Your Heart, Your Life: A Community Health Worker's Manual for the Hispanic Community

Manual Contents

Session 3 Take Heart: Say YES to Physical Activity

Page Contents

Objectives

By the end of this session, group members will learn that:

  • Physical activity is good for the heart and overall health.
  • Adults should be physically active for 30 to 60 minutes on most days.
  • Children and adolescents should be physically active for about 60 minutes on most days, preferably daily.
  • Brisk walking is a simple activity nearly everyone can do.
  • There are ways to fit more activity into a busy schedule.

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Materials and Supplies

To conduct this session, you will need:

  • “Your Heart, Your Life” manual and picture cards
  • Blackboard and chalk or several large pieces of paper, a marker, and tape
  • Optional Index cards for physical activity guessing game (prepare before the session)
  • Optional VCR or DVD and TV monitor
  • (Optional) “The New Health Machine: Exercise” telenovela or fotonovela
    Note: The telenovela is available in Spanish only.
  • Cool drinking water and cups
  • (Optional) Music for walking activity and tape player or CD player

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Handouts

Give group members these handouts during this session:

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Introducing the Session

  1. Welcome
  2. Review of Last Week's Session
  3. About This Session
  1. Welcome
    • Welcome group members to the session.
  2. Review of Last Week's Session
    • Say:
      At the last session we talked about the heart attack warning signs. Who remembers the warning signs of a heart attack?
      Note: Allow about 3 minutes for group members to answer. Write their answers on the blackboard or on a large piece of paper taped to the wall.
    • Add these signs if they are not mentioned:
      • Your chest may hurt or feel squeezed.
      • You may feel pain in your neck or jaw.
      • One or both of your arms, your back, or your stomach may hurt.
      • You may feel like you can't breathe.
      • You may break out in a cold sweat.
      • You may feel sick to your stomach.
      • You may feel light-headed.
    • Ask:
      Who remembers what you should do if you feel these symptoms?
    • Say:
      The answers are:
      • Call 9-1-1 in 5 minutes or less, even if you are not sure you are having a heart attack. Calling 9-1-1 gets you treated more quickly.
      • Do not drive yourself to the hospital.
    • Say:
      At the end of the session, we pledged to do one thing to be prepared if a heart attack happens. Please share with the group what you did.
      Note: Allow 2 to 3 minutes for group members to respond.
  3. About This Session
    • Say:
      During today's session, we will discuss physical activity and how important it is to your heart health. When the session ends, you will know:
      • How physical activity can help you and your family
      • What kind of activities are good for you and for your heart
      • How much activity you should do
      • How you can find time to be active
        Note: “Physical activity” and “exercise” mean the same thing.

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Conducting the Session

  1. Facts About Physical Activity
  2. (Optional) “The New Health Machine: Exercise” Telenovela or Fotonovela
  3. Benefits of Physical Activity
  4. Types of Physical Activity
  5. Getting Started: Important Things To Know
  6. Finding Time To Be Physically Active
  7. Walking: An Activity for Almost Everyone (Prepare for the walking activity by reading the walking tips.)
    1. Discussion and Stretching
    2. Walking Activity
  1. Facts About Physical Activity
    • Say:
      Not getting enough physical activity is a major health risk for people today.
      • Being physically inactive puts you at risk for heart disease. The good news is that you can do something about this risk factor.
      • Latinos, especially women and children, are not getting enough physical activity.
      • As a person gets older, having little or no physical activity can lead to health problems.
  2. (Optional) “The New Health Machine: Exercise” Telenovela or Fotonovela
    • If you choose, show the telenovela on physical activity, “The New Health Machine: Exercise,” or have volunteers read the fotonovela.
      Note: The telenovela is available in Spanish only.
  3. Benefits of Physical Activity
    • Ask:
      How do you think physical activity can help you?
      Note: Allow about 5 minutes for group members to answer. Write their answers on the blackboard or on a large piece of paper taped to the wall.
    • Show picture card 3.1.
    • Say:
      Physical activity can help you:
      • Strengthen your heart and lungs.
      • Build and maintain healthy bones, muscles, and joints.
      • Control your weight.
      • Have more energy.
      • Feel better about yourself.
      • Lower your stress.
      • Reduce feelings of depression and anxiety.
      • Sleep better.
    • Show picture card 3.2.
    • Say:
      Physical activity can also help you:
      • Lower your blood pressure.
      • Control your blood cholesterol.
      • Lower your risk of getting heart disease, diabetes, and some cancers.
    • Show picture card 3.3.
    • Say:
      People feel better when they are active. Physical activity may help you lose weight.
  4. Types of Physical Activity
    • Ask:
      What do you do to be physically active?
      Note: Allow about 5 minutes for group members to respond. Write their answers on the blackboard or on a large piece of paper taped to the wall.
    • Say:
      There are different types of physical activity. Physical activity includes some of the things that you probably do each day, like walking, climbing stairs, or doing household chores.
    • Show picture card 3.4.
    • Say:
      You may want to start with moderate (medium-level) activities. Moderate activities should require you to make some physical effort, but you should be able to have a conversation comfortably while doing them. Examples of moderate activities include:
      • Walking at a brisk pace
      • Gardening (mowing, raking)
      • Dancing (salsa, merengue)
      • Making home repairs (painting)
      • Washing and waxing a car
      • Scrubbing floors and washing windows
      • Weightlifting
      • Playing softball
      • Doing floor exercises (pushups, situps)
    • Show picture card 3.5.
    • Say:
      After a while, you will be able to do more vigorous (high-level) activities. Vigorous activities require hard physical effort and make your heart rate and breathing much faster. You usually can't carry on a conversation comfortably while you are doing vigorous activities. Vigorous activities that you might enjoy include:
      • Playing soccer, basketball, or baseball
      • Running or jogging
      • Bicycling fast or uphill
      • Doing aerobics
      • Swimming laps
      • Jumping rope
      • Skating
      • Performing heavy construction work

    A. (Optional) Physical Activity Guessing Game

    Note: You can play a physical activity guessing game. Ahead of time, write the names of the 8 medium-level physical activities on index cards of one color and the 10 high-level activities on index cards of a different color (Listed on the "Take Heart — Say Yes to Physical Activity" handout).
    • Divide participants into two groups, and give each person a card.
    • Ask the medium-level activity group to go first. One by one, each person will act out the physical activity on his or her card. Ask the rest of the participants to guess the activity.
    • Follow the same process for the high-level activity group.
    • Say:
      All types of physical activity are good for you. Aerobic activities, such as brisk walking that speeds your heart rate and breathing, help your heart. Other activities such as weightlifting and stretching can help improve strength and flexibility.
    • Say:
      Start slowly. Then move on to higher-level activities. For example, when you are comfortable walking, gradually begin to jog. You'll feel great!
    • Ask:
      How much physical activity do you think you need to do each day to improve your health?
    • Say:
      • Adults should have at least 30 minutes of moderate physical activity daily to lower their chances of getting heart disease.
      • Some adults need up to 60 minutes of moderate physical activity on most days to prevent unhealthy weight gain.
      • Adults who used to be overweight need 60 to 90 minutes of moderate physical activity every day to avoid regaining weight.
      • Children and adolescents need at least 60 minutes of moderate to vigorous physical activity on most days, preferably daily.
    • Show picture card 3.6.
    • Say:
      If you can't set aside 30 or 60 minutes at one time to be active, you can break your activity into shorter periods of 10 minutes or longer. It's the total time of physical activity that is important. Just make sure that the total time adds up to 30 or 60 minutes on most days.
    • Say:
      For example, if you can only do 30 minutes of physical activity a day:
      • Ride your stationary bike for 10 minutes before you go to work... +10
      • Take a 10-minute walk with your kids after work... +10
      • Do aerobic exercises for 10 minutes later in the day... +10
      • Total = 30 minutes
    • Show picture card 3.7.
    • Say:
      If you have more time, you can build up to 60 minutes a day with activities like these:
      • Use your stationary bike for 10 minutes before you go to work... +10
      • Take a 15-minute walk with coworkers during your lunch break.... +15
      • Lift weights (dumbbells) while dinner is baking... +10
      • Dance with your family to your favorite music... +15
      • Do aerobic exercises for 10 minutes later in the day... +10
      • Total = 60 minutes

    More Information: Just Move It

    • Physical activity is important in weight control.
    • Try to be physically active for 30 to 60 minutes on most days.

    Here are some examples of how many calories you can burn from various activities for 30 minutes (These calories are for a healthy 154-pound person. A lighter person burns fewer calories; a heavier person burns more.):

    • Weightlifting = 110
    • Walking (briskly), 3 ½ miles per hour = 140
    • Gardening = 165
    • Raking leaves = 165
    • Dancing = 240
    • Bicycling (slowly), 10 miles per hour = 145
    • Swimming laps = 255
    • Jogging, 5 miles per hour = 295

    Source: “The Compendium of Physical Activities Tracking Guide,” University of South Carolina, 2000

  5. Getting Started: Important Things To Know
    Note: This session gives information for people who are just starting to be active. It also helps people add more activity to what they already do.
    • Say:
      There are a few things you should know before starting to be physically active.
    • Give each group member the “Getting Started With Physical Activity” handout.
    • Say:
      It's very important to know when to talk with a doctor before starting a physical activity program. In the list on your handout, check which people should see a doctor before they begin physical activity.
    • Read the passages below while the participants check them off.
      • Carlos is 65 years old and had a heart attack 10 years ago, but he is fully recovered.
      • Maria is 32 years old and had a healthy baby 8 months ago.
      • Arturo is 38 years old and has diabetes, but he controls his condition very well with medication.
      • Carmen is 35 years old and wants to start being more physically active to lower her high blood pressure and help herself to quit smoking.
      • Gloria is 27 years old and in good health, and she wants to start running.
      • Hector is 57 years old and broke his leg 2 years ago, but it healed very well. He walks every day but wants to start jogging.
        Note: Allow a few minutes for group members to discuss.
    • Give each group member the “Getting Started With Physical Activity: Doña Fela's Answers” handout.
    • Say:
      Let's look at the handout to see what Doña Fela has to say about this.
      Note: Go over the answers with the group.
    • Say:
      These are Doña Fela's answers:
      • Carlos should see a doctor before starting a physical activity program, because he has had a heart attack. Even though he is fully recovered, he should still check with his doctor.
      • Maria does not need to see a doctor before starting a physical activity program. Having a baby is not a risk factor, and she is young.
      • Arturo should see a doctor before starting a physical activity program, because he has diabetes. Even though he is young and he controls his condition very well with medication, he should still check with his doctor.
      • Carmen should see a doctor before starting a physical activity program because she has two risk factors: high blood pressure and smoking.
      • Gloria does not need to see a doctor before starting a physical activity program. Even though she wants to start a harder activity, such as running, she is young and in good health.
      • Hector should see a doctor before starting a physical activity program. His broken leg is not a factor, but he should check with the doctor first, because he wants to start a harder physical activity program, and he is more than 45 years old.
    • Say:
      Here are some other things you should know before starting a physical activity program:
      1. Start slowly. Build up the time and effort that you put into any activity. You should not be tired the next day.
      2. Drink plenty of fluids before, during, and after physical activity, even if you are not thirsty. Drink water. Water has no calories and will prevent you from becoming dehydrated. Special sports drinks are not needed.
      3. Wear shoes and socks that give your feet support. Shoes with thick soles will cushion your feet and absorb shock.
      4. Wear comfortable clothing. You do not need to buy fancy outfits.
      5. Never wrap your body in plastic or wear clothing that is too heavy. This will not help you lose fat, but it can:
        1. Make you sweat too much.
        2. Make your body temperature rise.
        3. Make your heart beat too fast.
        4. Make you sick to your stomach.
        5. Cause you to pass out.
        6. Cause damage to your organs.
    • Say:
      You should also know that some people who are very overweight may face special challenges in trying to be physically active, but they too have good options.
      Start with these activities:
    • Weight-bearing activities, such as walking, involve lifting or pushing your own body weight.
    • Nonweight-bearing activities, such as swimming and water workouts, put less stress on your joints because you do not have to lift or push your own weight. If your feet or joints hurt when you stand, nonweight-bearing activities may be best for you.
    • Lifestyle activities, such as gardening, do not have to be planned.
      Note: For more information on being active at any size, visit the Weight-control Information Network at http://win.niddk.nih.gov or call 1–877–946–4627 (toll free).
    • Ask:
      Does anyone have any questions?
      Note: Allow 2 or 3 minutes for questions.
  6. Finding Time To Be Physically Active
    • Say:
      I know that all of you have busy lives. You may be wondering how you will ever find time to be physically active. Let's look at some ways.
    • Give each group member the “Take Heart—Say Yes to Physical Activity” handout. Read the handout aloud.
    • Ask:
      What are some other ways to become more active even when you don't have time?
      Note: Allow about 5 minutes for group members to answer. Write their answers on the blackboard or on a large piece of paper taped to the wall.
    • Add these ways if group members do not mention them.
      • Take a 15- to 20-minute walk during your lunch break at work or after dinner with your family.
      • Jump rope a few minutes each day. Work up to jumping for 10 minutes.
      • Dance with your children. You'll burn calories and have fun together.
    • Say:
      Spend more time being active, and cut back on watching TV, videos, or DVDs; using the computer; or playing video games.
  7. Walking: An Activity for Almost Everyone

    Tips for Preparing for the Walking Activity
    Before the start of this session:

    • Review the “Stretching Activities” handout.
    • Practice until you know each part well enough to teach it to the group members.
    • Practice a brisk walk. Take long strides, and swing your arms.

    When leading this activity, remember:

    • Music can get people in the mood for being active. Use a lively song for the warmup exercises, a faster beat for the walking, and a relaxing song for the cooldown period. Make sure that no one objects to the music.
    • Be enthusiastic. Group members will pick up on your enthusiasm and feel good about exercising.
    • Lead the walk in a circle if you have to do the walking indoors or if space is limited.
    • Have plenty of cool drinking water available before and after the activity.
    • Discussion and Stretching
      • Say:
        Brisk walking is an excellent form of physical activity. It's easy to do, and you do not need special equipment. All you need are shoes for support and socks for cushioning.
      • Say:
        Walking can be done outdoors or indoors. If you do not feel safe walking in your neighborhood, a school or churchyard may be a safer place to walk. Walk in well-lit areas at night. Many shopping malls let people walk inside the mall before the stores open. Some malls even have walking clubs that meet every day.
      • Say:
        It's important to spend time warming up and cooling down each time you are physically active. Although the risk of injury from walking is low, the warmup gets your leg muscles ready for the activity. The cooldown lets your heart rate slowly return to normal. This also keeps your leg muscles from getting stiff.
        Note: Ask the group members to stand up and spread out, with at least 3 feet between them and other group members.
      • Start the music.
      • Say:
        It is important to warm up your muscles and stretch before you begin physical activity. First, we will warm up our muscles, and then we will stretch. Let's walk in place slowly for 3 minutes.
      • Say:
        Now, I am going to show you some stretching activities. Watch me, and then try doing them yourselves. Some are easier to do than others. With time and practice, you will be able to do them all. If you have a bit of trouble at first, just do your best. You will get a handout that tells you how to do these stretching activities. Use the handout to help you do them at home.
    • Walking Activity
      • After the stretching activities, lead the group members on a 15- to 20- minute walk. Walk slowly for the first 5 minutes. Then show them how to do a brisk walk for 5 to 10 minutes.
      • During the last 5 minutes, slow your pace.
      • Say:
        We are slowing down now so that our bodies can gradually relax. This important part is called the cooldown period. It's usually recommended
        that you gradually slow your pace during the last 5 minutes of an activity. Doing a few stretching exercises to loosen the muscles should also be part of your cooldown.
      • Say:
        For example, runners or joggers may cool down by walking for a few minutes and then stretching their leg muscles before they stop entirely.
      • Ask:
        How do you feel? Do you think you could continue to walk like this? Why or why not?
        Note: Allow 3 to 5 minutes for group members to answer.
      • Say:
        If you already walk three or more times a week, add other activities to become more fit. Try running, jumping rope, or doing aerobics.
      • Say:
        One of the hardest parts of being more active is staying motivated. Many
        people find that having a partner helps them stay active. A partner can be a family member, neighbor, or friend. The benefits of having a partner are:
        • You can motivate each other. You can set goals together and help each other meet them.
        • It makes the time go by faster. You focus on talking rather than on the activity.
      • Say:
        Walking clubs are a great way to enjoy physical activity and make friends.
        Note: See tips on how to organize a walking club, so you can share the tips with group members.
      • Ask:
        • What would help you stay motivated to continue being physically active?
        • Where are some safe places in your neighborhood to be active?
          Note: Allow about 3 minutes for group members to answer. Write their answers on the blackboard or on a large piece of paper taped to the wall.
      • Give each group member the following handouts:
      • Say:
        Use the “Make Physical Activity a Habit—My Personal Record” handout to track your daily progress.

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Review of Today's Key Points

Say:
Let's review what we have learned today.

  • What are some of the benefits of regular physical activity?
    • Regular physical activity can:
      • Strengthen your heart and lungs.
      • Build and maintain healthy bones, muscles, and joints.
      • Help you lose excess weight and prevent weight gain.
      • Control blood cholesterol and lower blood pressure.
      • Help you sleep better, reduce stress, increase energy, and reduce feelings of depression.
      • Lower your chance for heart disease, diabetes, and cancer.
  • What is an activity that just about everyone can do?
    • Brisk walking
  • What are simple ways to become more active throughout the day?
    • Take a walk.
    • Get off the bus early and walk.
    • Dance to your favorite music.
  • What is the minimum amount of physical activity recommended for you to do every day?
    • Adults need at least 30 minutes, and children and adolescents need at least 60 minutes daily.

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Weekly Pledge

  • Say:
    You have learned a lot today about how you can become more physically active. Now let's think about how you can apply what you have learned. Please think of one change you can make in your everyday life to increase your level of physical activity. This will be your pledge for the week.
  • Say:
    Be specific about what you plan to do, how you plan to do it, and when you will start. Examples include:
    • I will talk to family members and friends this weekend about taking regular walks together.
    • I will start walking for at least 20 minutes during my lunch break at work, starting tomorrow.
  • Say:
    Write your pledge on the “Take Heart—Say Yes to Physical Activity” handout. Keep this handout in a special place so you can review your pledges and keep your goal in mind.
    Note: Allow 5 minutes for group members to think of a pledge and write it down.
  • Say:
    Would anyone like to share his or her pledge with the group?
    Note: Write down pledge ideas on the blackboard or on a large piece of paper taped to the wall.
  • (Optional) Say:
    Keeping a personal value in mind can help you make changes in your everyday life to become more physically active. Remember that a personal value is a quality that you consider important.
    Today the value is perseverance. Perseverance helps you have the willpower to keep your pledge, even if it means starting again after a slip. It helps you set a routine to keep you focused on your goal to improve your health.
  • Ask:
    How could you use perseverance or another value to help you keep your pledge?
    Note: Allow 3 minutes for group members to share their thoughts.
  • Say:
    We will talk about how you did with your pledge at the next session. Remember to keep working on your pledge to be prepared if a heart attack happens.

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Closing

  • Say:
    Thank you for coming today. What did you think of today's session?
    Note: Allow a moment for group members to respond.
  • Say:
    I am looking forward to seeing you at the next session. The next session will be about how to cut back on salt and sodium to prevent and control high blood pressure.
    Note: Think about today's class. What worked? What didn't work? Have you made any changes in your own life that were covered in today's session?

Go to Session 2

Go to Session 4


Information on this page is taken from the English print version of “Your Heart, Your Life, A Community Health Worker's Manual.” U.S. Department of Health and Human Services, National Institutes of Health, National Heart Lung and Blood Institute, NIH Publication No. 08-3674, Originally Printed 1999, Revised May 2008.




Last Updated March 2012




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