KNOW YOUR NUMBERS Understanding Blood Pressure and What it Means for Your Health Community Assessment and Intervention Project Leslie Franklin, Maggie Hatcher, Dani Burden, Caroline Brent

Introduction •  The purpose of this project: To raise awareness concerning the

need to monitor blood pressure values as well as to promote the education of the population regarding the prevention and/or maintenance of hypertension.

•  Objective: •  To evaluate the blood pressures of those in the community, allowing

the respondents to identify if the blood pressure values are within normal range; if blood pressure IS elevated, the participants are expected to identify their respective stage of hypertension (pre-hypertensive, or hypertensive stage I or II).

•  Healthy People 2020 objective: •  to increase the proportion of adults who have had their blood pressure

measured within the preceding 2 years and who can state their blood pressure.

•  Target population: Phenix City, Alabama

Community Assessment • Overview of the community’s origin and structure

•  Phenix City, Alabama is located inside of Russell County •  From 2009-2011, Heart Disease was the number one killer in Alabama as a whole, as well as

specifically in Russell County •  Russell County as a whole is at an increased risk to Heart Disease, due to 39% of their population

classifying as obese •  20.1% of the population is considered to be below the poverty level, adding stress to daily life which

leads to greater risk of Heart Disease

• Key findings (data gathering & data generating) •  There was an abundance of access to unhealthy, fast-food restaurants and extremely limited

access to healthy, on-the-go, options. This leads to unhealthy eating which can directly compromise health.

•  The Community Educator at the Regional Rehabilitation Hospital in Phenix City notices the need of local fast-food restaurants and grocery stores to “display health facts next to the high fat and high sodium foods” in order to help educate the community members of the impact each product may have on their health.

•  There were not many areas for physical activities such as walking, jogging, and recreational sports; this poses a barrier in achieving and maintaining a healthy physical state.

•  Hospitals are scarce in this area, with only one being inside city limits. The nearest hospital is about 15 miles away in Columbus, GA. This lack of access to local healthcare has the possibility to interfere with many efforts of the population to seek health care due to lack of transportation and increased hassle.

•  The presence of the church was well marketed throughout the city, with the predominant affiliations being Baptist, Methodist, and Church of Christ.

Community Assessment • Community-health oriented diagnosis:

•  There is a risk for elevated blood pressure among families in Phenix City related to lack of regular blood pressure screenings to identify hypertension, and a knowledge deficit regarding healthy lifestyle behaviors and the risk factors of heart disease.

•  Other health problems: •  Obesity related to poor lifestyle choices •  Knowledge deficit related to healthy lifestyle behaviors •  Stress overload related to poverty

Community Intervention • Plan: Place, target population, and topic

•  Place: Outside of Kmart on Highway 280 •  Target Population: Willing members of the Phenix City population, located at Kmart on July 9th,

2013 •  Topic: Offering shoppers the opportunity to have their blood pressure taken and educate them

on whether their blood pressure is normal or high, how it affects their body, and where to go for additional health care assistance.

Community Intervention •  Develop: Literature supporting intervention; method of delivery

(poster, ppt., handouts, etc.) •  In all three articles, health care screenings were offered to the community in a

number of areas including public places such as community centers and churches to help community members identify Cardiovascular disease and related risk factors, such as hypertension.

•  In Nashville-REACH 2010 Project offered 3,000 community health screenings over the course of 7 years. Leaders notified the community by posting flyers and distributing circulars.

•  In Boston, Massachusetts a mobile clinic was created to offer health screenings and provide resources for low-income people who may not otherwise seek health care.

•  A similar case in Britain offered public health screenings to various communities and reached a diverse group of people.

•  All three examples of community programs were successful in identifying new cases of hypertension and counseling those who were inadequately managing their condition.

Community Intervention •  Literature supporting intervention

•  Professional poster included an explanation of what hypertension is. •  Brochure included information pertinent to hypertension and provided health care facilities that

are available to the community. •  Both the professional poster and the brochure included The American Heart Association

guidelines for the stages of hypertension. •  Information provided

•  Risk factors for developing high blood pressure •  A family history of high blood pressure •  Older age •  Lack of physical activity •  Poor diet •  *Especially a diet high in salt •  Overweight/obese •  Drinking too much alcohol •  Stress •  Smoking and second-hand smoke •  Sleep apnea

•  Locations in the community to have your blood pressure taken, such as pharmacies grocery stores, The Health Department, etc.

•  Referral list if blood pressure is high, such has the hospital or local clinics, based on whether they are insured or uninsured, or receiving Medicare/Medicaid

•  Effects of hypertension on the body

Know Your Numbers!

What is Blood Pressure? •  Blood pressure is the pressure that

blood puts on the blood vessel walls as it is moves through the body.

•  The top number, the higher number, is called systolic. It measures the pressure in the arteries when the heart beats.

•  The bottom number is called diastolic. It measures the pressure in the arteries between heart beats, or when the heart is filling with blood.

•  High blood pressure can lead to weak and overstretched blood vessels, heart attack, stroke, blood clots, and even heart failure.

What do the numbers mean?

Community Intervention Our goal was for participants to state their blood pressure and identify whether their blood pressure was normal, pre-hypertensive, or stage I or II hypertensive. Those who allowed us to take their blood pressure were able to state their results, and identify the appropriate category on the chart either in the brochure or on the poster. We considered this to be effective teaching.

Community Intervention – findings •  The community response was surprising. Many people were willing

to listen and have their blood pressure taken. We handed out 50+ educational brochures to the community members.

•  31 participants elected to have their blood pressure measured. •  20 out of the 31 participants had a systolic blood pressure greater

than 120 mmHg and/or a diastolic blood pressure greater than 80 mmHg.

•  14 of the 31 participants were unaware of their condition. •  We allowed respondents to quietly sit for a moment to relax and then

measured their blood pressure again to confirm. •  Surprisingly, the majority of people who refused to have their blood

pressure measured made it clear that they already have hypertension and KNOW how to maintain it.

What Next? •  Future studies:

•  Alert the public of the location and details of the intervention ahead of time •  (flyers, radio announcements, etc)

•  Schedule routine screenings (approximately once a month) to ensure proper tracking of the effectiveness of education and referrals for individuals.

• Community participation: •  More blood pressure machines

•  Check for proper functioning! •  Should be located at all stores with a pharmacy

•  Nutritional facts displayed clearly at all restaurants •  Includes fast food!

•  Education regarding healthy food choices •  Possibly a follow-up intervention, or included in regular blood pressure

screenings