Healthy Heart, Healthy Family: A Community Health Worker's Manual for the Filipino Community

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Appendix Activities for Training Community Health Workers

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Handouts

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Activities for Training Community Health Workers

The “Healthy Heart, Healthy Family” manual can be used to train community health workers about heart health. The manual can also be used as a guide to conduct sessions to educate community members about heart health.

Trained community health workers can train other community health workers. Trained community health workers can also conduct heart health education sessions in the community to promote heart healthy behaviors, or they can conduct sessions in clinics to help patients control their risk factors for heart disease.

Part 1 of this appendix offers activities to help community health workers develop skills to present sessions from the “Healthy Heart, Healthy Family” manual to community groups. The handouts in this section offer suggestions for leading groups, as well as opportunities for group members to practice teaching session topics during the training. The flyer can be used to help groups publicize their community health worker training sessions. This flyer can be posted in local clinics and organizations, and community leaders can help find people who want to attend the training.

Part 2 provides a series of special activities and additional information that community health workers can use to enhance learning during the training. These special activities can also be offered separately at community events such as health fairs and health festivals.

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Part I – Training Session: Preparing To Make a Presentation

Note: If your goal is to train community health workers, deliver the following session after you have finished Sessions 1 and 7.

Effective community health workers must have good presentation skills. This section gives information on how a community health worker can prepare to teach the Healthy Heart, Healthy Family training.

At the end of Session 1

  • Say:
    When you complete the Healthy Heart, Healthy Family training, you will be able to conduct your own project for groups in your community. As a community health worker, you will not be giving medical advice. You will give information and support to encourage others to live healthier lives and to use health services that are available in their communities.
    Note: Give each community health worker the “Tips To Teach the ‘Healthy Heart, Healthy Family' Manual” and the “Seven Golden Rules for Teaching Groups” handouts.
  • Say:
    Now we will review some steps that will help you prepare an effective and interesting presentation of the “Healthy Heart, Healthy Family” manual.
  • Say:
    Let's review the “Tips To Teach the ‘Healthy Heart, Healthy Family’ Manual” and the “Seven Golden Rules for Teaching Groups” handouts. I recommend that you use these materials when you prepare your presentation and teach the “Healthy Heart, Healthy Family” manual.

Teaching Practice

Community health workers can gain confidence as presenters by practicing how to teach a session. Listed below are two ways that your group can practice during the training: (1) group members can present a complete session, or (2) they can make short presentations on topics from each session. Choose the method that works best for your group.

  1. Presenting a Session
    This activity gives community health workers the opportunity to practice teaching the sessions of the “Healthy Heart, Healthy Family” manual. At the end of Session 7, divide the participants into two groups. Assign one group to present Session 9 and one group to present Session 10.
    Allow the groups 30 minutes to practice at the end of Sessions 7 and 8. Give each group the handouts and other supplies needed to teach each session. The group that is not teaching will offer suggestions to the presenters about what was done well and what can be improved.
    • At the end of Session 7
      • Say:
        Now each of you will have the chance to be the trainer. Let's divide into two groups. One group will practice teaching Session 9, “Eat in a Heart Healthy Way – Even When Time or Money Is Tight.” The other group will practice teaching Session 10, “Enjoy Living Smoke Free.”
      • Say:
        Each group now has 30 minutes to review the assigned session and decide how to present the activities. You can use this time to divide the sections of the session among the members of your group.
      • Say:
        You will also have 30 minutes at the end of Session 8, which is next week, to continue practicing. After this, you will teach Sessions 9 and 10. Each group will have 1 hour to teach each session.
  2. Presenting a Topic
    For the second method, group members will make presentations on specific topics from each session. Each participant may make a 5- to 10-minute presentation individually, or in a team of two, on a session topic covered during the training. Present this activity at the end of Session 7 by asking the community health workers to choose the topic they will present and giving them time to practice.
    • At the end of Session 7
      • Say:
        At the end of Sessions 8, 9, and 10, each of you will make a short presentation on your own or with another group member. Each presentation will cover a topic from the manual and will last 5 to 10 minutes.
      • Give participants the “Healthy Heart, Healthy Family: Topics for Practice” handout.
      • Say:
        Here is a list of topics you can choose. I will give you a few minutes to select your topic and choose a partner if you decide to work in pairs. Then we'll make a list of the topics and presenters. Do not be nervous. We are here to learn and practice in a safe environment.
        Note: A list of topics to include appears below.
        Healthy Heart, Healthy Family: Topics for Practice
        • How the Heart Works (Session 1)
        • Heart Disease Risk Factor Activity (Session 1)
        • What Are the Warning Signs of a Heart Attack? (Session 2)
        • Types of Physical Activity (Session 3)
        • Benefits of Physical Activity (Session 3)
        • Lowering High Blood Pressure (Session 4)
        • Shake the Salt and Sodium Habit (Session 4)
        • Facts About Blood Pressure and Stroke (Session 5)
        • Metabolic Syndrome and Your Health (Session 5)
        • Nutrition Facts Label Activity – Fats (Session 5)
        • Facts About Saturated Fat, Trans Fat, Cholesterol, and Fiber (Session 5)
        • Cooking With Less Saturated Fat Activity (Session 5)
        • What Is a Healthy Weight? Activity (Session 6)
        • The Healthy Way To Lose Weight (Session 6)
        • ABCs of Diabetes Control (Session 7)
        • Think Before You Drink: Hidden Sugar in Common Beverages (Session 7)
        • The Traditional Filipino Diet (Session 8)
        • Eating in a Heart Healthy Way Even When There Is Little Time: Busy Times (Session 9)
        • Eating in a Heart Healthy Way Even When There Is Little Time: Eating Out (Session 9)
        • Saving Money on Your Food Bill (Session 9)
        • Smoking Harms You (Session 10)
        • Quitting Smoking (Session 10)
      • Say:
        Now, please tell me which topics you want to present.
        Write each group member's name (and his or her partner's name, if applicable) beside the topic.
        Note: If too many people choose the same topics, ask them to choose others.
      • Say:
        Remember to use the “Tips To Teach the ‘Healthy Heart, Healthy Family’ Manual” and the “Seven Golden Rules for Teaching Groups” handouts when you present your topics.
        Note: Decide which group members will present their topics at the end of Session 8, at the end of Session 9, and at the end of Session 10.
        Note: Now allow 30 minutes for group members to review their topics, ask questions, or practice their presentations.
    • At the end of Sessions 8, 9, and 10
      Note: When you finish presenting Sessions 8, 9, and 10, assigned group members should present their topics.
      • Say:
        Now we will present our topics. Each person or team will present for about 5 minutes. This exercise will give you a chance to practice your teaching skills and get feedback. Each time you present, you will become more comfortable and learn new ways to get people involved.
      • Ask a group member or pair to make the first presentation. After the presentation, allow 3 to 5 minutes for questions or comments about what was done well and what can be improved. Thank group members, and give positive comments. Politely correct any wrong information. Then ask another group member or pair to present a topic.
        Follow these instructions for each presentation, until all group members have finished presenting their topics.
      • Say:
        Your presentations have shown how much you have learned about heart health. I hope you will use every opportunity to spread the word – Filipino American families can make changes now to reduce their risk for heart disease. Community health workers, like you, are important to helping our families and communities live healthy lifestyles.
  3. You May Want To Practice More
    Say:
    Here are some ideas to build your confidence and give you more practice:
    • Observe an experienced trainer while he or she teaches a session or the entire training.
    • Schedule an opportunity for each health worker to present a full session to other community health workers.
    • Team-teach a session or the entire course to a community group with the help of a more experienced trainer. Ask for assistance from your project coordinator.

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Part II – Additional Information and Activities

Community health workers may add activities to the “Healthy Heart, Healthy Family” manual sessions to help with the training. This section of the appendix offers instructions on how to present five additional activities to the group members.

Activity 1: Face the Heart Truth

Note: You can review The Heart Truth information with group members and tell them how they can participate. The Heart Truth is a national awareness campaign for women about heart disease.

The Heart Truth for Women

  • Heart disease is a serious health problem for Filipinas and is one of the leading causes of death. In the United States, it is the #1 killer of women, regardless of race. It affects women at younger ages more than most people think, and the risk increases in middle age.
  • Heart disease can diminish health and the ability to do even simple activities like climbing stairs. It can decrease your quality of life. Two-thirds of women who have heart attacks never fully recover. If you have a heart attack, your risk of having another one increases.

Act Now To Protect Your Heart

  • Start protecting your heart now by learning about The Heart Truth at www.hearttruth.gov. You'll find out how and why women everywhere are embracing The Heart Truth's Red Dress, the national symbol for women that raises awareness of heart disease, which is the #1 killer of women.
  • Celebrate a new tradition. The first Friday of February is National Wear Red Day. Promote this event in your community. Participate by showing off your favorite red dress, shirt, or tie and by wearing the Red Dress pin. Visit http://www.hearttruth.gov to order your own official Red Dress pin.

Activity 2: How To Organize a Walking Club

Walking is an excellent form of physical activity. It is fun and easy, and it builds good health and well-being. Walking is inexpensive, and you do not need special equipment.

Promote the benefits of walking as a group.

  • It is more fun to walk as a group.
  • Team members can help each other to keep the pace and stick to the program.
  • Walking gives you time to spend with friends and meet new friends who are also interested in being active.
  • You can develop goals and work together to achieve them.
  • Your club can plan fun activities and themes, which increase participation.
  • Walking is an easy activity to begin.

How?

  • Form a group of people who are interested in starting a walking club.
  • Get the group together to share ideas and set goals.
  • Plan your program. Use a calendar to mark the date, place, and time when you will meet. Also, write down the distance you want to walk each day. Remember to make changes from time to time and to keep your activities fun and challenging.
  • Announce the start of the club in the Healthy Heart, Healthy Family classes, and invite the group members to bring their friends and family. Besides word of mouth, use interesting ways of advertising, including posters, church bulletins, calendars, and newsletters.
  • Ask club members to help you create a slogan or catchy name for your club.

Where?

  • Pick a location where your club will walk, perhaps in the surrounding neighborhood where you hold your classes. You may change the route to keep it fun, but you should always meet at the same time and in the same place.
  • Look for well-lit areas with sidewalks. If there is a school nearby, tracks are usually open to the public.
  • You can also walk inside a mall when it's too cold or too hot outside.

What?

  • Plan your activities, and use your imagination!
  • Encourage different members to lead the group.
  • Have special walk days each month to highlight themes, such as American Heart Month, Mother's Day, and other traditional celebrations.
  • Create daily or weekly theme walks, such as nature walks, discovery walks, and fitness walks.
  • Encourage participants to warm up, stretch, and cool down to avoid injuries. (See the “Stretching Activities” handout in Session 3.)
  • Use a calendar or notebook to record personal walks and distances.
  • Motivate group members to keep personal health records and to challenge themselves to improve.

When?

  • Decide when to walk (for example, before or after class or during weekend mornings or afternoons).

Do Not Forget

  • Stay alert. Be familiar with your surroundings.
  • Encourage walkers to dress appropriately and to bring a bottle of water.
  • Advise participants of the dangers of wrapping themselves with plastic. Tell them not to do this, because it is dangerous. (Session 3, for more information.)
  • Make sure that chatting does not interfere with the walking pace. Encourage group members to socialize, but also encourage them to keep moving.

Activity 3: Nutrition Displays

Displays are a great way to teach about nutrition. They visually encourage participants to learn about healthy food choices. Nutrition displays make a class or presentation more interesting, and they can be used with this manual. There are three nutrition displays that you can create and use along with nutrition activities in Sessions 4 through 9.

What you need:

  • One sheet of poster board (20 inches by 30 inches)
  • Food pictures or food models
  • Plastic spoons, preferably colored
  • White clay, Velcro®, glue, and markers
  • Sugar cubes and manila file folders
  1. Fat Matters – But Calories Count
    This nutrition display demonstrates the actual number of teaspoons of fat in foods. For example, you can compare fried chicken to baked or grilled chicken with the skin removed. Calculate the number of teaspoons by dividing the number of fat grams by four. For example, a food with 20 fat grams has 5 teaspoons of fat (20 grams divided by 4).
    Some foods that can be compared are:
    • Pork Longanisa, sweet (2 links) = 6 ¾ teaspoons of fat (27 grams)
      or
      3 ounces of lean pork tenderloin = 1 ¼ teaspoons of fat (5 grams)
    • 3½ ounces of chicken breast with skin (fried in 1 tablespoon oil) = 5 teaspoons of fat (19 grams)
      or
      3½ ounces of skinless chicken breast (broiled) = 1 teaspoon of fat (4 grams)
      or
      Chicken Siopao = 1 teaspoon of fat (4 grams)
  2. How Much Sugar and How Many Calories Are in Your Favorite Drink?
    This display is used to demonstrate how much sugar and how many calories are in common drinks.
    • Cut a manila file folder in half and fold each portion in half to make a card.
    • Write the name of the drink on one side. On the other side, write the number of calories, grams of sugar, and teaspoons of sugar in the drink. Glue the sugar cubes onto the folder to show the number of teaspoons of sugar in each drink.
    • Use the “How Much Sugar and How Many Calories Are in Your Favorite Drink?” handout (in Session 7) to find the number of calories and grams and teaspoons of sugar in common drinks.
  3. Making the Best Choice in Fast Food Places
    This display shows you how to make healthy choices at fast food restaurants. Nutrition information can be found on most company Web sites, and most fast food places have nutrition brochures available. Two sample meals are shown below:
    High-Calorie and High-Fat Menu Choices
    Food Items Calories Total Fat (g) Saturated Fat (g)
    102 grams of total fat = 25½ teaspoons of fat
    Double meat cheeseburger 1120 76 30
    Medium french fries 360 18 5
    Medium chocolate shake 500 8 5
    Total 1980 102 40
    Lower-Calorie and Lower-Fat Menu Choices
    Food Items Calories Total Fat (g) Saturated Fat (g)
    14 grams of total fat = 3½ teaspoons of fat
    Grilled chicken sandwich, no mayonnaise 330 7 1
    Garden salad 25 0 0
    Light dressing 50 5 1
    Low-fat (1%) milk 110 2 2
    Total 515 14 4

    The food choice sign can be made into a table tent sign by gluing the sign to a media folder.

Activity 4: Take Time for Sleep: Additional Presentation

Most adults need 7 to 8 hours of sleep each night. School-aged children and teens need at least 9 hours of sleep a night. Like eating healthy and being physically active, getting a good night's sleep is important to your heart health and your mood, and it is important when you are completing your daily activities. Not getting enough sleep can cause problems.

Sleep disorders, such as sleep apnea, can disturb how well you sleep and leave you sleepy the next day. In people with sleep apnea, their breathing stops briefly or becomes very shallow during sleep. They usually snore loudly and often.

If you Do not get enough sleep each night, or if you have sleep apnea that is not treated, you may be at increased risk of becoming overweight or developing high blood pressure, heart disease, or diabetes.

The Dos and Don'ts of Getting a Good Night's Sleep

  • Do go to bed and wake up at the same time each day – even on the weekends.
  • Do physical activity, but not too late in the day.
  • Do relax before bed – read or listen to music.
  • Do take a hot bath before bed – it can help you relax.
  • Do get rid of things that might distract you from sleep – noises, bright lights, an uncomfortable bed, or a TV or computer in the bedroom.
  • Do keep the room temperature cool.
  • Do see a doctor if you have trouble sleeping. If you are tired during the day, even after spending enough time in bed at night, you may have a sleep disorder.
  • Do not have caffeine or nicotine after 3 p.m.
  • Do not eat large meals or drink beverages late at night.
  • Do not take medicines that delay or disrupt your sleep. Check with your doctor about your prescribed medicines if you have trouble sleeping.
  • Do not take naps after 3 p.m.
  • Do not lie in bed awake. Get up and do some relaxing activity until you feel sleepy.

To learn more about sleep and sleep disorders, visit the National Heart, Lung, and Blood Institute (NHLBI) Web site at www.nhlbi.nih.gov, and click on “sleep.”

Activity 5: Heart Healthy Cooking Demonstrations

Cooking demonstrations can be an important part of group discussions. A cooking demonstration can show participants how to prepare foods that still taste good, but include less saturated fat, trans fat, cholesterol, and salt and sodium. Most people like to eat, and they will be interested in learning how to prepare food in a heart healthy way. This section gives you more information about how to use cooking demonstrations as a part of the training and how to make sure they go smoothly.

  1. Recruiting a Food Demonstration Facilitator
    If you are not going to conduct the food demonstration yourself, you can recruit a registered dietitian by contacting the local health department, the local American Dietetic Association, or the local Cooperative Extension Service office.
  2. How To Plan the Demonstration
    • Choosing the Facility
      • Is food permitted? Make sure the site where you will be presenting the group discussion allows cooking demonstrations. If food may be brought in for tasting, but not cooking, you may be limited to bringing a prepared dish. You also may be limited in the type of food you can bring. Some organizations have special dietary restrictions. Check these out beforehand. If you are doing a cooking demonstration at a festival or outdoor fair, you may need a special permit to use cooking equipment. Most important, be sure to visit the site beforehand to look at the facilities.
      • Is water accessible? You will need to wash your hands frequently. You may need large amounts of water for the recipes. Having a sink behind you or in the same room as the demonstration is ideal.
      • Is electricity accessible? This is necessary if you plan to cook onsite. If electricity is in the room, but not close by, be sure to bring heavy-duty extension cords with multiple outlets. If the demonstration is outside, you may need extension cords to bring the electricity outside, or you may need a generator or gas stove.
      • Is lighting adequate? Make sure there is enough light for participants to see what is being demonstrated.
      • Is the location convenient? Make sure the building is accessible by public transportation and parking is available.
      • Are tables and chairs available? You will need at least one table for your demonstration. If you demonstrate several recipes, you may need more. If the demonstration is long, you will need chairs for participants.
    • Choosing the recipes
      The recipes you choose depend on which principle of heart healthy cooking you want to show, the amount of time you have to prepare for the session, the amount of time you have for the demonstration, your budget, the facilities available at the presentation site, and the equipment you have available. Make sure you are familiar with your recipes and that you have prepared them at least once before the demonstration. The “Strawberry-Banana Yogurt Parfait Recipe” is a simple and tasty demonstration.
      • Consider your message. If you want to demonstrate how to reduce the saturated fat in food, look for a recipe that uses ground beef (to show how to drain the fat), uses skinless chicken, or uses low-fat (1%) or fat-free milk or milk products. If you want to demonstrate low-sodium cooking, look for recipes that use small amounts of salt, low-sodium ingredients, or lots of herbs and spices for flavor to replace the high-sodium condiments and sauces, such as monosodium glutamate (MSG), tuyo (dried salty fish), hibi (dried salty shrimp), pusit (dried squid), bagoong (salted fish paste), patis (fish sauce), and alamang (salted shrimp paste).
      • Consider your time. If you have limited time before the food demonstration, look for very simple recipes that do not require a lot of ingredient preparation, such as chopping or slicing, or bring ingredients that are already prepared.
      • Determine total cooking time. Consider the total time it takes to prepare the recipes. Read through the recipes, and look for those in which the preparation and cooking times are less than the total time you have for the demonstration. If you want to demonstrate more than one dish, determine the total cooking time for each one. Start with the dish that has the longest cooking time, and then go to the next longest cooking time, and so on. That way, all the food will be done at the same time or as close to the same time as possible.
      • Demonstrate just one concept. If you Do not have the time or the resources to demonstrate a whole recipe, consider demonstrating just one concept. For example, to demonstrate skimming the fat off soup, open a can of soup and use a spoon to skim the fat off. Or to demonstrate draining the fat from ground beef, cook ground beef in a skillet, and drain off the fat after it is browned.
      • Prepare in advance. Make a list of what you need to buy from the store, and buy the food, equipment, or other things you need. Buy foods as close to the demonstration date as possible.
      • Consider food safety. Wash your hands frequently with soap and water. You need to wash your hands whenever you touch an unclean surface, raw meats, or any part of your body. Cover your mouth and nose if you cough or sneeze, and immediately wash your hands in hot, soapy water. Keep all food that needs to be cold or frozen in a refrigerator or freezer until you are ready to go to the site. Gather and pack all other equipment you will need first. Fill a cooler with ice or freezer packs, put the food into the cooler last, and go to the site as quickly as possible.
      • Wrap prepared dishes and ingredients tightly. Do not let raw ingredients touch or run onto cooked ingredients. For example, keep raw meats, poultry, and fish separate from other raw or cooked vegetables. Use separate utensils, bowls, and cutting boards for these foods. Wash all utensils and cutting boards in hot soapy water when used to cut raw ingredients.
      • Have a handy supply of wet paper towels to wipe up spills as they happen. Use a vinyl tablecloth as a table covering so spills can be wiped up easily. Keep a trash can nearby, so you can easily toss in used items (such as empty cans and plastic wrap), and keep the table clear.
      • Make sure your appearance is neat and clean. Remember that participants will be eating the food you are preparing. Keep your hands clean. You may want to wear an apron to protect your clothes and a hairnet or scarf to keep your hair off your face.
  3. Setting up the Food Demonstration
    • Give yourself enough time. Allow more time than you think you will need to set up.
    • Set up the room. Consider the best arrangement to make sure everyone can see and hear you, and make sure you have access to the electricity and water. Be sure all food contact surfaces are clean.
    • Set up the food. At the latest possible time before the demonstration, set out all food according to which skillet or container you will use and the order in which you will prepare it. Put all food together for each recipe.
    • Keep cool. If you forget an ingredient, or a pot doesn't boil quickly enough, let group members know. Give them examples of ingredients that can be used in place of the one you forgot. While the pot boils, go over the changes that you made to the recipe to make it more heart healthy.
    • You can begin the cooking demonstration, finally! Explain how easy it is to prepare a recipe. Relax and have fun!

The scientific content of this manual comes from the following sources:

For More Information

The NHLBI Health Information Center is a service of the NHLBI of the National Institutes of Health. The Health Information Center provides information to health professionals, patients, and the public about the treatment, diagnosis, and prevention of heart, lung, and blood diseases. Please contact the Health Information Center for prices and availability of publications.

NHLBI Health Information Center
P.O. Box 30105
Bethesda, MD 20824-0105
Telephone: 301–592–8573
TTY: 240–629–3255
Fax: 301–592–8563
E-mail: nhlbiinfo@rover.nhlbi.nih.gov

Selected publications are also available on the NHLBI Web site at http://www.nhlbi.nih.gov. Also see the NHLBI Diseases and Conditions Index: http://www.nhlbi.nih.gov/health/dci/index.htm.

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Information on this page is taken from the English print version of “Healthy Heart, Healthy Family: 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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