1. Using preventative care at a younger age to decrease incidence and bring awareness. By: Halla Hammoud, Angela Leyrer, and Alison Skellenger

2.  Southern United States and Urban areas  42,020,743 African American population size as of 2010  45% home owners  Median household income $32,229  Life expectance for men: 70.8 years  Women: 77.5 years  Higher rates of: Obesity, diabetes, hypertension  42% are hypertensive  Higher rates of Cardiovascular mortality than ANY other racial or ethnic group

3. 70% of African American Men are overweight or obese (Picket et al. 2013) 80% of African American women are overweight or obese (Picket et al. 2013) 40% of African Americans are physically inactive (Picket et al. 2013) Low rates of eating a heart healthy diet (Picket et al. 2013) Many feel stress causes their HTN as opposed to it being a chronic illness (Shaya et al., 2012 ) Lower rate of sticking to a medication regimen(Picket et al. 2013)

4.  Hypertension is higher in U.S. Blacks than blacks living in Africa  African Americans have 51% greater prevalence of obesity than whites (Fuchs, 2011)  41% of U.S Blacks have hypertension as opposed to 27% of Whites (St John Providence, 2014)  Blacks worldwide have similar rates of hypertension as Whites  More than half of non-Hispanic Black women age 20 and older are obese (St John Providence, 2014)  12.6% of Blacks over the age of 20 have been diagnosed with diabetes which is a contributing risk factor (St John Providence, 2014)

5. Genetics Blacks respond differently to blood pressure meds than other populations African Americans are more sensitive to salt Higher sensitivity to alcohol HTN develops earlier in life for African Americans than Whites Lifestyle Diet Exercise Obesity Type II Diabetes

6. Social Factors:  Racial Discrimination  Higher rates of unemployment among African Americans  Living in disadvantaged neighborhoods (Pickering, 2001):  chronic stress from violence and poverty  walking paths and fitness centers not available in all neighbor hoods  lack of safety in neighborhoods limiting walking/exercise opportunities Economic Factors  Less access to healthcare and healthcare information  Lower levels of income and education

7.  Five stages of change  Precontemplation  Contemplation  Preparation  Action  Maintaince

8.  Health fair at a college  Engage people in education session regarding six self care activities determined by Joint National Committee on prevention, detection, evaluation, and treatment of high blood pressure  Take antihypertensive  Maintain or lose weight  Low-salt diet  Limit alcohol  Exercise  No smoking  Use self-efficacy  Encourage keeping journal regarding blood pressure, weight reduction, salt intake, physical activity, and non-smoking

9.  Counselling session at three months and six months  Bring journal to session  Evaluate how people are doing  Provide encouragement  Reteach if need be

10.  Prevention activity focuses on two aspects of Healthy People 2020  One of the adolescent health care focus is on the use of positive youth development interventions for preventing adolescent health risk behaviors (Healthy People 2020, 2014).  Decreasing cardiovascular disease by increasing awareness of hypertension in young adults.  Our plan promotes  Blood pressure awareness  Decreasing risk factors  Access to healthcare

11.  The African American population are in need of awareness and prevention strategies to help decrease their cardiac risk factors. By educating a population of college students, we are training them to make those lifestyle changes. They are at a young enough age to make those lifestyle changes and bring the information back to their family members. This age group can adapt to these changes, understand the consequences of an unhealthy lifestyle, and utilize appropriate resources. The students that are impacted by this outreach program can help to reduce the HTN rates and decrease cardiovascular disease. Our outreach program aligns it’s goals with Healthy People 2020s, by decreasing the incidence of cardiovascular disease.

12. American Heart Association. (2014). African Americans and blood pressure. Retrieved from http://www.heart.org/HEARTORG/Conditions/HighBloodPressure/UnderstandYourRis kforHighBloodPressure/High-Blood-Pressure-and-African- Americans_UCM_301832_Article.jsp Cuffee, Y.L., Hargraves,J.L., & Allison, J. (1991). Exploring the association between reported discriminations and hypertension among african americans: A systemic review. Ethnicity & Disease, 22(4), p. 422-431. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/23140072 Cuffee, Y.L., Hargraves, J.L., Rosal, M., Briesacher, B.A., Shchoenthaler, A., Person, S.,…Hullet, S. (2013). Reported racial discrimination, trust in physicians, and medication adherence among inner-city African Americans with hypertension. American Journal of Public Health, 103(11), p. 55-62. Retrieved fromhttp://www.ncbi.nlm.nih.gov/pubmed/24028222 Fuchs, F. (2011). Why do black americans have a higher prevalence of hypertension? Hypertension, 57(3), p.379-380. Retrieved from http://hyper.ahajournals.org/content/57/3/379.full

13. Pickering, T. (2001). Why is hypertension more common in African Americans? Retrieved fromhttp://www.medscape.com/viewarticle/407721 Pickett, S., Allen, W., Franklin, M., & Peters, R. M. (2013). Illness beliefs in African Americans with hypertension. Western Journal of Nursing Research. 36(2), 150-170. doi: 10.1177/0193945913491837 Shaya, F. T. PhD, MPH., Chirikov, V. V. MS., Mullins, C. D. PhD., Shematek, J. MD., Howard, D. MPH., Foster, C. RN., Saunders, E. MD. (2012). Social networks help control hypertension. doi: 10.1111/jch.12036 St John Providence. (n.d). High blood pressure and African-Americans. Retrieved from http://www.stjohnprovidence.org/HealthInfoLib/swarticle.aspx?type=1&id=2998 Velicer, W.F., Prochaska, J.O., Fava, J.L., Norman, G.L., & Redding, C.A. (1998). Detailed overview of the transtheoretical model. Cancer Prevention and Research. 38, 216-233. Retrieved from http://www.uri.edu/research/cprc/TTM/detailedoverview.htm. Warren-Findlow, J.,Seymour, R., Brunner, L. (2012). The association between self-efficacy and hypertension self-care activities among African American adults. Journal of Community Health. 37, 15-24. DOI 10.1007/s10900-011-9410-6.