University of Idaho

HS 490 Health Promotion

Interventions
Assignment 2

Directions

The following pages guide you on each step of this assignment. You
will look for intervention resources on web sites, class readings, class
notes and peer reviewed journals (Research Notes 1-3). You will pull it
all together and create an evidence based plan based on your findings
(Pulling it All Together) and include references, APA format. You may
type directly on these pages but it is not required. I put the assignment
in boxes to make it easier to follow but it may be easier for you to
create a word document with all the assignment components.

Total Point Value- 100 points- 20% of course grade

Website Review -15 points

Intervention Research Readings- 15 points
Research Articles-Peer Reviewed 30 points
Pulling it All Together- 35 points

Unlike the other assignments you will submit in this in hard copy
in class and also on Bblearn.

Professor Helen Brown- Spring 2017

Name: Sarah Tuffield

Health Topic: Heart Health, Target: men and women age 25 to 40 and Location: Ada
County, Boise, Idaho

NAME: #1
Intervention Website Review- 15 pts.
Review a website with intervention strategies related to your topic. Only 1 is
required, recommend you look at more than one for greater learning.
Website and Link:
How to prevent Heart Health

URL: https://www.goredforwomen.org/fight-heart-disease-women-go-red-women-
official-site/live-healthy/prevent-heart-disease/

APA citation of website:

How to Prevent Heart Disease. (2004). Retrieved from
https://www.goredforwomen.org/fight-heart-disease-women-go-red-women-official-
site/live-healthy/prevent-heart-disease/

General Purpose of the Website

This website is for an organization called Go Red for Women which is a part of the American
Heart Association and was founded in 2004. The primary information is used for raising
awareness about Cardiovascular disease in women and how to recognize the risks and
decrease the risks. Its a call to take action to know and reduce the risk of heart disease in
their lives and the tools to lead a heart healthier lifestyle.

What did you learn about effective interventions for your topic? Answer the
questions below and add additional comments.

What intervention tools and resources are available? What are the top recommended
interventions? Is there an evidence base for the recommended interventions? (Make sure the
website is useful to your topic).

This website has many informational pieces and provides the tools not only to reduce
the risk of heart disease in your own life but also the tools to recognize symptoms in
others and how to reduce some of the risks in your own lives. They provide links to
everything imaginable that relates to heart health. There are resources about heart
health, knowing your risk for heart disease, getting involved and living healthy.

When you open a page on the website it gives you information about that specific part
of heart health but it also provides links to personal stories about accomplishments
made from people who have suffered a heart related incident, tips for quitting smoking
or making a change, links to pages that address some of the topics needed covered but
that can be awkward to talk to your doctor about, and even links to places that address
the stigmas and stereotypes associated with heart health.

The intervention tools are links to other resources that say heres how to quit smoking,
or how to improve eating healthier, exercising more and targeting the major risks of
heart health but also educating people on how to help, how to prevent, and the tools
and steps you can take to be heart healthy yourself.

Critical thinking and relation to your health promotion topic

What did you learn from the website that you can apply to your project?

I learned that there are many different aspects of educating women on heart health
and that there are so many different areas of heart health and what you can do to
prevent and to understand it. Another big thing that this website made clear was that
educational intervention can be done in different ways and that some people are not
going to want to be talked at by a doctor or a friend and would rather have something
they can read at their own time and own pace.
1) Intervention activities that are appropriate for your project

I think that the educational links and activities would be appropriate, this
website made it a good intervention and I think that women of all ages need to
be addressed about heart health no matter how healthy they think they are.
This website made it easy to show that every woman is different and at
separate times in her life but that there are steps to take and things to do for
each step of heart health from prevention, to early screenings and even how to
communicate with family and how to accept dealing with heart health in your
life. Its important to be able to reach all ages of women so that you prevent
and provide awareness to all of them regardless of how healthy they think they
are.

I also liked the ideas of having testimonials of all ages. It was really shocking to
see that a 20 year old had a stroke because she seems so young but the fact
that she had the courage and support to work through it and end up walking a
5k on her own shows people that anything can happen but that you can
overcome it. On the other end of the spectrum a 57 year old woman struggled
with type I diabetes and had a history of heart attacks in her family, lost weight
to where she didnt need a kidney transplant because her kidney function had
improved. Its stories like these that make people realize that heart health issues
can affect anyone of all ages but that it can be overcome too.
2) Useful tools and resources, including health education/promotion resources

The website had resources for women mainly geared at young adult to older adult.
They also had an area for external resources. With this it looked at different places
that you could go to look at different risk factor resources and how to decrease your
risk for heart disease with that specific resource. Another tab that they had was a how
to get involved with Go Red and help yourself but also the women around you. I
thought it was really amazing to see that you could help others by donating your time
and making sure that you take care of your heart too. I think my favorite promotional
area was that there was an area dedicated specifically to living healthier and how to
do that with exercise, stress management and how to make heart-healthy recipes.
3) Other resources-

https://recipes.heart.org/: this website is very useful if youre trying to improve your diet
because it provides you with easy recipes to make that support your heart health. They
provide recipes for snacks, main dishes, appetizers and even snacks. They provide videos
of how to make the foods and related food articles about almost everything from going
back to school lunches for little ones to care for cooking utensils and even how to eat a
healthy breakfast on the run. This would be a great resource for someone who really
wants to change their diet.
http://www.heart.org/HEARTORG/Conditions/My-Life-Check---Lifes-Simple-
7_UCM_471453_Article.jsp#.WPMRWfnyvIU: This is a place to find out what your heart score
is. The American Heart Association and the medical experts that help the Association have a
health assessment that can help you: Understand your current level of cardiovascular health, Assess
your individual health needs, Commit to steps to improve your health and quality of life, and Move closer to your
personal health goals (AHA).

#2 Intervention Research Readings- 15 pts.

General Intervention Considerations- Answer the following using lectures and
readings. 1 paragraph for each.

1. Health Behavior Theory- Identify the theory (or theories) that is most important to
guide your intervention and discuss how that theory will guide interventions. (See
Theories at a Glance).

Theory: Social Cognitive Theory: the idea that it is continuous and repetitive
which causes behaviors environment and behaviors to change.

Level: interpersonal factors

This is an important guide for awareness of heart health in women because the
amount of education needs to be increased for women of all ages. They need to
know the behavioral patterns and access to resources to know about heart
health, the risks for it and if they are at risk. There also needs to be
observational learning of this through other women around them and those
important celebrities and authoritative people to raise the awareness and
importance of knowing your risk. Also at some point there should be
observational learning for the women to the women that they are surrounded
with to keep each other accountable and to help increase the awareness of
heart health.
2. Spectrum of Prevention- Based on the reading from the Prevention Institute-what levels
of prevention are most important for your topic/target and location? The type/level of
change desired will direct you to types of interventions that will have the most impact.

The level of prevention that is most important for heart health awareness in College
aged women is primary prevention. Many women aged 18 or older are not aware of the
risks you have for heart disease until your doctor says you should consider them or
youve experienced one. Many of them think Im young and it wont happen to me but
anything can happen and it does happen to girls who are 20, 25 and older. The level of
change that I think needs to be changed is awareness and attitudes; with this the
strategy would be influence expectations and gains attention. More women who are
around the age of 18 and up need to be educated about the potential risks and what
they can do to live a healthy lifestyle that will reduce their risk for heart disease.

3. Discuss what you learned about the predisposing, enabling and reinforcing factors that
are most related to the health behaviors you are trying to change.

I think that for changing the behavior of heart health awareness the most related
factors are the lack of awareness and education provided and women 18 or older arent
thinking about their health until their doctor brings it up or they experience something
 that relates to a heart disease. For predisposing factors most women 18 to 30 are
unaware of the risk factors for heart disease and what they can be doing to live a heart
healthy lifestyle. Many of them think that they are young and dont need to worry
about the risk factors but even someone who is 20 years old can experience a stroke or
heart attack. For reinforcing factors, there needs to be women in peoples lives that are
raising awareness for heart health and advocating that its something that is important
and an issue for women. Lastly for enabling factors, we need to provide resources that
educate women about heart risk factors and strategies and resources to help them
achieve this. If women dont know about heart health and the risks then how are they
supposed to live a heart healthy life?

#3 RESEARCH ARTICLES PEER REVEIWED- 1 of 3

3 peer reviewed research articles needed- 1 can be a review article.

Correlates of the Sustainability of Community-Based Heart Health Promotion Interventions

APA Citation of article

OLoughlin, J., Paradis, G., Renaud, L., Richard, L., and Sanchez Gomez, L. (1998) Correlates of
the Sustainability of Community-Based Heart Health Promotion Interventions. (ABSTRACT).
PREVENTIVE MEDICINE 27. Retrieved from
http://www.sciencedirect.com/science/article/pii/S0091743598903486

Participants or population reached

189 heart health promotion interventions initiated by a public health department or research
initiative across Canada implemented in the past 8 years

Describe the intervention and its effectiveness

The intervention looked into factors related to perceived effectiveness of heart health
promotion interventions initiated by schools, restaurants, grocery stores, health care
facilities, and sports facilities that implemented a heart health promotion intervention.
These ranged from risk factor screening, smoking cessation courses, healthy eating,
and physical activity to support group for promoting healthy lifestyles and distributing
heart health information

I thought it was interesting that they used data from Canada and contacted all of these
places by telephone and that it looks at the sustainability of heart health promotion
interventions

For the results of the study, overalls 43.6% of 189 interventions were perceived to be
very permanent, 34.8% were somewhat permanent, and 21.5% were not permanent.
This showed that our sustainability of heart health promotion intervention strategies
are below 50% but that there is room for improvement and that heart health promotion
intervention is being done.

The main conclusions of this was that taking these statistics and what worked well in
the interventions could increase the potential for better created interventions and the
potential for sustainability of heart health promotion interventions in the community.

For what were the main conclusions about the interventions reached by the author(s)
 including limitations?

Critical thinking and relation to your project

It showed me that interventions for heart health promotion are actually out there and
are being somewhat successful. I can apply this to my project in knowing that its hard
to create an intervention for raising awareness and how best to reach a target
audience.

This article also taught me that there arent a whole lot of heart health awareness
interventions but rather interventions that target one specific risk factor of heart
disease. While these are good interventions that help reduce an aspect of heart health
people arent aware of why they are completing this intervention in their lifestyle. You
can run an intervention for smoking cessation but why would you do that and how
would you create the awareness that smoking is one risk factor of cardiovascular
disease.

I think I can apply a more indirect approach to my topic and make it more about the
awareness aspect of heart health and less of what people should be doing because it
will help reduce their risk. Its not that we dont want people to make lifestyle changes
that will help reduce the risk but if they dont understand that it relates to the risk of
cardiovascular disease then they have ulterior motives for smoking cessation or
exercising more.

I would need to narrow down the collection of interventions into one intervention that
will best suit my population of women aged 18 and up and even more specifically
women college students and what they do or dont know. By creating an intervention
specifically for heart health awareness my target population can then look into the
specific interventions or how to make changes for the specific heart health risk that
they think they need to work on. By raising awareness first it gives the target audience
a sense of direction and what they can do next but also is saying you dont have to do
anything you dont want to. As a college student myself I like that the University of
Idaho provides screenings and think that implanting a heart health screening on
college campuses could be a great idea.

#3 RESEARCH ARTICLES PEER REVEIWED- 2 of 3

My student body: effects of an internet-based prevention program to decrease obesity among

college students.

APA Citation

Lachausse, R.G. (). My student body: effects of an internet-based prevention program to

decrease obesity among college students. Journal of American College Health, 60. Retrieved
from https://www.ncbi.nlm.nih.gov/pubmed/22559092

Participants or population reached

320 ethnically diverse undergraduate students

Describe the intervention and its effectiveness

For this intervention they assigned three hundred and twenty ethnically diverse
undergraduate students to an MSB-Nutrition program, an on-campus weight
management course or a comparison group to determine the impact of an online
nutrition program focusing on an obesity prevention program called My Student Body-
Nutrition for college students.
 This intervention looked at how online resources verses resources that you can
physically go to work in reducing and preventing obesity. It allows the college students
to see how effective these resources can be.

To understand how the measured weather these were effective they had the students
fill out a brief pre and post survey about their nutrition, physical activity behaviors, self-
efficacy, stress, attitudes, and body weight. This could pose as a limitation for the
conclusions because many people like to lie on surveys because they dont like where
they actually are in life based on the surveys.

I thought it was interesting but also very effective to have ethnic diversity among the
undergraduate students because it allows you to have a better understanding of the
campus as a whole rather than just one specific group of people.

The intervention study found that with the online MSB- nutrition program more
students had an increase fruits and vegetables intake, reduced stress, and increase
self-efficacy with fruits and vegetables but had no effect on physical activity behaviors,
weight loss and the self-efficacy of physical activity. This does not surprise me as
physical activity can be a harder habit to change and want to make a change with.
There are many barriers to face with physical activity and being self-efficient with it.
Nutrition is something that more people are aware of and can more easily break down
into parts of nutrition like consumption of more fruits and vegetables instead of do you
know how to make a proper balanced meal. This intervention idea would be a good
intervention to apply to my topic and target population because many college students
are well aware and experienced with technology and can learn from an online program.
I was surprised that the on campus weight management program didnt do as well but
can also understand that many people are ashamed of their weight and are scared to
have others be ashamed of them and wouldnt want to come.

The main conclusion was that the MSB-nutrition program was effective in changing
nutrition behaviors among students but had no effect on physical activity behaviors or
weight loss. Ive discussed a few limitations in the above bullets but a limitation that
could be affecting this is that we approached only nutrition online and should look at
approaching weight loss and physical activity behaviors online as well because it is
easier to access, you can do it on your own or with a trusted friend and not feel
ashamed and some people want to make a change and just dont know where to start.

Critical thinking and relation to your project

I learned that online intervention strategies can be proven to be effective with specific
parts of the risk factors that pertain to leading a healthy lifestyle and that contribute to
one or more of the risk factors for cardiovascular disease. I think it would be interesting
to try and apply this concept to heart health awareness as a whole instead of just one
specific cardiovascular risk factor.

This intervention also taught me that there is hope in reaching college students with
information that is important to their overall health. I know that many students receive
a survey and dont participate because its too much time or effort or they dont have
an interest in it. This intervention doesnt provide an incentive but its reaching out to
students and saying heres how to make a lifestyle change and in a way it challenges
the students to see what they know and how well they are doing with many health
behaviors.

I would need to change the target population to women only because women are at
more risk for heart disease than men are and there isnt a whole lot of research for
womens cardiovascular health. I would also need to adapt the intervention to be about
 heart health awareness and if they know their risk for heart health instead of just one
or two risk factors that pertain to heart health. When you challenge someone to see
how healthy they are, many people, especially girls because of the stereotypes put on
women, will want to accept the challenge and see how healthy they are.

I think I would also need to adapt this intervention to fit not only a college campus but
women of all ages and how would be best to reach them because not everyone checks
their emails or has a social media account and when you only have one part of the
population you cant gear the next intervention to a wider population.

#3 RESEARCH ARTICLES PEER REVEIWED 3 of 3

Peer 2 Peer: Efficacy of a Course-Based Peer Education Intervention to Increase Physical

Activity Among College Students.

APA Citation

Boyle, J., Lassiter, J. W., Mattern, C.O., and Ritzler, J. A. (). Peer 2 Peer: Efficacy of a Course-
Based Peer Education Intervention to Increase Physical Activity Among College Students.
Retrieved from http://web.a.ebscohost.com/ehost/detail/detail?sid=c1f8c702-b8fe-450a-a788-
90acc72b923b
%40sessionmgr4006&vid=0&hid=4204&bdata=JnNpdGU9ZWhvc3QtbGl2ZSZzY29wZT1zaXRl
#AN=

61157883&db=aph

Participants or population reached

Participants were 178 students enrolled in a personal health class during the 2007-2008
academic year

Describe the intervention and its effectiveness

This intervention looked at the effectiveness of peer health educators in working to

increase Physical activity levels in college students and if they could increase physical
activity in college students in general.

Students were required to complete three assignments throughout the intervention.

The first one being a behavior change contract, the second being a weekly journal and
the third being a final report. This really holds the students accountable and I think it
gives them a sense of how much they can accomplish and change when they thought
they werent capable of change or didnt know how to change.

Those who were paired with a peer health educator were given information about
exercise, what a realistic goal is, and individually tailored the workout to the person
instead of in general. They also provided support and were there to help hold the
individual accountable. With the peer health educator they were taught how to exercise
properly and what are the proper and good ways to exercise specifically for the
individual.

I think its interesting how they really put their peer health educators into practice and
allowed them to teach someone because it not only helps the person being taught but
gives them experience in the field of study that they are interested in and they are
giving back to the college too.

Women in the treatment group classified as 'Inactive' at baseline increased PA, whereas 'Inactive' control women had reductions in
PA. Women in the treatment group who were 'Active' at baseline reduced their waist-to-hip ratio and increased flexibility. There
were no differences by treatment group among men.

The intervention was somewhat effective in its goal of increasing physical activity
levels in college students. The results showed a higher impact on women than men.
The results suggest that for women who are considered inactive increased their
Physical activity and women who were considered active reduced their waist- to hip
ratio and increase flexibility.

The social Cognitive/learning theory was used in this article when talking about college
based interventions for increasing physical activity in college students. It shaped the
intervention in how they decided to approach the intervention because they knew that
there were limitations to having an intervention at the college level including the
attitudes and beliefs towards exercise from the individuals being tested.

There was small to moderate impact for this intervention and found that it was geared
more towards women than men and that this might be due to the fact that women put
a higher value in social support and having that one on one training than men do.
Some limitations mentioned were that it was too small of a sample size so that you
couldnt generalize it, and if the attention rather than what the peer educators were
teaching made the impact for change.

Critical thinking and relation to your project

I learned that involving a peer health educator group could be effective in a college
setting because I know that the peer health educators on the UI campus really make a
difference and have become a big part of helping advocate for many top issues
concerning health. I think it would be interesting to look into creating a heart health
awareness part for a peer health educator group or something along the lines of it.

I learned women will probably have a greater impact made on them when they feel
supported because when you feel like you have support you feel like you can
accomplish more. With knowing this I can keep it in mind for intervention strategies
and how to make a greater impact on women with heart health awareness.

I learned that there is more than one way to look at implementing an intervention
strategy and how an intervention strategy can have a different impact or result than
what you were hoping for but that it can still be helpful and make a difference in the
area of concern.

I would need to make the intervention be only women because Im focusing on women
and their heart health instead of both men and women. I would also want to look at
broadening the intervention to be more about heart health awareness and how to
make little changes in life instead of focusing on one specific risk factor of heart health.

Pulling it All Together- 35 pts.

1. Select a performance measure target based on the Healthy People 2020

objectives or Healthy Campus 2020 as appropriate.

Increase overall Cardiovascular health awareness in college women ages 20 and older
in the Boise, Idaho area.

2. Deciding on strategies for interventions

1. Educational Activities

Have a week long heart health awareness week on the college campus,
with this each day would be themed and would include different
information and activities

Offering a nine week course about heart health and the risk factors and
how to reduce them. This would provide students with information on
why its important and how it effects everyday life.

Have a heart healthy screening day where students can come and take
a test to determine how at risk they are for heart disease like how the
UI campus does alcohol screenings.

Guest speaker coming onto campus to talk about heart health and to
inform students about the effects of heart health and diseases and
maybe even have a survivor come and talk about her experience with
heart health.

Incorporating a themed well-being Wednesday around heart health

awareness on campuses. Students can come ask questions and learn
about heart health, the risks of it and where to find resources.

2. Health Status evaluations/assessment

Send out a survey by email to the female population asking them a

series of questions about heart health and what they know to build up a
demographic of how much female students know about heart health.

Have an optional heart health screening to assess your heart health

and be more aware of how healthy your heart is.

Have a tabling event that hands out a quiz about heart health to see
how much you know about heart health and on the other side have
heart healthy facts that students can follow to improve their heart
health.

Have health related courses hand out a survey asking questions about
heart health to see how much students know about heart health and
their own heart health too.

3. Marketing and communication

A health fair that included booths about different aspects of health,

including a booth about heart health and the individual risks of heart
health.

Having pamphlets about heart health be included in doctors offices

and the campus clinics office to promote heart health, gives people
visiting the doctor to think about heart health and maybe ask their
doctor about their heart health

Look at advertising options and whats being done to advertise having a

healthy heart and living a healthy lifestyle on campus, if you can add
 something to get students thinking about their heart health then they
might look into it more

Having a showing of a movie or documentary that relates to heart

health to raise awareness about heart health.

3. Potential for Success- 10 pts (critical thinking questions)

a.) Discuss why your intended approaches would work (e.g., how do they impact
predisposing, enabling or reinforcing factors?) Write no more than 2 paragraphs and
cite the literature you used to come up with your ideas/strategies.
My intended approaches would work because even though there hasnt been much
research done, just starting to do something and trying new interventions would help
make a difference and some interventions have been done that relate to the risks of
cardiovascular diseases. I think that with these interventions it will bring more
awareness to a younger age group of people and put it in their heads to start being
aware of their heart health and their overall health. As college students they are
focusing on school and their social lives but implementing some of these
interventions could get them thinking about their overall health and what they can
do to live healthy lives.
I think an educational approach will help change the reinforcing factors because it
would be implemented by teachers in the 9 week course and they would reinforce
the students to continue to do the intervention and do the change. I think for my
program the peers also need to be a part of the reinforcing factor. This is because
they know how the students think and can relate to them more easily than a
professor or parent can and could reinforce that the behavior and attitude towards
having a healthy heart and a healthy lifestyle is a good thing and would be
increased. With this you will see that they are a big part in the intervention program.

b.) Limitations and possible barriers to success? Discuss what might impact the project
as well as limitations cited by the authors of the literature you reviewed.
I think a big limitation with the intervention for promoting heart health is that
college students arent thinking about their overall health unless its when theyre
sick with the flu or not feeling so well from a hangover. Students arent thinking
about their health in the long run. They might listen to the heart health talks but not
take action. Being able to promote heart health and taking action on what you learn
is a big barrier.
I think another barrier is how well we present the material to the students. All
students have different perspectives and might take what we present in the wrong
way and instead of wanting to take action on their heart health will completely
ignore the information weve given them. If we can present the material in a way
that makes students start to think about their overall health past their college years
then we can start to make a difference in how students think about health and heart
health. Another big barrier is the media; the media portrays an image that is not
necessarily promoting a healthy lifestyle and taking care of your health for students.
This would be a hard barrier because controlling the media is not the easiest to do
and students may still believe that the media is correct.
 References

Boyle, J., Lassiter, J. W., Mattern, C.O., and Ritzler, J. A. (). Peer 2 Peer: Efficacy of a Course-
Based Peer Education Intervention to Increase Physical Activity Among College Students.
Retrieved from http://web.a.ebscohost.com/ehost/detail/detail?sid=c1f8c702-b8fe-450a-
a788-90acc72b923b
%40sessionmgr4006&vid=0&hid=4204&bdata=JnNpdGU9ZWhvc3QtbGl2ZSZzY29wZT1zaX
Rl#AN=

61157883&db=aph
How to Prevent Heart Disease. (2004). Retrieved from
https://www.goredforwomen.org/fight-heart-disease-women-go-red-women-official-
site/live-healthy/prevent-heart-disease/

Lachausse, R.G. (). My student body: effects of an internet-based prevention program to

decrease obesity among college students. Journal of American College Health, 60. Retrieved
from https://www.ncbi.nlm.nih.gov/pubmed/22559092

OLoughlin, J., Paradis, G., Renaud, L., Richard, L., and Sanchez Gomez, L. (1998) Correlates of
the Sustainability of Community-Based Heart Health Promotion Interventions. (ABSTRACT).
PREVENTIVE MEDICINE 27. Retrieved from
http://www.sciencedirect.com/science/article/pii/S0091743598903486