Read the attachment and follow all instructions for the assignment. everything you need to successfully complete both assignments is attached below. The first is the literature review created that was based on the mission statement needed for this assignment which will be the second attachment. the third attachment will be the first assignment that should be completed. “Please refer to Chapter 7 of the textbook to review the theories and models that are used to develop health education programs and Chapter 8 to review interventions and intervention activities. You will also develop four potential intervention activities that support your health education program and provide theoretical support for these activities.” please read all the requirements and follow every step-by-step detail. the fourth attachment will be the “Final Paper sample” mentioned in the assignment. The fifth attachment will be the second and final assignment that should be completed that goes hand-in-hand with the first assignment that is completed. “Now, you will actually create a portion of your intervention itself Select one of the four intervention activities that you developed in Project Assignment 4 and create the intervention activity. For example, if one of your intervention activities was a lecture, you will create the actual presentation with notes to accompany that activity. If your intervention includes a cooking component on healthy eating, you will create the recipes and provide step-by-step instructions for the activity. If your intervention includes an informative brochure, you will create that brochure. Remember that your activity must be compelling enough to increase knowledge and, in turn, change the behaviors and ideas of the participants. In addition to the activity, please provide a description of the activity and how the activity is supported by all the background research you’ve done and the theory/model you have chosen.” please read all the requirements and follow every step-by-step detail. Please submit each assignment individually, 2 separate word documents.
1
Project Assignment 2
Mays Karzone
June 16, 2022
2
Project Assignment 2
Mission Statement
Lung cancer’s health-seeking behavior allows victims or lung cancer patients to seek
medical intervention. So, health-seeking behavior in lung cancer includes a long-standing cough
that only worsens with time, persistent breathlessness, coughing blood, pain when breathing or
coughing, and recurring chest infections. Individuals who show these symptoms should always
seek medical help since they could be having lung cancer. Unexplainable weight loss and
persistent tiredness or lack of energy are other reasons that could drive a person to seek health
consultation or medical help for lung cancer. The priority population for this study is middle
eastern men aged between 25 to 40 years.
Background on Health Condition and Priority Population
Lung cancer is one of the most fatal, serious, and common types of cancer in the world
today. The Centers for Disease Control and Prevention identifies it as the third most diagnosed
cancer in the United States in both men and women. Understandably, lung cancer tops the list of
the leading causes of cancer death globally, contributing to a significant percentage of all global
cancer deaths. Yearly, more people die from lung cancer than any other type of cancer. However,
recent trends indicate that lung cancer’s prevalence and mortality rates continue to decline partly
because more people are realizing the negative health impacts of smoking and are quitting the
deadly habit. Malhotra et al. (2016), Chen and Wu (2020), and Huang et al. (2022) underlined
smoking as the leading cause of lung cancer globally. The CDC further identifies cigarette and
tobacco smoking as the leading risk factors for lung cancer in the U.S., linking to about 80 to 90
percent of lung cancer deaths reported in the country annually. According to the CDC, tobacco
smoke includes a mixture of at least 7,000 toxic chemicals that, when introduced into the lungs,
3
increase the smoker’s susceptibility to developing lung cancer. Concisely, lung cancer is a fatal
type of cancer mainly caused by long-term cigarette or tobacco smoking.
The priority population of this study is middle eastern men aged between 25 to 40 years.
Understandably, men aged between 25 to 40 years are the most vulnerable population to lung
cancer since they find smoking a lifestyle. This lifestyle becomes a habit and an addiction, with
quitting becoming hard. Besides, men are the most vulnerable group than women. Men are the
most prone due to their daily undertakings and the nature of their work. Men comprise the largest
percentage of the population that work in environments with heavy metals, chemicals, asbestos,
and silica, which are also significant causes of lung cancer. Typically, this study’s target or priority
population is at a higher risk of lung cancer due to their lifestyle and occupation.
Why Lung Cancer is a Health Problem
Lung cancer is a serious health problem due to several reasons. One reason that shows lung
cancer is a serious health problem is its high prevalence rate. The CDC identifies lung cancer as
one of the most common types of cancer globally and the second most diagnosed cancer in the
U.S. This means that its prevalence rate in the U.S. and globally is high, making it a serious health
problem and concern. Lung cancer’s mortality rate also indicates that the condition is a serious
health problem and concern. The CDC underlines that smokers are 15 or 30 times more likely to
die from lung cancer than nonsmokers. Hence, with high prevalence and death rates, lung cancer is
a serious health concern and problem.
Successful, Unsuccessful, and Existing Programs and Interventions
The priority population needs assistance in reducing their susceptibility to lung cancer.
Some of the programs and interventions put in place are proving to be beneficial and successful
since more people are quitting smoking and adopting healthy and good lifestyle choices. The other
4
programs yet to be implemented are more likely to be successful and beneficial since they have
succeeded in other areas. Health education programs have been introduced to help smokers and
addicts reduce smoking and avert the vice. Free health consultations have been successful with
other health conditions; therefore, they are also more likely to be effective in helping the priority
population. This initiative can help in the early diagnosis of lung cancer to reduce lung cancer
death rates among middle eastern men aged between 25 to 40 years. Annual screening or
examinations for lung cancer in the priority population will also contribute to their overall
betterment. The U.S. Preventive Service Task Force (USPSTF) has emphasized that annual
screening for lung cancer in grownups can facilitate early diagnosis of the condition, leading to
timely prevention, treatment, and better outcomes. Furthermore, online ads addressing lung
cancer’s health risks will help educate society. Additionally, free health education seminars for
workers, especially in the workplace, addressing the prevention of lung cancer and the dangers of
smoking will benefit the priority population.
5
1
Project Assignment 2
2
Project Assignment 2
Mission Statement
Lung cancer’s health-seeking behavior allows victims or lung cancer patients to seek
medical intervention. So, health-seeking behavior in lung cancer includes a long-standing cough
that only worsens with time, persistent breathlessness, coughing blood, pain when breathing or
coughing, and recurring chest infections. Individuals who show these symptoms should always
seek medical help since they could be having lung cancer. Unexplainable weight loss and
persistent tiredness or lack of energy are other reasons that could drive a person to seek health
consultation or medical help for lung cancer. The priority population for this study is middle
eastern men aged between 25 to 40 years.
Background on Health Condition and Priority Population
Lung cancer is one of the most fatal, serious, and common types of cancer in the world
today. The Centers for Disease Control and Prevention identifies it as the third most diagnosed
cancer in the United States in both men and women. Understandably, lung cancer tops the list of
the leading causes of cancer death globally, contributing to a significant percentage of all global
cancer deaths. Yearly, more people die from lung cancer than any other type of cancer. However,
recent trends indicate that lung cancer’s prevalence and mortality rates continue to decline partly
because more people are realizing the negative health impacts of smoking and are quitting the
deadly habit. Malhotra et al. (2016), Chen and Wu (2020), and Huang et al. (2022) underlined
smoking as the leading cause of lung cancer globally. The CDC further identifies cigarette and
tobacco smoking as the leading risk factors for lung cancer in the U.S., linking to about 80 to 90
percent of lung cancer deaths reported in the country annually. According to the CDC, tobacco
smoke includes a mixture of at least 7,000 toxic chemicals that, when introduced into the lungs,
3
increase the smoker’s susceptibility to developing lung cancer. Concisely, lung cancer is a fatal
type of cancer mainly caused by long-term cigarette or tobacco smoking.
The priority population of this study is middle eastern men aged between 25 to 40 years.
Understandably, men aged between 25 to 40 years are the most vulnerable population to lung
cancer since they find smoking a lifestyle. This lifestyle becomes a habit and an addiction, with
quitting becoming hard. Besides, men are the most vulnerable group than women. Men are the
most prone due to their daily undertakings and the nature of their work. Men comprise the largest
percentage of the population that work in environments with heavy metals, chemicals, asbestos,
and silica, which are also significant causes of lung cancer. Typically, this study’s target or
priority population is at a higher risk of lung cancer due to their lifestyle and occupation.
Why Lung Cancer is a Health Problem
Lung cancer is a serious health problem due to several reasons. One reason that shows
lung cancer is a serious health problem is its high prevalence rate. The CDC identifies lung
cancer as one of the most common types of cancer globally and the second most diagnosed
cancer in the U.S. This means that its prevalence rate in the U.S. and globally is high, making it a
serious health problem and concern. Lung cancer’s mortality rate also indicates that the condition
is a serious health problem and concern. The CDC underlines that smokers are 15 or 30 times
more likely to die from lung cancer than nonsmokers. Hence, with high prevalence and death
rates, lung cancer is a serious health concern and problem.
Successful, Unsuccessful, and Existing Programs and Interventions
The priority population needs assistance in reducing their susceptibility to lung cancer.
Some of the programs and interventions put in place are proving to be beneficial and successful
since more people are quitting smoking and adopting healthy and good lifestyle choices. The
4
other programs yet to be implemented are more likely to be successful and beneficial since they
have succeeded in other areas. Health education programs have been introduced to help smokers
and addicts reduce smoking and avert the vice. Free health consultations have been successful
with other health conditions; therefore, they are also more likely to be effective in helping the
priority population. This initiative can help in the early diagnosis of lung cancer to reduce lung
cancer death rates among middle eastern men aged between 25 to 40 years. Annual screening or
examinations for lung cancer in the priority population will also contribute to their overall
betterment. The U.S. Preventive Service Task Force (USPSTF) has emphasized that annual
screening for lung cancer in grownups can facilitate early diagnosis of the condition, leading to
timely prevention, treatment, and better outcomes. Furthermore, online ads addressing lung
cancer’s health risks will help educate society. Additionally, free health education seminars for
workers, especially in the workplace, addressing the prevention of lung cancer and the dangers of
smoking will benefit the priority population.
5
References
Chen S, Wu S. Identifying Lung Cancer Risk Factors in the Elderly Using Deep Neural
Networks: Quantitative Analysis of Web-Based Survey Data,
https://www.jmir.org/2020/3/e17695/
Huang J, et.al (2022), Distribution, Risk Factors and Temporal Trends for Lung Cancer
Incidence and Mortality, A Global Analysis, https://journal.chestnet.org/article/S00123692(22)00017-4/fulltext
Lung Cancer Screening,
https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/lung-cancerscreening
Malhotra, J et. al (2016), Risk factors for lung cancer worldwide,
https://erj.ersjournals.com/content/48/3/889
What is Lung Cancer? https://www.cdc.gov/cancer/lung/basic_info/what-is-lung-cancer.htm
HLT 4310 – Project Assignment 3
The University of Houston
Dr. Eliz Markowitz
This assignment builds upon the previous assignments, in which you determined both your health
condition and priority population and conducted a basic needs assessment. Based on both the
information you have found in your research and the feedback you have received, you will now develop
goals and objectives for your health education intervention. Please refer to the information on SMART
Objectives on Blackboard and Chapter 6 of the textbook for more information on goals and objectives.
Due: 06/21/2022 at 11:59 PM
Value: 100 points
•
•
Clearly Defined Mission Statement (10 points)
Program Goals and Objectives (90 points)
Format: See example below and the next page for general template
Goals and objectives should be SMART (Specific, Measurable, Achievable, Relevant, and Time-Bound).
Read the supplemental materials on developing SMART objectives in the Class Six Module and consider
the following example:
Mission Statement:
To increase the survival rate of uninsured Hispanic males aged 40-54 of a lower socioeconomic status
living in Harris County, Texas through health education interventions that both provide information
regarding the risk factors for cardiovascular disease and promote the use of preventive health measures
for this target group.
Program Goal: Increase the proportion of individuals in the priority population who are
aware of the early warning signs and symptoms of cardiovascular disease.
Project Objective: By the year 2022, members of the priority population
diagnosed with cardiovascular disease will be reduced by 20%.
Health Education Objectives:
• Upon completion of the program, at least 80% of participants will
be able to identify two of their own risk factors for cardiovascular
disease.
• Upon completion of the program, at least half of the participants
will be able to explain the four principles of cardiovascular
screening.
• In a follow-up call one month after completion of the program, at
least one-third of the participants will be able to describe two ways
in which they have adjusted their lifestyles to reduce the risk of
cardiovascular disease.
Health Education Program: Goal and Objectives
This assignment requires you to state your program’s mission statement, goals, and objectives based
upon your literature review. Please ensure that your goals and objectives are SMART and supported by
the literature! You must have three program goals, three project objectives, and nine health education
objectives!
Mission Statement:
1. Program Goal:
Project Objective:
Health Education Objective(s):
•
•
•
2. Program Goal:
Project Objective:
Health Education Objective(s):
•
•
•
3. Program Goal:
Project Objective:
Health Education Objective(s):
•
•
•
HLT 4310 – Project Assignment 4
The University of Houston
Dr. Eliz Markowitz
At this point, you all have completed thorough research on both your health condition and your priority
population. Now we will focus on the intervention that you have decided to develop to address gaps
you’ve identified in existing programs. Please refer to Chapter 7 of the textbook to review the theories
and models that are used to develop health education programs and Chapter 8 to review interventions
and intervention activities. You will also develop four potential intervention activities that support your
health education program and provide theoretical support for these activities.
Please refer to the Final Paper Samples available on Blackboard and, as always, ask me if you have any
questions!
Due: 06/25/2022 at 11:59 PM
Value: 100 points
•
Part I: Theoretical Support for Health Education Program (55 points)
o Provide your Mission Statement and a description of the health education program you
have decided to develop to address your health concern. (5 points)
o Select a theory or model that is commonly used in health promotion interventions to
use as a guide in developing your intervention to address the problem. (10 points)
o Describe the theory or model you’ve selected, including any associated steps, phases,
or constructs. (15 points)
o Show how the problem you are working to solve “fits into” the theory. (15 points)
o Defend why you think this is the best theory to use. (10 points)
•
Part II: Potential Intervention Activities (40 points)
o Develop four potential intervention activities that would support your health education
program. For each activity, you must describe the activity, the type of objective,
program outcomes, methods, theory, and intervention strategy. For an example of the
information necessary, please see page 232 of the textbook. (10 points per activity)
•
Grammar, Spelling, Structure, etc. (5 points)
Format: Your paper should be APA Style, double-spaced, size 12 Times New Roman font, and a
minimum of 3 pages, not including Cover Sheet and References.
CARDIOVASCULAR DISEASE PREVENTION PROGRAM
Cardiovascular Disease Prevention Program for African American Women
Amber Schwamkrug
Department of Psychological, Health, and Learning Sciences, University of Houston
HLT 4310 – Program Planning for the Health Professions
Dr. Eliz Markowitz
May 2, 2021
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CARDIOVASCULAR DISEASE PREVENTION PROGRAM
2
Part I: Diagnosis
Mission Statement
To reduce the prevalence of cardiovascular disease among low- to middle-income
African American women aged 35-50 years old living in the south-central Houston area by
providing education regarding physical and mental health and their impacts on cardiovascular
disease risk factors.
Cardiovascular Disease Among African American Women
Cardiovascular disease (CVD) is the leading cause of death for men and women in the
United States, and there is a disproportionate burden of CVD seen in minority populations
(Saban, Tell, & Janusek, 2019). African-American women (AAW) have the highest CVD rates
in comparison to other ethnicities and genders. Compared to a prevalence of 36.1% in nonHispanic white women, the prevalence of CVD in AAW was 48.3% in 2012 (Braun, Wilbur,
Buchholz, Schoeny, Miller, Fogg, Volgman, & McDevitt, 2016). Moreover, cardiovascular
health disparities among AAW are not fully explained by traditional risk factors (Saban et al.,
2019). AAW experience additional CVD risk factors not experienced by men or women of other
ethnic groups. Firstly, AAW have the highest rates for many CVD risk factors such as obesity,
diabetes, hypertension, and physical inactivity (Ebong & Breathett, 2020). The article by Ebong
& Breathett (2020) list many characteristics about AWW. They found that AAW are the least
likely group to participate in physical activity, and the majority of AAW do not eat their
recommended amounts of fruits and vegetables. They write that the reason for this is likely a
result of deep-rooted, constant institutional and cultural oppression. In addition to the systemic
formulation of racially segregated environments, AAW often live in areas with limited access to
resources, limited educational opportunities, inadequate and/or unaffordable housing, high crime
CARDIOVASCULAR DISEASE PREVENTION PROGRAM
3
rates, and limited access to and/or prejudicial health care services. These circumstances
experienced uniquely by AAW facilitates health behaviors associated with the development of
CVD. Secondly, AAW are more likely to be affected by psychosocial risk factors than women of
other ethnic groups (Copeland, Newhill, Foster, Braxter, Doswell, Lewis, & Eack, 2017). Many
AAW must cope with chronic life stressors associated with racism and discrimination. In the
study by Copeland et al. (2017), the authors write that the negative emotional response
precipitated from such stressors elevates cortisol, adrenaline, and epinephrine levels, and overall
heightens cardiovascular activity. Chronically, this physiological response increases the chances
of developing CVD.
Because the traditional risk factors for CVD do not explain the health disparities seen in
AAW, researchers have been looking into the connection between mental health status and CVD.
Studies have found that individuals suffering from depression are 50% more likely to develop
CVD, and AAW report symptoms of depression at higher rates in comparison to their White
counterparts (Copeland et al., 2017). A possible explanation for this is the systemic
disadvantages experienced by AAW and their resulting effects on mental health. Psychosocial
stressors affect minority populations at a greater rate, especially African Americans. Remaining
in a constant fight-or-flight mode physiologically can lead to an accumulation of visceral fat,
high blood pressure, and hyperglycemia (Sims, Glover, Gebreab, & Spruill, 2020). Researchers
also suggest AAW’s poor health behaviors may be a coping response to psychosocial stressors
(Sims et al., 2020). This would explain the higher rates of diabetes, obesity, and hypertension
among AAW. As stated by Copeland et al. (2017), the aforementioned bio-psycho-social factors
that contribute to the poor mental health outcomes of AAW are collectively recognized as the
‘triple jeopardy’ of being African American, female, and impoverished.
CARDIOVASCULAR DISEASE PREVENTION PROGRAM
4
Fortunately, researchers have found a connection between positive mental outlooks and
lower CVD risks. Some studies show it is possible to reduce CVD risk when mental health issues
are addressed. The study by Saban et al. (2019) found that resiliency can reduce the effect social
stressors have on an individual’s risk of developing CVD and can improve risk factors. They
write that higher resilience is seen to reduce the activation of stress response hormones and
improve the physiologic response to stress. Another psychological attribute being studied
associated with improved cardiovascular outcomes is gratitude. Evidence demonstrates that
dispositional gratitude can actually foster protective factors against depression and improves the
effect psychosocial stressors have on the body (Cousin, Redwine, Bricker, Kip, & Buck, 2020).
Strengthening an individual’s sense of gratitude and spirituality is a possible way to improve
AAW cardiovascular health.
Why This is a Problem
First and foremost, this is a public health problem because the observed disparities are a
result of sociocultural risk factors that are otherwise completely preventable. Primary prevention
practices, such as visiting a doctor and getting regular health screenings, should be a priority for
this population, but evidence shows African Americans are less likely to participate in routine
medical checkups compared to White Americans (Smedley, Stith, & Nelson, 2003). AAW who
seek healthcare to improve their CVD risk factors often run into the same racial and
discriminatory exposures within the health care system that they do in other areas of society. To
make matters worse, the strongest evidence for the existence of racial and ethnic disparities in
healthcare is found in studies of cardiovascular care, as noted by Smedley et al. (2003). Among
their discoveries, researchers found that there is an underuse of treatment services amid racial
and ethnic minorities. This either suggests that physicians are less likely to offer treatment
CARDIOVASCULAR DISEASE PREVENTION PROGRAM
5
services to minority patients, or minority patients are more likely to refuse treatment services.
They also find that there is evidence supporting the theory that the race of a patient influences
physicians’ decisions regarding diagnosis and treatment recommendations. In one study,
physicians rated African American patients as least intelligent, more likely to abuse
drugs/alcohol, and more likely to fail to comply with and participate in treatment protocols.
AAW that seek to improve their cardiovascular health may be essentially deemed not worthy
enough due to a physician’s implicit negative racial stereotype. Though physicians may be acting
on their implicit biases, but AAW are still being negatively affected.
Additionally, there is a legacy of distrust among healthcare providers and racial
minorities in America that may make AAW less likely to accept healthcare services and/or
procedures. In the same study by Smedley et al. (2003), evidence suggests minority patients may
be more receptive and trusting of physicians who are minorities themselves. However, minority
physicians represent only 9% of the physicians in the country; of the 9%, one-third is AfricanAmerican. AAW who have perceived discrimination from White physicians are less likely to
seek health care and are even less likely to find a healthcare provider they feel they can trust.
This could be the reason AAW are more likely to avoid healthcare services altogether.
Existing Programs
Successful Programs
AAW are more likely to have multiple CVD risk factors at one time, so interventions that
target multiple risk factors are necessary for success (Ebong & Breathett, 2020). The Love Your
Heart program was a 12-week nutrition and physical activity intervention that aimed to reduce
cardiovascular risk factors among African American women living in the Boston area
(Rodriguez, Christopher, Johnson, Wang, & Foody, 2012). This program was culturally tailored
CARDIOVASCULAR DISEASE PREVENTION PROGRAM
6
for African American women, and it used a self-help group methodology to address the physical,
mental, emotional, and spiritual aspects that affect weight and cardiovascular health. The
intervention included fitness classes, educational sessions spotlighting the importance of
nutrition and exercise on CVD, group meetings and discussions, and personalized wellness
plans. The results of the study found significant improvements in CVD risk factors. Comparing
the pre-and post-test data, participants reduced their systolic blood pressure, body-mass-index,
body weight, and waist circumference. This program highlights the effectiveness of communitybased interventions that combine health information, individual support, and group support to
lower CVD risk.
Another successful program, Prime Time Sister Circles, was a 10-week health program
that aimed to improve diet and increase physical activity among African American women aged
>35 years across the country (Gaston, Porter, & Thomas, 2007). It utilized the Social Cognitive
Theory and Transtheoretical Model for program creation. The intervention was a curriculumbased approach to behavioral change and incorporated a support group appeal. The groups met
once a week for 10 weeks and received information about spirituality, self-esteem, self-care,
nutrition, exercise, CVD, and diabetes. This program is unique in that it also targeted stress-relief
strategies. The results of the study found improvements in the participants self-reported stress
management, physical activity, and nutrition. Data also shows that the program improved
participants knowledge of CVD risk factors and attitudes towards prioritizing their health. This
study is yet another that emphasizes the value culturally tailored interventions in support group
settings have on reducing CVD risk in African American women.
Unsuccessful Programs
CARDIOVASCULAR DISEASE PREVENTION PROGRAM
7
STEPS (Sisters Together Empowered for Prevention and Success) to a Healthier Heart
was a 12- week, quasi-experimental, pre-posttest educational intervention that targeted AAW
between 35 and 65 years of age (Brown, Alexander, Cummins, Price, & Anderson-Booker,
2018). The purpose of this health program was to assess if AAW’s general knowledge about risk
factors of heart disease improved with participation in informational and physical activity
sessions. The women chose to participate in either the intervention group, which involved
information and physical activity sessions, or the comparison group, which received an
informational packet only. The Coronary Heart Disease Knowledge Test was used to assess each
participant’s knowledge of heart disease risk factors. This program was ultimately unsuccessful
because, in comparing the pre- and posttest data, no significant changes occurred and there were
no between-group differences. One possible reason this program was unsuccessful could be due
to the use of standard surveys, and future studies should use a more reliable and valid
measurement to assess knowledge among AAW. Another possibility is due to the intervention’s
short duration with little attention on physical activity. This program underscores the importance
of multicomponent, culturally tailored interventions that address multiple risk factors for AAW
for success.
Part II: Planning
Program Goals and Objectives
Program Goal Number 1
Reduce the impact psychosocial stressors have on the priority population’s CVD risk.
Project Objective
CARDIOVASCULAR DISEASE PREVENTION PROGRAM
8
By December 2021, when comparing pre-post test scores, one-half of the participants will
report lower general stress as measured by the general stress subscale of the Chronic Stress
Questionnaire (CSQ).
Health Education Objectives
1. By the end of the first trimester, the majority of the participants will be able to list three
healthy and three unhealthy stress and anxiety relief practices.
2. Upon completion of the program, one-half of the participants will be able to identify
stressors associated with racism and discrimination and effective coping methods.
3. Six months after completion of the program, one-half of the participants will be able
to list at least one coping and/or stress management skill utilized daily.
Project Objective
By June 2022, one-fourth of participants will report higher levels of resilience, in
comparison to pre-test scores, as measured by the Conner-Davidson Resilience Scale (CD-RISC25).
Health Education Objectives
1. By the end of the second trimester, more than half of the participants will be able to
identify factors that foster resilience.
2. Upon completion of the program, one-fourth of the participants will be able to list
three self-reflection practices.
Program Goal Number 2
Increase participation in physical activity and/or exercise that targets cardiac health
among individuals in the priority population.
Project Objective
CARDIOVASCULAR DISEASE PREVENTION PROGRAM
By June 2022, one-fourth of participants will engage in thirty minutes of moderate
physical activity at least 3 times a week.
Health Education Objectives
1. By the end of the first trimester, more than half of the participants will be able to
identify three exercises that improve heart health.
2. By the end of the first trimester, the majority of the participants will be able to
identify three CVD risk factors associated with physical inactivity.
3. One-half of the participants will be able to locate areas in the community with gyms
and/or green space upon completion of the program.
Program Goal Number 3
Increase the awareness of primary and secondary prevention practices and their
importance among individuals in the priority population.
Project Objective
By December 2023, yearly health care checkups among the participants will increase by
25%.
Health Education Objectives
1. By the end of the second trimester, the majority of the participants will be able to
identify two primary and two secondary prevention practices.
2. By the end of the second trimester, the majority of the participants will be able to
identify three CVD risk factors that are easily preventable by modifying behaviors.
3. Upon completion of the program, one-third of the participants will be able to locate
the nearest healthcare center in their community accessible to them.
9
CARDIOVASCULAR DISEASE PREVENTION PROGRAM
10
4. Upon completion of the program, one-fourth of the participants will be able to state
the recommended schedule for healthcare screenings.
Theoretical Support of Intervention
Due to the high rates of depression seen among AAW, successful interventions must
address both the physical and mental risk factors for CVD. The Transtheoretical Model (TTM)
and the Social Cognitive Theory (SCT) will both be used to guide the development of this
program (McKenzie, Neiger, & Thackeray, 2013). According to McKenzie et al. (2013), the
TTM posits that behavior change happens over time, and that people move through five distinct
“stages of change” phases in the process of adopting a health behavior change. This model has
been effective for a variety of health behavior changes because it considers that people may
begin in different stages. Most individuals will not respond to action-oriented behavior change
programs because the majority are not prepared to act. Specific principles are applied at specific
stages to maximize efficacy and ensure individuals move forward to the next stage. In other
words, individuals are matched with interventions depending on the stage they are in. The SCT
posits that learning happens in a social context. Individual experiences, environmental factors,
and the actions of others influence health behavior. An important component of the SCT is
reinforcement. Theorists believe reinforcement is essential for learning. Moreover, reinforcement
with the addition of an individual’s expectations of the outcome is what determines behavior.
The reason I chose to use two theories is because mental needs to be addressed at a
personal level, however, past programs have shown that AAW respond to interventions best
when group support and social interactions are given. I chose the TTM because it addresses each
participant as individuals. Some AAW may fare better in the face of adversity than others, so the
mental health status of the participants is going to vary. Additionally, though some participants
CARDIOVASCULAR DISEASE PREVENTION PROGRAM
11
will share the same barriers to action, others are going to have barriers no one else has. This is
the best intrapersonal level theory to use for many reasons. Firstly, we can implement
interventions that can best facilitate change based on the stage the participants are in.
Interventions that require immediate action will lose the participants that are not ready for action.
By allowing the participants to progress through the stages on their own time ensures maximum
participants retention in the program. The second reason I chose this theory was because of how
well the Processes of Change correlate to what our participants are likely to go through
throughout the intervention. For example, after learning more about the psychosocial factors,
participants may begin to notice each time they are subjected to toxic, negative emotions due to
their environment, which is explained by the process of dramatic relief. This will accompany the
realization of the effects it has on them and their environment, which is explained by the
constructs of self- and environmental reevaluation. Further, the intervention’s aim of finding new
ways to cope with stressors and fostering resiliency is explained by the construct of
counterconditioning. Lastly, as explained by the construct of social liberation, being able to
effectively cope with negative emotions can/will allow the participants to focus their attention on
all the positive experiences they have.
To target the interpersonal level, I chose the SCT because it addresses the influence that
observational learning has on behavior. As stated above, similar programs with the most success
have included group support/meetings in the intervention. Participants credited their continued
participation and enthusiasm to the relationships they created with others and the desire to help
one another succeed. Seeing others succeed due to a behavior change influences others to adopt
that change as well. I also chose this theory because it addresses the idea of monitoring and
adjusting behavior to gain control over it. This is the best interpersonal level theory to use
CARDIOVASCULAR DISEASE PREVENTION PROGRAM
12
because of the emphasis it has on learning in social contexts. We already know AAW respond
best with group support, and the SCT has roots in learning from and believing in others. AAW
who may not feel confident in the behavior changes will be encouraged by seeing other women
succeed, or they will be encouraged to try when they see the support other participants are giving
them. For example, participants will gain knowledge and skills about how to eat healthy after
learning about healthy dinner options, as explained by the construct of behavioral capability.
When a participant shares their meal plan that they have been following, positive feedback and
praise from program instructors and other participants will help to maintain that participant’s
behavior change, which is explained by direct reinforcement. On the other hand, participants
who are struggling with that same behavior change may be encouraged to work for it after seeing
the commendation others receive, as explained by vicarious reinforcement. To maintain this
behavior, the participant will have to monitor and adjust their behavior, which is explained by
the construct of self-control. As their self-control increases and their healthy eating behavior is
maintained, they will gain confidence in their ability to create meaningful change in their life, as
explained by self-efficacy. Lastly, as described by the construct of collective efficacy,
participants will become confident that more women in the priority population can successfully
make this behavior change because of the successes they observed from themselves, and their
fellow participants.
Part III: Intervention and Evaluation
Intervention Activities
Many different activities will be implemented to increase the participants knowledge on
various aspects of the health behavior and to promote behavior change. First, the participants will
be given pamphlets containing information on CVD, risk factors, prevention strategies, healthy
CARDIOVASCULAR DISEASE PREVENTION PROGRAM
13
eating habits, the recommended schedule for women’s healthcare screenings, and local
healthcare centers. Second, the participants will attend weekly group physical activity sessions at
a local community center. At the beginning of each session, the participants will be taught a new
exercise that targets cardiac health. The participants will spend the remainder of the session
practicing the new exercise, while the instructor observes and corrects their technique. A third
activity the participants will attend is a presentation on stress-management skills. The speaker
will talk about common stressors found in many AAW’s lives, triggers to such stressors, healthy
coping mechanisms, and daily stress-relief practices to engage in. Following the presentation,
there will be a group discussion in which participants will be encouraged to share and talk about
their personal stressors, and how they successfully or unsuccessfully cope with them. Lastly, the
participants will be expected to complete weekly check-in charts that track their behavior change
progress throughout the duration of the program. The chart will include various self-care
behaviors including stress-management, diet, physical activity, and preventive activities. Once a
month, participants will be encouraged to share their progress in both group and individual
sessions. In the group sessions, participants can gain feedback and encouragement from fellow
members. In the individual session, participants may talk with their instructor about unique
barriers they may be facing, and express their thoughts about their progress, or stagnation, in the
program. The chart is a great tool to show what stage participants are in and encourages
accountability for behavior change maintenance. It is an integral part of targeting each
participant as individuals, as it encourages the participants to move forward through the stages in
their own way, at their own pace.
Relevance of Selected Activity to Intervention
CARDIOVASCULAR DISEASE PREVENTION PROGRAM
14
The weekly check-in chart is based on the principle of self-help. Self-help is the belief
that, “self-knowledge, validation of experiences, and sharing information are key factors that set
the tone for healing…for a disease or condition” (Rodriguez et al., 2012). Rodriguez et al. (2012)
utilized the self-help methodology in the Love Your Heart (LYH) program, a CVD prevention
and risk reduction intervention for AAW. The program found that incorporating the self-help
methodology in health education programs can increase the chances of sustainable behavior
change. Furthermore, the researchers state that, given the opportunity and encouragement to talk
and listen to women with similar circumstances, women begin to fully conceptualize their health
circumstances. They begin to develop individualized strategies to address their own health needs
while incorporating strategies and ideas from other group members. This is supported by the
groundwork of the transtheoretical model that suggests behavior change occurs over time, in a
specific set of stages (McKenzie et al., 2013). Therefore, the weekly check-in chart is especially
helpful in getting participants to move from the precontemplation stage to the action stage.
Plan for Evaluation
We will conduct a summative evaluation, using both impact and outcome evaluations, to
determine the effects of the program. Participants will complete the Chronic Stress Questionnaire
(CSQ) and the Conner-Davidson Resilience Scale (CD-RISC-25) at both the start of the program
and at the program’s conclusion. The baseline and post-test measurements will help determine
changes in behavior and attitude. Additionally, information taken from the week one check-in
chart and the final week check-in chart will further help to determine any changes in behaviors
and/or attitude. Measurements on weight, blood pressure, cholesterol level, and resting heart rate
will also be taken at both baseline and the program’s conclusion. This data will help determine if
the program was effective in decreasing physical CVD risk factors.
CARDIOVASCULAR DISEASE PREVENTION PROGRAM
15
References
American Heart Association. (2017, August 15). The american heart association diet and
lifestyle recommendations. https://www.heart.org/en/healthy-living/healthy-eating/eatsmart/nutrition-basics/aha-diet-and-lifestyle-recommendations
American Heart Association. (2014, June). 3 tips to manage stress.
https://www.heart.org/en/healthy-living/healthy-lifestyle/stress-management/3-tips-tomanage-stress
Braun, L. T., Wilbur, J., Buchholz, S. W., Schoeny, M. E., Miller, A. M., Fogg, L., Volgman, A.
S., & McDevitt, J. (2016). Cardiovascular risk in midlife African American women
participating in a lifestyle physical activity program. Journal of Cardiovascular Nursing,
31(4), 304-312. https://doi.org/10.1097/JCN.0000000000000266
Brown, C. W., Alexander, D. S., Cummins, K., Price, A. A., & Anderson-Booker, M. (2018).
STEPS to a healthier heart: Improving coronary heart disease (CHD) knowledge among
African American women. American Journal or Health Education, 49(2), 57-65.
https://doi.org/10.1080/19325037.2017.1414640
Conway-Phillips, R., Dagadu, H., Motley, D., Shawahin, L., Janusek, L. W., Klonowski, S., &
Saban, K. L. (2020). Qualitative evidence for resilience, stress, and ethnicity (RiSE): A
program to address race-based stress among Black women at risk for cardiovascular
disease. Complementary Therapies in Medicine, 48, 1-6.
https://doi.org/10.1016/j.ctim.2019.102277
Copeland, V. C., Newhill, C. E., Foster, L. J. J., Braxter, B. J., Doswell, W. M., Lewis, A. N., &
Eack, S. M. (2017). Major depressive disorder and cardiovascular disease in African
CARDIOVASCULAR DISEASE PREVENTION PROGRAM
16
American women. Journal of Social Service Research, 43(5), 624-634.
https://doi.org/10.1080/01488376.2017.1370682
Cousin, L., Redwine, L., Bricker, C., Kip, K., & Buck, H. (2020). Psychometrics of the gratitude
questionnaire-6 in African Americans at risk for cardiovascular disease. Western Journal
of Nursing Research, 42(12), 1148-1154. https://doi.org/10.1177/0193945920922777
Ebong, I., & Breathett, K. (2020). The cardiovascular disease epidemic in African American
women: Recognizing and tackling a persistent problem. Journal of Women’s Health,
29(7), 891-893. https://doi.org/10.1089/jwh.2019.8125
Gaston, M. H., Porter, G. K., & Thomas, V. G. (2007). Prime time sister circles: Evaluating a
gender-specific, culturally relevant health intervention to decrease major risk factors in
mid-life African American women. Journal of the National Medical Association, 99(4),
428-438.
McKenzie J. F., Neiger, B. L., & Thackeray, R. (2013). Planning, implementing, and evaluating
health promotion programs: A primer (6th ed.). Pearson Education.
Rodriguez, F., Christopher, L., Johnson, C. E., Wang, Y., & Foody, J. M. (2012). Love your
heart: a pilot community-based intervention to improve the cardiovascular health of
African American women. Ethnicity & disease, 22(4), 416–421.
Saban, K. L., Tell, D., & Janusek, L. (2019). Resilience in African American women at risk of
cardiovascular disease: An exploratory study. Journal of Urban Health, 96(Suppl 1), 4449. https://doi.org/10.1007/s11524-018-00334-0
Sims, M., Glover L. S. M., Gebreab. S. Y., & Spruill, T. M. (2020). Cumulative psychosocial
factors are associated with cardiovascular disease risk factors and management among
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African Americans in the Jackson Heart Study. BMC Public Health, 20(566).
https://doi.org/10.1186/s12889-020-08573-0
Smedley, B. D., Stith, A. Y., & Nelson, A. R. (Eds.). (2003). Unequal treatment: Confronting
racial and ethnic disparities in health care. The National Academies Press.
https://www.nap.edu/catalog/12875/unequal-treatment-confronting-racial-and-ethnicdisparities-in-health-care
17
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Appendix
Weekly Check-In Chart
Name:
This week I…
Prevention activities
Checked my blood
pressure
Checked my
cholesterol
Performed a selfbreast exam
Got a mammogram
(over past 12 months)
Stress-management
Took time to do
something I enjoy
Performed deep
breathing exercises
Engaged in positive
self-talk
Followed my
scheduled sleep-time
Talked with a
friend/family member
about my stressors
Diet
Week of:
Completed
!
Almost!
Thought
About It
Needs
Improvement
Not
Applicable
CARDIOVASCULAR DISEASE PREVENTION PROGRAM
Had one ‘colorful’
meal per day
Drank the
recommended amount
of water each day
Incorporated fruits and
vegetables into every
meal
Substituted a red meat
for poultry or fish
Replaced at least one
high-sugar beverage
with water
Physical activity
Did an outdoor activity
that I enjoy
Asked a friend to
exercise with me
Did stretching
exercises every day
Completed at least 30
minutes of moderate
physical activity each
day
Took the stairs instead
of the
elevator/escalator
Progress check
I ate at least five
servings of fruit and
vegetables each day
I have been doing this
for more than one
week
Yes!
No
19
CARDIOVASCULAR DISEASE PREVENTION PROGRAM
20
I intend to do this in
the next week
I intend to do this in
the next 30 days
I intend to do this in
the next six months
How Did You Check-Out?
Did you score…
Keep up the great work! Get with others that may be struggling and share the
More than 10 checks
in Completed?
techniques that you found worked for you!
Which areas are missing Completed checks? Talk with friends and try
implementing some new techniques that have worked for them!
We can see the effort you are putting in, great work! Consider working on
More than 10 checks
in Almost?
small goals you can confidently complete first, then add in a new, more
difficult goal, one at a time. Don’t overwhelm yourself.
Consider implementing a rewards system for yourself. You want that cookie?
More than 10 checks
in Thought About It?
You can have it IF you drink only water that day! You really don’t want to take
the stairs? You can take the elevator IF you park in the back of the parking
lot! Small changes make a big difference!
Consider switching up the techniques that you are using. If you are focusing
More than 10 checks
in Needs
Improvement?
on a large goal, try completing a few small goals first. Can’t seem to modify
your diet? Then focus on your physical activity goals! Are you having trouble
finding motivation? Talk with others and find out what motivates them!
HLT 4310 – Project Assignment 5
The University of Houston
Dr. Eliz Markowitz
At this point in the project, you’ve done all the background research for your intervention; you’ve
identified your priority population and health concern, created project goals and objectives, selected the
theory or model used to support your intervention, and developed intervention activities to achieve the
project goal. Now, you will actually create a portion of your intervention itself!
Select one of the four intervention activities that you developed in Project Assignment 4 and create the
intervention activity. For example, if one of your intervention activities was a lecture, you will create the
actual presentation with notes to accompany that activity. If your intervention includes a cooking
component on healthy eating, you will create the recipes and provide step-by-step instructions for the
activity. If your intervention includes an informative brochure, you will create that brochure. Remember
that your activity must be compelling enough to increase knowledge and, in turn, change the behaviors
and ideas of the participants.
In addition to the activity, please provide a description of the activity and how the activity is supported by
all the background research you’ve done and the theory/model you have chosen.
Due: 06/30/2022 at 11:59 PM
Value: 100 points
Requirements:
a. Part I: Intervention Activity Paper
• Describe the intervention activity you’ve decided to fully develop and discuss how the
activity supports the goals and objectives of your health education program. (25 points)
• Explain how the intervention activity you’ve selected is supported by research. (25
points)
i. These sections of your final paper would be titled Intervention Activity and
Relevance of Intervention Activity to Health Education Program, respectively.
ii. Format: APA Style, double-spaced, size 12 Times New Roman font, and a
minimum of 1.5 pages (does not include Cover Sheet and References)
b. Part II: Intervention Activity. (50 points)
• Develop the actual intervention activity that you selected.
i. This section would be the Appendix of your final paper.
ii. Format: Varies based on activity
1
Mission, Objectives, and Health Education Objectives
Mays Karzone
University of Houston
HLT4310
Eliz Markowitz
June 20, 2022
2
Mission, Objectives, and Health Education Objectives
Mission statement: To reduce the incidence of lung cancer for low-income Middle Eastern men (2540) living in Orange County, Texas through the provision of routine screening and health education
interventions that provide information on the preventive measures for lung cancer.
Program goals: Increase the number of individuals that are aware of the causes of lung cancer in the
target population Good!
Program objectives: By the end of 2022, about 90% of the targeted population will be aware of the
risk factors leading to lung cancer Good!
Health education objectives
•
•
•
Upon completion of the program, about three-thirds of the participants will be aware of
lung cancer risk factors. Remember that objectives need to be SMART, and the M stands for
measurable; how do you measure awareness. Consider “…will be able to identify three lung
cancer risk factors” (-3)
After the program ends, 80% of the targeted population will be educated on the
contribution of environmental factors such as heavy metals, chemicals, asbestos, and silica
toward lung cancer. Same as above! (-3)
By the end of the programs, at least half of the participants will learn the need to seek
health interventions for individuals with explained weight loss, fatigue, persistent
breathlessness, coughing blood, pain when breathing or coughing, and recurring chest
infection. Same as above! (-3)
Program goals: Reduce lung cancer death rates among members of the priority population.
Program objective: By the end of 2023, about 80% of the men between 25 and 40 will be aware of
the importance of early diagnosis Same comment as above! Consider; “be able to explain the
importance…” (-3)
Health education objectives
•
•
•
After completing the program, at least half of the targeted population will learn about the
need for annual lung cancer screening and examination. Same as above! Remember that
objectives need to be SMART, and the M stands for measurable; how do you measure
learning. Consider “…will be able to explain the need…” (-3)
On follow-up call after completing the program, two-thirds of the participants will learn the
importance of early diagnoses, such as timely prevention, treatment, and better outcomes.
Same as above! (-3)
Upon completion of the program, 90% of the targeted population will have had health
education seminars from health workers and online ads addressing lung cancer. This is a
program objective, not a HEO! Remember, learning objectives measure knowledge, not
behaviors; these objectives use words like identify, list, recall, compare, distinguish, explain,
describe, etc… (-3)
Program objectives: Reduce the incidence of lung cancer among the PP
3
Program goals: By the end of 2022, the members of the priority population diagnosed with lung
cancer will be reduced to 2%. Is this realistic and achievable? Down to 2% in six months? What does
the literature say? (-2)
Health education objectives
•
•
•
Upon completion of the program, at least 90% of the targeted population will be able to
identify their risk factors for developing lung cancer. Good!
In the follow-up call after one month of completion of the programs, at least half of the
targeted population will be able to state one lifestyle change that reduces the risk of lung
cancer. Good!
By the end of the program, at least a third of the participants will be able to explain reasons
for the high prevalence of lung cancer among the PP.
Hey, Mays!
You have a lot of great ideas, but, unfortunately, many of your HEOs were not SMART.
Please see specific notes, review the supplemental material on BB, read your textbook, and
let me know if you have any questions! (77/100)
All the best,
Eliz