Health Promotion for African American’s with Cardiovascular disease Nurs 310 VL1 Ferris state university Group Members: Andrea Baumgart, Jennifer Discher, & Brittany torok

Plan of action This group is going to carry out our health promotion plan within the workplace. Our group is going to give the employees who participate a quick questionnaire before we educate them on prevention, detection, & treatment of risk factors for cardiovascular disease. The goal is to educate and ensure that the employees in our community understand the need to obtain screenings, routine physicals, and follow a healthy diet. Our main focus is with African Americans because the prevalence of cardiovascular disease is higher within this group.

Evaluation This plan will be evaluated when our group returns to the facility, 6 months after our first visit and give the employees a similar questionnaire to review the employees outcomes. This questionnaire will inform our group of the employees follow-up care received if they were at risk, inform us how well they kept up with their diets, and if they obtained screenings & physicals. Ultimately this review will let us as a group know how well we educated the employees and will show us how successful our presentation was to the employees of this workplace.

Demographic data “ The 2010 census showed that the united states population on april 1, 2014 was 308.7 million. Out of total population, 38.9 million people, or 13 percent, identified as black alone. In addition 3.1 million people, or 1 percent, reported combination with one or more other races. Together 42.0 million people. 14 percent of all people in the united states” (“ the black population 2010”, 2011). “Among non-Hispanic blacks age 20 and older, 44.4% of men and 48.9% of women have CVD” (“African Americans and Cardiovascular disease”, 2013). “In 2009, CVD caused the deaths of 46,334 black males and 48,070 black females” (African Americans and cardiovascular disease”, 2013). “The 2009 overall death rate from CVD was 236.1. Death rates for blacks were 387.0 for males and 267.9 for females”(“African Americans and cardiovascular disease”, 2013).

Cultural descriptors that impact health A 2009 study (as published in the new England journal of medicine) showed that many African-Americans do not utilize healthcare for preventative purposes but rather wait until they are sick (Kam, N.D.). The study further revealed that African-Americans tend to trust and therefore more frequently visit primary care physicians, as opposed to specialists such as cardiologists (Kam, N.D.). Genetics, socioeconomic factors, and Even racism have all been shown to play major roles in the statistically poorer health of African-Americans as opposed to whites and other minorities (DeNoon, n.d.).

Cardiovascular disease in African Americans “ CVD is the most common cause of death in African Americans and they experience death due to cvd and stroke rates higher than any other groups in the united states” ( Yancy & Sica, 2004).

Health risk factors Hypertension Obesity The American Heart Association states that African-Americans have a highest rate of cardiovascular disease than any other race group in the world. Not only is hypertension more severe in American-American than Caucasian but, it occurs earlier in life as well. “Research suggests African-Americans may carry a gene that makes them more salt sensitive, increasing the risk of high blood pressure (American Heart Association, 2014).” The AHA states that 63% of men and 77% of African-American women are overweight or obese (American Heart Association, 2014)

Health Risk Factors Diabetes “African-Americans are nearly twice as likely to have diabetes as non-Hispanic whites (American Heart Association, 2014).” Around 15% of African-Americans 20 years old or older have diabetes.

Environmental and Community Risk Factors Health Disparities It has been proven that there are disparities between populations in the Us African Americans are of the most seriously affected by these disparities Aside from biological disparities, social and environmental factors affect their health, morbidity and mortality as well Environmental Poor transportation (unable to attend dr. appointments, work, fruit market, etc.) Unsafe or lack of places to exercise outside (sidewalks, track, etc.) Community Social group (eating poorly, drinking alcohol, smoking, etc.) Unavailability of high quality health care Bias in treatment (Yancy, Abraham, Albert, Clare, Stough, Gheorghiade, Greenberg, O’Connor, She, Sun, Young & Fonarow, 2008)

Our Health Promotion Model Healthy People 2020 “Access to and availability of healthier foods can help adults follow healthful diets. For example, better access to retail venues that sell healthier options may have a positive impact on a person’s diet. These venues may be less available in low-income or rural neighborhoods.” “Longer hours, compressed work weeks, shift work, reduced job security, and part- time and temporary work are realities of the modern workplace and are increasingly affecting the health and lives of U.S. adults. Research has shown that workers experiencing these stressors are at higher risk of injuries, heart disease, and digestive disorders.” African Americans are among the minorities that generally populate low-income neighborhoods. 13.4 million families were living less that 200 percent of the federal poverty level; of these, 22% were black or African American (Simms, Fortuny & Henderson, 2009). Many do not have access to transportation to get to a market that sells healthy food. (U.S. Department of Health and Human Services, 2014)

Our Health Promotion Model Healthy People 2020 “According to the National Assessment of Adult Literacy, African American, Hispanic, and American Indian or Alaska Native adults were significantly more likely to have below basic health literacy compared to their white and Asian or Pacific Islander counterparts.” “In 2007, African Americans and Hispanics were more likely to be unemployed compared to their white counterparts.” “Low socioeconomic status is associated with an increased risk for many diseases, including cardiovascular disease, arthritis, diabetes, chronic respiratory diseases, and cervical cancer as well as for frequent mental distress.” (U.S. Department of Health and Human Services, 2014)

Pender’s Health Promotion Model Our Health Promotion Model Pender’s Health Promotion Model Pender’s model defines health as “a positive dynamic state not merely the absence of disease” (Nursing Planet) Describes the characteristics of individuals as well as how behavior and environment affect health It incorporates Interpersonal Influences (family, peers, providers) and situational influences Also incorporates prior behavior Perceived benefits of action Perceived barriers to action Perceived self-efficacy Activity-related affect Pender’s Model takes a person’s prior experiences and incorporates that behavior with social and cultural factors that affect them, to create a plan for a new, learned behavior to change the outcome of a person’s health. (Pender, Murdaugh & Parsons, 2011)

Pender’s health promotion model Image retrieved from http://nursingplanet.com/health_promotion_model.html

Our Health Promotion Model Health Promoting Behavior (A healthier behavior leads to a healthier outcome) Commitment to a Plan of Action (Each individual recognizes their health risks and identifies an action that can be taken to change that risk) Benefits of Action (lower blood pressure, lower cholesterol, weight loss, etc.) Perceived Barriers to Action (Expense and difficulty of cooking healthy, loss of satisfaction from smoking, etc.) Competing Demands and Preferences Perceived Self-efficacy (Joining a sport they excel at, join a group of friends to exercise, etc.) Activity-related Affect (Teach and reinforce the positive outcomes of each action taken to promote health) Our Health Promotion Plan using Pender’s Model

References American Heart Association, (2014). African-Americans and cardiovascular disease. (N.D.). Statistical fact sheet update. Retrieved August 4, 2014, from http://www.Heart.Org/idc/groups/heart-public/@wcm/@sop/@smd/documents/dow Denoon, D. (N.D.). Why 7 deadly diseases strike blacks most. Webmd. Retrieved august 4, 2014, from http://www.Webmd.Com/hypertension- high-blood-pressure/features/why-7-deadly-diseases-strike-blacks-most?Page=3 Kam, K. (N.D.). Why are African-Americans at greater risk for heart disease?. Webmd. Retrieved August 4, 2014, from http://www.Webmd.Com/heart-disease/features/why-african-americans-greater-risk-heart-disease?Page=2 Pender, N., Murdaugh, C., Parsons, M.A., (2011). Health promotion in nursing 6th ed., Pp. 44-51. Upper Saddle River, NJ: Pearson.

Our Health Promotion Model References The black population: 2010. (2011, September 1). 2010 census briefs. Retrieved August 4, 2014, from http://www.Census.Gov/prod/cen2010/briefs/c2010br-06.Pdf U.S. Department of Health and Human Services, (2014). Leading health indicators, Healthy People 2020. Retrieved from http://healthypeople.Gov/2020/LHI/socialdeterminants.Aspx?Tab=determinants Yancy, C., Abraham, W., Albert, N., Clare, R., Stouch, W., Gheorghiade, M., Greenbert, B., O’connor, C., She, L., Sun, J., Young, J., & fonarow, G., (2008). Quality of care and outcomes for African Americans hospitalized with heart failure. Journal of the American college of cardiology, 51(17), pp. 1975-1684. Yancy, C. W., & Sica, D. (2004). Cardiovascular disease in African Americans. The journal of clinical hypertension, 6(4), 54-56