You are important to us. We need your help to deliver lifesaving information to African Americans. Sadly, too many African Americans die of cardiovascular disease (CVD), particularly heart disease and stroke. Among African Americans, heart disease is the #1 killer, and stroke is the #3 leading cause of death. About 1 in 4 African American men and women dies of heart disease, and about 1 in 19 African American men and 1 in 13 African American women die of stroke.
The good news is that we already know a lot about what to do to prevent heart disease and stroke. High blood pressure, high blood cholesterol, obesity, smoking, not being physically active, and diabetes are all factors that increase a person's risk of heart disease and stroke. African Americans can lower their risk of heart disease and stroke by making healthy lifestyle changes, getting their risk factors checked, and seeing health care providers and following their advice if risk levels are elevated. Community health workers like you can help. The With Every Heartbeat Is Life project can guide you as you begin this journey.
"With Every Heartbeat Is Life: A Community Health Worker's Manual for African Americans" is a heart health manual created especially for African American communities by the National Heart, Lung, and Blood Institute (NHLBI) at the National Institutes of Health (NIH), U.S. Department of Health and Human Services (DHHS). You will notice that cultural adaptations are used to make the manual more appealing and relevant to African American communities.
The "With Every Heartbeat Is Life" manual provides all the information you need to put a heart health project into action in your community. Taught by trained community health workers, the manual helps people build skills to make practical, lasting changes to help fight heart disease. The manual can be used to train community health workers, to teach members of the African American community, and to serve as the basis for other community activities.
"With Every Heartbeat Is Life" is dedicated to community health workers like you who devote time and energy to help others improve their health and live longer. Thank you for making a difference.
Gregory J. Morosco, Ph.D., M.P.H.
U.S. Department of Health and Human Services
Nationa Heart Liung and Blood Institute
NIH Publication No. 08-5844
The Role of the Community Health Worker
Community health workers play a key role in promoting better health in African American communities. They help people learn about health issues and show them ways to live healthier lives. Without them, many African Americans might not receive such vital information.
Successful community health workers have special qualities. They know their communities well. They are dedicated to improving the health of their communities. They enjoy teaching others, feel comfortable in front of a group, and know how to work with a group. Successful community health workers are also:
We thank you for your interest and efforts to help African Americans take steps to protect their hearts. We invite you to give us your feedback on how you are using the manual in your community.
This manual has been reviewed by or received support from the following organizations:
Association of Black Cardiologists
District of Columbia Housing Authority
The "With Every Heartbeat Is Life" manual was developed with the dedication of many people. The NHLBI gratefully acknowledges the contributions of community health workers, families, groups, and organizations for the success of this manual.
Special appreciation is extended to Lenee Simon, M.P.H., formerly of NHLBI, who initiated the development of this manual. Ms. Simon is currently with the Office of Disease Prevention and Health Promotion, DHHS.
NHLBI also wishes to acknowledge the resident leaders and public housing residents who provided input to the development of the "Baltimore City Public Housing Community Health Worker Educator's Manual," which was the springboard to the development of the "With Every Heartbeat Is Life" manual.
NHLBI extends special recognition to the following individuals for assisting NHLBI in pilot testing selected sessions and/or activities from this manual:
Janice Bowie, Ph.D.
Anne B. Clark
Judith Fradkin, M.D.
Joanne M. Gallivan, M.S., R.D.
Marie Y. King
Samuel B. Little, Ph.D.
Sheila D. Moore
Carol Bryant Payne, M.S.N.
Elisa Rodriguez, M.S.
Angelia D. Scott
Matilde Alvarado, R.N., M.S.N.
Camina Davis, M.S.H.P.
Robinson Fulwood, Ph.D., M.S.P.H.
Janet de Jesus, M.S., R.D.
Laina Ransom, M.B.A.
Madeleine Wallace, Ph.D.
IQ Solutions, Inc.
About the With Every Heartbeat Is Life Project
This manual is one part of the With Every Heartbeat Is Life project. The project includes:
Ordering information for these materials appears on page 453.
How To Use This Manual
Community Health Workers
This manual is for you! The "With Every Heartbeat Is Life" manual can be used to train community health workers. After you've been trained, you can conduct your own trainings, and teach others how to be community health workers.
The "With Every Heartbeat Is Life" manual consists of 12 sessions that include step-by-step instructions on how to teach 11 fun and educational sessions to community residents or patients. Each session is taught in motivational and interactive ways to keep the attention of the group members. Each session helps people learn about what they can do to prevent heart disease. The manual includes worksheets and handouts for project participants (group members) to take home to read and share with their family and friends.
It also includes a special session for community health workers on how to evaluate completed projects. This session helps community health workers determine how successful they have been in implementing their training and educational activities and helping community residents to adopt heart healthy habits. The Appendix features special training activities and teaching tips and explains how to start a project in your community.
"With Every Heartbeat Is Life" Sessions
About the Sessions
Each session covers a different topic related to heart health. The sessions generally follow the same structure, which will be explained next. Sessions also include "More Information" boxes, which have extra facts on selected health topics to help you answer questions from group members.
Length of Sessions
Most sessions last about 2 hours. Session 5, "Be Heart Smart: Keep Your Cholesterol in Check," and Session 7, "Protect Your Heart: Take Good Care of Your Diabetes for Life," could last a little longer.
Session 12, "Use Evaluation To Track Your Progress (Especially for Community Health Workers)," describes how to evaluate the effectiveness of the "With Every Heartbeat Is Life" manual. This session is designed to guide community health workers and project evaluators in the planning, implementation, and evaluation of the project. The purpose of the session is to provide ideas for tracking project activities and tools for measuring changes in group members' behaviors and clinical values. You can use the ideas and tools to: (1) improve the quality of the project, (2) show that your activities work, and (3) provide information to organizations that support your project through funding, referrals, and in-kind contributions.
Community Health Workers may find it helpful to have a glossary of terms or more information on cardiovascular topics covered in this manual. The NHLBI Diseases and Conditions Index, http://www.nhlbi.nih.gov/health/dci/index.html, contains information on diseases, conditions, and procedures related to heart disease.
Each session begins with a summary page that explains:
In addition, each session includes five major parts:
Part 1—Introducing the Session
Part 2—Conducting the Session
Part 3—Review of Today's Key Points
Part 4—Weekly Pledge
The following symbols are used throughout the manual to let you know quickly what comes next:
The "With Every Heartbeat Is Life" picture cards can be used with the manual to help you present information for each session. When you see the picture card symbol in the manual, you will know to show a picture that relates to the information you will be presenting. On the back of each picture card is a script that you can read aloud while you show the picture card.
Breaks and Refreshments
You should take a short break about halfway through each session. You may want to use the time to do some easy stretches (see the "Stretching Activities" handout). Another option is to serve a small healthy snack with water during the break. Snack ideas include light yogurt, fruit or vegetables with low-fat dip, and water. Or you can prepare one of the recipes from this manual and have group members taste it.
At Least 6 Weeks in Advance
At Least 1 Week Before Each Session
The Day of the Session
Working With Your Group
Leading the Group
Motivating Group Members
Taking Small Steps Toward Change
People are more likely to develop new habits if you promote small changes slowly. This brings more success.
Getting People To Attend
Answering Hard Questions
Remember that it's okay not to know all the answers! Say that you will have the correct answer by the next session. Call a local health educator, registered dietitian, or nurse to find out the correct information.
Keeping People on Track
Give the correct information when a group member gives incorrect or incomplete information. Give the person credit for any part of his or her answer that is correct. Say that people often hear incorrect information and believe it to be true. Tell the group members that this is one important reason why they are coming to the sessions—to get correct information.
And Finally . . .
Have a good time. You are doing an important service for yourself and your community. Thank you!
Let's Hear From You!
We thank you for your interest and efforts to help African Americans take steps to protect their hearts. We invite you to give us your feedback on how you are using the "With Every Heartbeat Is Life" manual in your community.
Your feedback will help promote the expansion of the project and contribute to the growth of the With Every Heartbeat Is Life network. Establishing a large network of community health workers is important to keep the project going strong!
You may send your feedback to:
About one out of four African Americans dies of heart disease.