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

Manual Contents

Session 1 Knowledge Is Power: Know Your Risk for Heart Disease

Page Contents

Objectives

By the end of this session, group members will:

  • Know about the Healthy Heart, Healthy Family project.
  • Know how the heart works and its importance.
  • Know that heart disease is a serious health problem for Filipinos and is one of the leading causes of death.
  • Know that heart disease can be prevented.
  • Be able to name six risk factors for heart disease that can be prevented.
  • Know other group members.

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Materials and Supplies

To conduct this session, you will need:

  • “Healthy Heart, Healthy Family” manual and picture cards
  • Name tags
  • Hearts cut from red felt (try to get the kind that has a sticky backing) or red construction paper. Use the “Begin with a Heart” handout to cut out the heart.
  • Safety pins (if not using felt with sticky backing)
  • Map of the Philippines
  • Pushpins
  • Blackboard and chalk or several large pieces of paper, a marker, and tape
  • Clear container that is filled with 1 liter (about 4 cups) of water

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Handouts

Give each group member these handouts during this session:

Note: Read the More Information chart to be ready to answer questions from group members:

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Introducing the Session

  1. Welcome
  2. Project Overview
  3. Course Rules
  1. Welcome
    • Introduce yourself as people walk in.
    • Ask each person his or her name. Write it on a name tag. Give each person a name tag and a felt or paper heart.
    • Ask group members to wear the name tags on their shirts. Ask them to place the felt or paper hearts where their own hearts are found.
    • Welcome group members to the session. Tell them that you are very happy to see them.
  2. Project Overview
    • Say:
      Heart disease is the #1 reason why people die in this country. The National Heart, Lung, and Blood Institute, part of the National Institutes of Health, created the Healthy Heart, Healthy Family project to help Filipinos prevent heart disease.
    • Say:
      Together, we will learn about the risk factors for heart disease. We will also learn things that you and your family can do to have healthy hearts.
    • Show the names of the sessions on the blackboard or on a large piece of paper taped to the wall.
      1. “Knowledge Is Power: Know Your Risk for Heart Disease”
      2. “Act in Time to Heart Attack Signs”
      3. “Get Energized! Say YES to Physical Activity”
      4. “Help Your Heart: Control Your High Blood Pressure”
      5. “Be Heart Smart: Keep Your Cholesterol in Check”
      6. “Keep Your Heart in Mind! Aim for a Healthy Weight”
      7. “Protect Your Heart: Prevent and Control Diabetes”
      8. “Welcome Heart Healthy Eating Into Your Home”
      9. “Eat in a Heart Healthy Way–Even When Time or Money Is Tight”
      10. “Take Control of Your Health: Enjoy Living Smoke Free”
      11. “Review and Graduation”
    • Say:
      Please come to all of the sessions. I will lead the sessions, but I need each of you to participate. This will help you learn the information and enjoy the sessions more. Please feel free to ask questions. Your questions also help others to learn.
    • Say:
      For some, the knowledge or information we cover may be as straightforward and simple as tying your shoe.
      To others, the sessions may introduce lots of new information. This may be as challenging as taking care of a sampaguita plant in cold weather so it grows into a strong, beautiful flower.
      If there is something you do not understand, please ask a question. Your questions also help others to learn.
      Hearing information, especially new information, is not the same as carrying out what the information says. I hope what you learn will help you and your family take action to prevent heart disease.
  3. Course Rules
    Note:This section will help group members feel comfortable with each other at these sessions. It also will make it easier for you to lead the sessions.
    • Say:
      Everyone will feel more at ease if they know what to expect from this project. Before we begin, let’s talk about the best way to run the sessions. Let’s agree as a group on a few basic rules.
    • Say:
      This course takes effort and time from each group member. It is important for you to attend each session and to arrive on time. Each of the sessions is about 2 hours long.
    • Optional (if you are able to make changes) Ask:
      • How often do you want to meet (once a week, twice a week, etc.)?
      • Is this a good time to meet?
        Note: If not, set a meeting time that is best for most of the group.
      • Ask:
        Is this a good place to meet?
        Note: If not, decide on a location that is best for most of the group.
    • Say:
      Here are some things you can do to help you learn the most from the sessions.
      1. Feel free to ask questions.
      2. Share your personal experiences. This will make the program mean more to all of us.
      3. Try to stay on the subject. We have a lot of information to talk about in a short time.
      4. (Optional) Call me at [telephone number] if you have questions or concerns about this course. I am here to help you in any way that I can.
    • Say:
      Because you will share your experiences and opinions, we need to agree on a few things.
    • Ask:
      • Do you agree to keep other group members’ comments to yourself?
      • Do you agree not to judge others?
      • Do you agree to try to come to all of the sessions?
    • Ask:
      • Do you have other rules that you would like to talk about?
        Note: Allow a few minutes for group members to respond.
      • Ask:
        How many of you have heard this Ilocano proverb? The proverb reads, “Ang karunungan ay kayamanan mo, na di maaring manakaw sa iyo,” which means, “Knowledge is wealth that cannot be stolen.”
      • Ask:
        Would someone like to share what this proverb means to you?
        Note: Allow 2 to 3 minutes for group members to respond.
      • Say:
        With knowledge, you can make positive changes in your life to keep your heart healthy. Later in this session, you will meet the de la Cruz family, and they will share with us their journey to heart health.

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Conducting the Session

  1. Getting To Know Each Other
  2. Getting To Know the Secrets of the Heart
    1. How the Heart Works
    2. The Heart's Structure
  3. Facts About Heart Disease
  4. Risk Factor Activity
  5. (Optional) A Day With the de la Cruz Family
  1. Getting To Know Each Other
    • Say:
      We’ll begin today’s session by introducing ourselves and getting to know each other a little better.
      Note: Before the session, post the map in a central place in the room. Keep the pushpins nearby for this activity.
    • Give group members the “My Family Is From…” handout, and show the map of the Philippines.
      Note: Start this activity by going first. Tell the group where your family is from in
      the Philippines and why you are interested in heart health. Be honest, and talk about your own personal experience. Give each group member a chance to answer. Use the pushpins to mark on the map where the group members’ families come from in the Philippines.
      Ask group members to:
      • Give their names and tell one or two things about themselves (for example, where in the Philippines their families are from, or how long they have been living in the United States).
      • Tell why they came to this course and what they hope to learn.
    • Say:
      While our families may come from different parts of the Philippines, we all view the family as the backbone of support, knowledge, and love. You can help your family and friends by being a good example, sharing with them what you learn, and encouraging them to live healthier lives. Thank you for making this effort.
    • Say:
      I would like to introduce you to another family that will help guide us through each of these sessions, the de la Cruz family.
    • Give each group member the “Meet the de la Cruz Family” handout. Ask for a volunteer to read.
  2. Getting To Know the Secrets of the Heart
    Say:
    Now that we know a little bit about each other and the de la Cruz family, let’s get to know a few facts about the heart.
    1. How the Heart Works
      • Say:
        The heart is a gift that represents strength, life, and love. The heart is an amazing part of the body. It can pump approximately 5 liters of blood every minute. It beats about 100,000 times a day.
        Note: Hold up a clear container that has 1 liter (about 4 cups) of water in it. Remind the group that the heart pumps five times this amount of blood each minute.
      • Say:
        The heart sends blood to the lungs to pick up oxygen. Then it delivers oxygen to all the cells in the body.
      • Say:
        You can feel the beat of your heart by taking your pulse. To find your pulse, gently place the index and middle fingers of one hand on the inside wrist of your other hand. Slide your two fingers toward the thumb side of your wrist until you feel a slight heartbeat.
      • Show group members how to do this.
    2. The Heart’s Structure
      • Show picture card 1.1.
      • Say:
        The heart is a hollow, muscular, cone-shaped organ, about the size of a fist.
      • Hold up your fist for the group members to see.
      • Point out each part of the heart on the picture card.
      • Say:
        • The heart has two upper chambers and two lower chambers.
        • The upper chambers (right atrium and left atrium) receive blood.
        • The lower chambers (right ventricle and left ventricle) pump blood.
      • Show picture card 1.2.
      • Say:
        • The heart is located in the middle of the chest. Did you place your felt or paper heart in the correct spot?
        • The heart is one of three main components of the circulatory system. The others are blood vessels and the blood.
        • The circulatory system is very important for sustaining life. It is made of all the vessels that carry the blood throughout the body.
        • Blood vessels are long, hollow tubes of tissue, much like drinking straws. There are various kinds of blood vessels. The main ones are called arteries (shown in red), veins (shown in blue), and capillaries (not shown).
        • The circulatory system delivers oxygen and nutrients to cells in your body and removes carbon dioxide and other waste products.
      • Show picture card 1.3.
        Note: Point to each artery and vein. Describe the following two steps while pointing to pictures 1 and 2.
      • Say: Let’s go over the major veins and arteries.
        1. Blood (with little oxygen) enters the right top chamber of the heart through the largest veins in your body. These veins are called the superior and inferior vena cava.
        2. Blood then flows down to the right lower chamber so it can be pumped out to the lungs through the pulmonary arteries. In the lungs, waste (carbon dioxide) is removed from the blood. The blood then gathers more oxygen.
      • Show picture card 1.4.
        Note: Describe the two steps while pointing to pictures 3 and 4.
      • Say:
        1. The blood, rich with oxygen, returns to the heart and enters the upper left chamber through the pulmonary vein.
        2. The blood then flows down to the lower left chamber and is pumped out of the aorta to the rest of your body. Your left and right coronary arteries carry oxygen-rich blood to all parts of your heart.
      • Say:
        Heart disease is a condition that affects the heart muscle, heart valves, or the vessels of the heart. The major form of heart disease is coronary heart disease. Because the heart is such an important organ, you want to keep it free from heart disease. When the heart stops, life stops. So when you take care of your heart, you take care of your life.
  3. Facts About Heart Disease
    Note: Before the session, read the “More Information” chart. This chart lists the risk factors for heart disease that you can do something about. It gives you steps you can take to prevent or lower those risk factors. There is also a “More Information in Tagalog.”
    • Say:
      Now that we know how important the heart is, let’s talk about heart disease and what we can do to protect our hearts.
    • Ask:
      Do you know someone who has heart disease?
    • Note: Allow about 2 minutes for group members to respond.
    • Show picture card 1.5.
    • Say:
      Heart disease is a serious health problem for Filipinos.
      • It is one of the leading causes of death among Filipinos in the United States.
      • Filipino Americans have higher blood pressure than other Asian Americans.
      • Filipino women have higher rates of blood pressure compared to other Asian American women.
      • In the Philippines, approximately 23 percent of Filipino adults (or one in four adults) have high blood pressure (140/90 millimeters of mercury [mmHg] or more).
      • Say:
      • Many people believe that a heart attack or stroke happens suddenly, because of a scary experience, getting bad news, stress caused by work, family problems, worries, or having strong feelings such as anger.
      • A heart attack or stroke may seem sudden, but the truth is that heart disease develops over many years. It often starts when you are very young.
      • Taking steps to prevent heart disease is important at any age. It is like performing regular service on a car (for instance, changing the oil and checking the fluids and the tires). Car maintenance helps keep the engine running smoothly so that the car won’t break down on the road. In the same way, you need to take steps to care for your body so you can lower your chances of getting heart disease.
      • This course will show you the steps you and your family can take to have healthier hearts.
    • Show picture card 1.6.
    • Say:
      In many sessions, you will hear about something called a “risk factor.” Risk factors are traits or habits that make a person more likely to get heart disease. Some risk factors–such as age, family history, and gender–are things you cannot change. But the good news is that you can do something about some risk factors:
      • High blood pressure
      • High blood cholesterol
      • Cigarette smoking
      • Diabetes
      • Overweight
      • Not being physically active
  4. Risk Factor Activity
    • Give each group member the “Are You at Risk for Heart Disease?” handout. Read aloud each risk factor. As you read each one, ask group members to check off the risk factors they have.
    • Say:
      The more risk factors you have checked, the greater your risk for heart disease and stroke. Talk to your doctor about your risk.
    • Say:
      This session will explain how these risk factors affect the health of the heart. It will also teach you how you and your family can prevent or control those risk factors. You will learn how to:
      • Lose weight if you are overweight.
      • Be physically active.
      • Cut down on salt and sodium.
      • Eat foods that are lower in saturated fat and trans fat.
      • Eat more fruits and vegetables and low-fat milk and milk products.
      • Get your blood pressure, blood cholesterol, and blood glucose (blood sugar) levels checked.
      • Take prescribed medications as your doctor tells you.
      • Quit smoking.
    • (Optional) Note: You can share information on The Heart Truth campaign described in the Appendix.
  5. A Day With the de la Cruz Family (Optional)
    • Ask:
      How did you feel when you learned that you or your loved one(s) have risk factors for heart disease?
      Note: Allow 3 minutes for group members to answer.
    • Give each group member the “A Day With the de la Cruz Family” handout.
    • Say:
      People act in different ways when they learn they must make changes in their habits to lower their risk for heart disease. Let’s read the examples from the “A Day With the de la Cruz Family” handout.
    • Ask a volunteer to read the handout.
      Note: You can make puppets to represent each member of the de la Cruz family from socks or paper bags. Use glue, markers, and other craft scraps to give your puppets features and costumes.
    • Add these answers if they are not mentioned:
      • Which family member do you identify with the most?
      • What reasons do you have to improve your health?
      • What barriers keep you from making daily changes?
      • What can you do to reduce these barriers?

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Review of Today's Key Points

  • Ask:
    What are the risk factors for heart disease that we can prevent or control?
  • Add these answers if they are not mentioned:
    • Overweight and obesity
    • Not being physically active
    • High blood pressure
    • High blood cholesterol
    • Diabetes
    • Smoking
  • Say:
    It may be hard to change old, unhealthy habits and learn new healthy ones. This course will teach you what you need to know and how to make these changes slowly. Seeing you make healthy changes may make others want to make these changes, too.

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Lola's Life Lessons: A Time to Reflect

  • Ask:
    How did you feel (or how would you feel) when you learned that you or your loved ones have risk factors for heart disease? Allow 3 minutes for group members to answer.
  • Say:
    In the de la Cruz family, Lola Idad will show us how she made healthy lifestyle changes.
    Note: Give each group member the “Lola’s Life Lessons: Session 1” handout. Ask a volunteer to read the handout.
  • Say:
    Please take a few minutes to reflect on Lola’s advice and how this applies to your life. At the bottom of the handout, there is a space called “A Time To Reflect.” Use this section to record your thoughts and feelings about this week’s session. Remember, this is for you and no one else.
    Note: Give each group member 2 to 3 minutes to write down their thoughts.

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Closing

  • Ask:
    Do you have any questions about the project?
    Note: Give group members a moment to respond.
  • (Optional) Ask:
    How many of you want to go on a grocery store tour? During week 8 or 9, a nutritionist can lead us through a grocery store and help us learn how to shop with our hearts in mind.
    Note: If enough group members are interested, call the grocery store in your area and set up a date for a tour.
  • Say:
    Thank you for coming today. What did you think of today’s session?
    Note: Allow a moment for group members to respond.
  • Say:
    In the next session, we are going to discuss the warning signs of a heart attack.
  • Note for Educator: Think about today’s session. What worked and what didn’t? Did the session help group members learn about their risk for heart disease?

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Go to Session 2


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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