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

Session 12 Handout Recording Log (for Strategies 1, 2a, 2b, and 3)

Download Recording Log (for Strategies 1, 2a, 2b, and 3) pdf document (267k, 3 pages) handout.

Which strategy you use determines which form you use. Enter the number of patients after the appropriate areas.

  1. Train the Trainer
    • Attendance Record
      • Number of participants trained
      • Number of sessions taught
    • Feedback Form
      • Number and percentage of participants who rate the training “good” or higher
      • Number and percentage of participants who report that they “will” or “most likely will” change their health habits
    • Community Health Workers Train the Trainer Posttest only
      • Number and percentage of participants using the “Healthy Heart, Healthy Family” manual 30 days after the training
      • Types of activities participants have done 30 days after the training
  2. Community Education
    • Teach the educational manual only.
      • Attendance Record
        • Number of participants counseled/taught
        • Number of sessions taught
      • My Health Habits Posttest
        • Number of participants satisfied with project
        • Number of participants who shared information about the project
    • Teach the educational manual, and screen project participants.
      • Attendance Record
        • Number of participants counseled/taught
        • Number of sessions taught
      • My Health Habits Posttest
        • Number of participants satisfied with project
        • Number of participants who shared information about the project
      • Screening Form
        • Number of participants screened
        • Number of participants with elevated clinical values
        • Number of participants referred to a health care professional
  3. Lifestyle and Clinical Management
    • Attendance Record
      • Number of patients counseled/taught
      • Number of sessions taught
    • My Health Habits Posttest
      • Number of participants satisfied with project
      • Number of participants who shared information about the project
        Clinical Measures and Followup Form
        Patients Baseline 6 Months 12 Months
        Number of Patients Screened      
        Number of patients with Prehypertension      
        Number of patients with High blood pressure      
        Number of patients with high blood cholesterol      
        Number of patients with prediabetes      
        Number of patients with high blood glucose      
        Number of patients with body mass index (BMI) of 25 or more      
        Number of patients with waist measurement greater than 35 inches for women      
        Number of patients with waist measurement greater than 40 inches for men      
        Number of patients who are taking medications for high blood pressure      
        Number of patients who are taking medications for high blood cholesterol      
        Number of patients who are taking medications for diabetes      
    • Community Health Workers Activities Form
      • Number of patients contacted at first encounter
      • Number of patients contacted at 3 months
      • Number of patients contacted at 6 months
      • Number of patients contacted at 12 months
      • List the activities Community Health Workers conducted at first encounter, at 3 months, at 6 months, and at 12 months

Back to Session 12

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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