2011). For the program in Lafayette County, the techniques used for analysis of the data and interpretation of findings should be discussed and determined before data collection begins. This will require that the stakeholders in the Heart to Heart program know that the conclusions for the data must be directly linked to the evidence (Centers for Disease Control and Prevention, 2011).
The final step, step 6, is ensuring use and sharing lessons learned. The step focuses on what the group does with the results. For the Lafayette County program, this will involve stakeholders stating their needs to each other so that trust can be built and maintained. In sharing of lessons learned, this can take place in a formal report or a less formal verbal meeting that should be predetermined by the stakeholders (Centers for Disease Control and Prevention, 2011).
Stakeholders, when developing the program evaluation framework, should discuss strengths and weaknesses. For the Heart to Heart program in Lafayette County, strengths include reducing heart disease for the target population, educating the population about heart disease and the associated risk factors. Other strengths of the program include reducing the number of people with high blood pressure, high cholesterol and smoking history. One weakness that I have been able to determine is participants not following through with recommendations or appointments. Another weakness is patients who lack the self-efficacy to change their behavior.
References
Blood Pressure in Adults: Screening. U.S. Preventive Services Task Force. July 2015. http://www.uspreventiveservicestaskforce.org/Page /Document/UpdateSummaryFinal/blood-pressure-in-adults-hypertension-screening
CABUN Rural Health Services - Providing Healthcare for All in Arkansas. (2015). Retrieved September 2, 2015, from http://www.cabun.org
Center for Disease Control and Prevention. (2015). Women and Heart Disease Fact Sheet. Retrieved September 16, 2015, from http://www.cdc.gov/dhdsp/data_statistics/fact_sheets/fs_women_heart.htm
Centers for Disease Control and Prevention. (2011). Program Performance and Evaluation Office. Retrieved from Centers for Disease Control and Prevention: http://www.cdc.gov/eval/steps/index.htm
Centers for Disease Control and Prevention, National Center for Health Statistics. Underlying Cause of Death 2013 on CDC WONDER Online Database, released 2015. Data are from the Multiple Cause of Death Files, 2013, as compiled from data provided by the 57 vital statistics jurisdictions through the Vital Statistics Cooperative Program. Accessed at http://wonder.cdc.gov/ucd-icd10.html on Sep 7, 2015 10:57:09 PM
Conway Cemetery State Park. (2015). Retrieved September 2, 2015, from https://en.wikipedia.org/wiki/Conway_Cemetery_State_Park
Health Unit Details. (2015). Retrieved September 2, 2015, from http://www.healthy.arkansas.gov/programsServices/localPublicHealthOffices/Pages/huDetails.aspx?show=Lafayette County Health Unit - Lewisville
James, P. A., Oparil, S., Carter, B. L., Cushman, W. C., Dennison-Himmelfarb, C., Handler, J., ... & Ortiz, E. (2014). 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). Jama, 311(5), 507-520.
Lafayette County, Arkansas. (2015). Retrieved August 30, 2015, from https://en.wikipedia.org/wiki/Lafayette_County,_Arkansas#Demographics
Lafayette County, Arkansas Extension Office. (2015). Retrieved September 3, 2015, from http://www.uaex.edu/counties/lafayette/
Lafayette County School District. (2015). Retrieved September 1, 2015, from http://www.lcscougars.org
Magnolia Regional Medical Center. (2015). Retrieved September 2, 2015, from http://magnoliarmc.org
Maya Angelou City Park. (2015). Retrieved September 3, 2015, from http://www.arkansas.com/attractions/detail/maya-angelou-city-park/96650/
McKenzie, J., Neiger, B., & Thackeray, R. (2013). Planning, implementing, evaluating health promotion programs: A Primer (6th ed.). San Francisco, CA: Pearson Benjamin Cummings.
Occupations in Lafayette County, Arkansas. (2015). Retrieved September 17, 2015, from http://statisticalatlas.com/county/Arkansas/Lafayette-County/Occupations
Southwest Arkansas Counseling and Mental Health Center. (2015). Retrieved September 2, 2015, from http://www.swacmhc.com
U.S. Department of Health and Human Services. (2012). About healthy people. Retrieved from http://www.healthypeople.gov/2020/topics-objectives/topic/heart-disease-and-stroke
U.S. Department of Health and Human Services. (2015). About healthy people. Retrieved from http://www.healthypeople.gov/2020/topics-objectives/topic/heart-disease-and-stroke
United States Census Bureau. (2015). Retrieved September 2, 2015, from http://quickfacts.census.gov/qfd/states/05/05073.html
References
Blood Pressure in Adults: Screening. U.S. Preventive Services Task Force. July 2015. http://www.uspreventiveservicestaskforce.org/Page /Document/UpdateSummaryFinal/blood-pressure-in-adults-hypertension-screening
CABUN Rural Health Services - Providing Healthcare for All in Arkansas. (2015). Retrieved September 2, 2015, from http://www.cabun.org
Center for Disease Control and Prevention. (2015). Women and Heart Disease Fact Sheet. Retrieved September 16, 2015, from http://www.cdc.gov/dhdsp/data_statistics/fact_sheets/fs_women_heart.htm
Centers for Disease Control and Prevention. (2011). Program Performance and Evaluation Office. Retrieved from Centers for Disease Control and Prevention: http://www.cdc.gov/eval/steps/index.htm
Centers for Disease Control and Prevention, National Center for Health Statistics. Underlying Cause of Death 2013 on CDC WONDER Online Database, released 2015. Data are from the Multiple Cause of Death Files, 2013, as compiled from data provided by the 57 vital statistics jurisdictions through the Vital Statistics Cooperative Program. Accessed at http://wonder.cdc.gov/ucd-icd10.html on Sep 7, 2015 10:57:09 PM
Conway Cemetery State Park. (2015). Retrieved September 2, 2015, from https://en.wikipedia.org/wiki/Conway_Cemetery_State_Park
Health Unit Details. (2015). Retrieved September 2, 2015, from http://www.healthy.arkansas.gov/programsServices/localPublicHealthOffices/Pages/huDetails.aspx?show=Lafayette County Health Unit - Lewisville
James, P. A., Oparil, S., Carter, B. L., Cushman, W. C., Dennison-Himmelfarb, C., Handler, J., ... & Ortiz, E. (2014). 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). Jama, 311(5), 507-520.
Lafayette County, Arkansas. (2015). Retrieved August 30, 2015, from https://en.wikipedia.org/wiki/Lafayette_County,_Arkansas#Demographics
Lafayette County, Arkansas Extension Office. (2015). Retrieved September 3, 2015, from http://www.uaex.edu/counties/lafayette/
Lafayette County School District. (2015). Retrieved September 1, 2015, from http://www.lcscougars.org
Magnolia Regional Medical Center. (2015). Retrieved September 2, 2015, from http://magnoliarmc.org
Maya Angelou City Park. (2015). Retrieved September 3, 2015, from http://www.arkansas.com/attractions/detail/maya-angelou-city-park/96650/
McKenzie, J., Neiger, B., & Thackeray, R. (2013). Planning, implementing, evaluating health promotion programs: A Primer (6th ed.). San Francisco, CA: Pearson Benjamin Cummings.
Occupations in Lafayette County, Arkansas. (2015). Retrieved September 17, 2015, from http://statisticalatlas.com/county/Arkansas/Lafayette-County/Occupations
Southwest Arkansas Counseling and Mental Health Center. (2015). Retrieved September 2, 2015, from http://www.swacmhc.com
U.S. Department of Health and Human Services. (2012). About healthy people. Retrieved from http://www.healthypeople.gov/2020/topics-objectives/topic/heart-disease-and-stroke
U.S. Department of Health and Human Services. (2015). About healthy people. Retrieved from http://www.healthypeople.gov/2020/topics-objectives/topic/heart-disease-and-stroke
United States Census Bureau. (2015). Retrieved September 2, 2015, from http://quickfacts.census.gov/qfd/states/05/05073.html