Healthy Lives,

Healthy Hearts
2015-2016 Initiative
A team-oriented approach to heart disease prevention with a focus
on nutrition education

Team Heart Disease

Meredith Brown, Becca Gay, Micaela Jones, Erica Joyner, and Jess Krauss
Pg. i Table of Contents

Sections
Executive Summary _____________________________________________ 1
Needs Assessment _____________________________________________ 3
Mission Statement, Goals, and Objectives ___________________________ 6
Intervention Implementation ______________________________________ 7
Program Resources _____________________________________________ 9
Program Marketing ____________________________________________ 12
Budget ______________________________________________________ 13
Evaluation ___________________________________________________ 14
References __________________________________________________ 15
Pg. 01 Executive Summary

Executive Summary
Health Problem
Coronary artery disease (CAD), a form of heart disease, is the health problem in focus.

Heart disease is the greatest global cause of death (World Health Organization [WHO], 2015).

Heart disease is responsible for 25% of deaths in the United States every year (Centers for
Disease Control and Prevention [CDC], 2015c). CAD is the most prevalent form of heart
disease in the US (CDC, 2015a).

In South Carolina, the rate of cardiovascular diseases has been dropping over the past twenty
years, but according to SCDHEC (2010), the rates still remain higher than the national rates.

Richland County’s heart disease mortality rates are higher than both the state and the national
rates (SCDHEC, 2010).

Target Population
The chosen target population is African American males ages 18 to 25 within Richland
County, South Carolina.

Heart disease is the second leading cause of death for men, and has killed more men than
women (SCDHEC, 2010).

Mortality rates due to heart disease are highest among non-Hispanic Black Americans
(Gillespie, Wigington, & Hong, 2013), and African Americans in South Carolina have a 30%
higher mortality rate due to heart disease that white South Carolinians (SCDHEC, 2010).

Many of the American Heart Association’s (AHA) seven poor cardiovascular health metrics
(smoking, high body mass index [BMI], low physical activity, unhealthy diet pattern, high
cholesterol, high blood pressure, and high blood glucose) are modifiable through behavior
change, so addressing habit formation early in life is key for primary prevention of heart
disease (Mozaffarian et al, 2014).
Pg. 02 Executive Summary

Program Benefits
Participants in the Healthy Hearts, Healthy Lives program can expect to gain valuable
knowledge regarding CAD and its risk factors, heart-healthy nutrition, and eating well on a
budget. Through the team-oriented approach, participants will also enjoy the benefits of social
support and accountability in creating life-long healthy eating behaviors.

As the Healthy Hearts, Healthy Lives program expands, it will serve to decrease mortality rates
due to CAD among African American men in Richland County as this generation ages. An
expected decrease in medical expenditures will be seen with the decrease in CAD incidences
and deaths.

Program Marketing
Awareness of the threat of CAD and its effects on quality of life will play a key role in gaining
interest from both the target population and other stakeholders. Because many risk factors for
CAD can be reduced through lifestyle change (e.g., increasing physical activity or monitoring
diet), the simplicity in prevention efforts should also increase interest in the program.

A large part of the campaign to attract participants from the target population will be through
social media as online communication is popular among young adults.
Pg. 03 Needs Assessment

Needs Assessment
Overview of CAD
Coronary artery disease (CAD), a form of heart disease, is the health problem in focus.

Heart disease is the leading cause of death nationally and within South Carolina (SCDHEC,
2010). CAD is a form of heart disease where plaque (cholesterol deposits) accumulates in the
heart’s coronary arteries (AHA, 2015). Such buildup inhibits the flow of blood to cardiac
muscle tissue. Weakened cardiac muscle from CAD can cause heart failure, arrhythmia, and
heart attack (CDC, 2015b).

Populations Affected
Populations most likely to be affected by CAD and other heart diseases are adults over 65,
men, African Americans, overweight or obese individuals, sedentary persons, and smokers
(AHA, 2015). The risks and effects of heart failure, arrhythmia, and heart attack will not only
affect the quality of life for those who develop CAD, but also may largely affect their family and
caretakers. Medical care for CAD places increased burdens on the healthcare system which
could have been prevented. Expenses may run high and further complicate the individual’s
ability to live a healthy life.

Target Group Demographics

The chosen target population is African American males ages 18 to 25 within Richland
County, South Carolina.

Although individuals 18 to 25 years old are not affected by CAD directly, they are the age
where life-long habits are formed that may greatly affect their likelihood of developing CAD.
African American men have shown to have high mortality rates due to heart disease, so by
addressing lifestyle factors such as nutrition and physical activity early in their lives, they may
form healthy habits that will stay with them through later years.

CAD Risk Factors

Risk factors related to behavior that affect the development of CAD include being obese or
overweight, poor diet, sedentary lifestyle, hypertension, diabetes mellitus type 2, and smoking
(Cahill et al., 2014; Jahangir, De Schutter, & Lavie, 2014; Mack & Gopal, 2014).
Pg. 04 Needs Assessment

CAD risk factors related to the environment generally affect an individual’s stress (Mack &
Gopal, 2014). These include long work hours, stressful jobs, and unsafe or unhealthy living
situations.

Unlike the risk factors above, age, gender, and race are risk factors for CAD which cannot be
changed (Mack & Gopal, 2014). Older adults, males, and African Americans are all more likely
to develop CAD than other individuals.

Unhealthy Eating Behaviors

Like most behaviors, unhealthy eating behaviors are regulated by predisposing, enabling, and
reinforcing risk factors specific to the behavior of unhealthy eating.

Predisposing risk factors:

• Growing up without proper nutrition education
• Being unaware of disease risk factors such as poor nutrition
• Learning poor eating habits at home

Enabling risk factors:

• Being unable to access and/or afford healthy food
• Choosing food based on convenience and not health

Reinforcing risk factors:

• Saving money on food
• Saving time with fast food or take out
• Enjoying familiar foods

Target Population Input

Two African American men from the University of South Carolina have been recruited and
have committed to assisting the planning committee in creating a program that is relevant,
relatable, and enticing to the target population. They have helped the planning committee in
collecting feedback from other members of the target population and creating interest in the
program. These two will be vital members of the planning committee throughout every stage of
the program.
Pg. 05 Needs Assessment

Actual and Perceived Needs

As aforementioned, two members of the target population are integral members of the planning
committee. The basic ideas of the program began with their input and have continued to grow
as these members have assisted in creating and distributing surveys to members of the target
population. Through these surveys, information assessing the perceived needs for lifestyle
intervention regarding CAD prevention has been collected. The perceptions of the target
population will be addressed in the program’s educational curriculum in relation to the
epidemiological needs found in current literature.
Pg. 06 Mission Statement, Goals, and Objectives

Mission Statement, Goals, and Objectives

Mission Statement
Team Heart Disease strives to reduce heart disease risk factors by addressing community and
individual needs through educational programs for disease prevention and health promotion in
an effort to decrease heart disease mortality rates.

Goals
• Educate individuals about heart-healthy nutrition
• Motivate individuals to adopt heart-healthy nutrition habits
• Provide individuals with the skills and resources to adopt heart-healthy nutrition habits

Objectives
Process Objectives:
• By January 15, 2016, program planners will safe route for the 5k race planned and
approved by the city.
• Event caterers will be hired for program kick-off and closing events by February 1, 2016.

Learning (Impact) Objectives:

• Upon program completion, 90% of participants will be able to identify all five sections of
the MyPlate guide.
• Upon program completion, 75% of participants will be able to list at least 3 non-animal
protein sources.

Behavior (Impact) Objective: Educate individuals about heart-healthy nutrition

• Four weeks after program completion, 80% of participants will report eating five servings
of fruits and vegetables per day for at least fourteen days.
Pg. 07 Intervention Implementation

Intervention Implementation
Health Belief Model
The Health Belief Model (HBM) was selected for use in program planning. “According to this
class of theory [the HBM], the tendency to a particular act is a function of the expectancy that
the act will be followed by certain consequences (e.g., ‘How vulnerable am I to the danger?’)
and the value of those consequences (e.g., ‘How severe is the danger?’)” (Prentice-Dunn &
Rogers, 1986, p. 157).

Many individuals do not change their nutrition habits because they do not believe their eating
habits affect their quality of life. With the HBM, it is possible to compare the target population’s
perceived harmful behaviors versus the degree to which they believe those behavior affect
their health. Such comparison helps to create a cost-benefit analysis based on the perceived
severity of the effects of the health behaviors. Kim, Ahn, and No (2012) demonstrated success
in using the HBM to identify factors affecting nutrition habits of college students. Because the
target population focuses on college aged males and the objectives set focus on nutrition
behavior change, the HBM should lead to success.

Intervention Strategies
The intervention strategies that will be implemented are health communication strategies,
health education strategies, and behavior modification activities. Team Heart Disease hopes
to increase awareness of the behaviors that can impact CAD risk factors as well as help
individuals within the target population to modify those behaviors, specifically encouraging
health eating strategies.

Program Kick-off
The program kick-off event will be the first of 10 sessions of the program. It will be structured
slightly differently from the other sessions in that most of the time will be dedicated to grouping
the participants into teams and having activities for them to get to know each other in the
context of the program, have some recreational time, and share ideas about perceptions of
healthy eating. A short educational introduction will be given about the program and its goals,
and a buffet-style meal with heart-healthy items will be served.
Pg. 08 Intervention Implementation

Materials
Personnel:
• 2 of USC’s registered dieticians/nutrition educators
• 2 members of target population for planning committee
• Social media coordinator
• Police officers for 5k event
• 10 members of planning committee to act as group leaders for participants
• Catering staff for meals

Space:
• 1 conference room in Darla Moore School of Business for committee meetings
• 5k race location
• 5 basketball courts at Strom Thurmond Fitness and Wellness Center for weekly program
basketball activities
• 1 large lecture room in Darla Moore School of Business (DMSB) for weekly program
meetings
• 1 small classroom in DMSB for food set-up for weekly program meetings

Equipment:
• Computer
• Projector, screen, and sound equipment (in lecture room)
• Printer access
• 5k race timing equipment

Supplies:
• Paper
• Advertisement flyers
• Social media accounts
• Basketball rentals
• Pens
• Note sheets for participants
• Recipe hand outs
• 2 catered meals – one for kick-off, one for closing
• 8 snacks for other sessions
• Gift cards to grocery stores and healthy restaurants
Pg. 09 Program Resources

Program Resources
Logic Model

INPUTS OUTPUTS OUTCOMES

 Social media  5k event  Heart-healthy nutrition

coordinator  10-week nutrition education
 5k location/ timing education program  Nutrition behavior
equipment  Friendly basketball change – short and long
 Police officers for 5k competition term
 Registered dieticians  Team accountability in  Adequate knowledge of
 Group leaders nutrition behavior CAD and modifiable risk
 Catering staff  Review games to earn factors
 Basketball courts team points  Lowered risk of CAD
 Lecture room  2 meals and 8 heart development
 Classroom healthy snacks  Lowered CAD mortality
 Computer throughout program rates within target

 Projection equipment  Take home notes and population in years to

 Flyers recipes come

 Note pages  Prizes at closing for

 Pens teams with the most

points
 Basketballs
 Recipe sheets
 Food
 Giftcards

Get the Program Running

What is needed to get this program going? Sponsors! Sponsorship has already been secured
from Walmart, Subway, and Fitbit. A 5k event is also in the works for February 2016 to raise
awareness and some program funding. However, financial support is still necessary, so do not
miss this opportunity to become involved with a group of people dedicated to bettering young
people’s futures through health education today.
Pg. 10 Program Resources

Gantt Chart Timeframe

Tasks Aug Sept Oct Nov Dec Jan Feb Mar Apr May Jun Jul

Development of program
rationale

Needs assessment

Development of mission
statement, goals and
objectives

Secure 3+ sponsors

Hire 2 nutrition experts

Pilot test

Revise program based on

pilot test

Program and 5k promotion

5k event

Run program

Conduct participant follow-

up

Program evaluation
Pg. 11 Program Resources

Program Staff
Registered dieticians:
• Assist planning committee in planning program
• Teach 10 nutrition education sessions

Social media coordinator:

• Organize and facilitate social media campaign

Group leaders:
• Will be the members of the program planning committee
• Facilitate group discussions
• Answer questions of participants
• Give feedback from participants at planning committee meetings

Catering staff:
• Provide heart-healthy meals for kick-off and closing events

Police officers:
• Will be present for the 5k event to ensure safe route for all 5k participants

Eligible Participants
The program will be marketed mainly to USC students, as that’s where events will be held.
However, individual who fits the criteria of the target population (18-25 years old, African
American male in Richland County, SC), may register for participation. There will be a limited
number of spots (100) for the initial program, but following program success, there may be
expanded programs to come.
Pg. 12 Program Marketing

Program Marketing
Promotional Tools
A social media campaign will comprise a large portion of the promotion for the program.

Tabling events will also be held on Greene Street of USC’s campus for the program and the 5k
event.

The 5k event will serve not only as a fundraising tool, but also as a promotional tool to spread
the word about the upcoming program.

Incentives
One of the biggest incentives will be fun! The friendly competition of the recreational
basketball games before the educational sessions each week will allow participants to get their
hearts pumping and enjoy getting to know their teammates.

At the end of the program, points will be tallied from basketball game wins as well as review
game points, and giftcard prizes will be given to the teams with the most points. This will
encourage teamwork and active learning through the program and increase program
effectiveness.
Pg. 13 Budget

Budget
Materials Expenses Sponsored
Personnel Registered dieticians $5,000
Social media coordinator $1,000
Planning committee/group leaders $20,000
Catering staff $4,000
Police officers $2,000
Space Conference room $1,000
Race location (closed streets) $0*
Basketball courts in Strom in kind**
Lecture room in DMSB in kind**
Classroom in DMSB $1,000
Equipment Computer $0***
Projection equipment in kind**
Printer access in kind**
Race timing equipment in kind**
Supplies Papers/notes/flyers $1,000
Social media accounts $0****
Basketball rentals $100
Pens $100
Food/dining supplies $4,000
Giftcards $1,000
Sponsors Walmart $10,000
Subway $8,000
Fitbit $7,000
Fundraising Race event $4,000
Total $40,200 $29,000
Funds needed $11,200

*portions of streets will only be blocked off as runners pass, no cost associated with this
**lecture room and basketball court and associated equipment and race timing equipment use permitted
in kind as the program will benefit a population of students and other accessory rooms will be rented
***computer(s) used will be those owned by planning committee and dieticians
****free social media accounts will be used
Pg. 14 Program Evaluation

Program Evaluation
Qualitative Evaluation
Knowledge assessment surveys will be used as qualitative evaluation methods to assess
program effectiveness based on program objectives. Participants will be given a total 3
surveys: one at the beginning of the program as baseline data, one mid-way through the
program (5 or 6 weeks), and one at the end of the program. Surveys will consist of questions
about the MyPlate Guide, non-animal protein sources, and other heart-healthy nutrition topics
covered throughout the program. Surveys will also assess participants’ knowledge of CAD and
its risk factors.

One member of the planning committee will be overseeing program evaluation to ensure timely
and proper completion of all tasks so that the program runs smoothly and effectively.
Pg. 15 References

References
References
American Heart Association. (2015, August 7). Coronary artery disease - Coronary heart disease.

Retrieved from http://www.heart.org/HEARTORG/Conditions/More/MyHeartandStrokeNews/

Coronary-Artery-Disease---Coronary-Heart-Disease_ UCM_436416_Article.jsp

Cahill, L., Pan, A., Chiuve, S., Sun, Q., Willet, W., Hu, F., & Rimm, E. (2014). Fried-food consumption

and risk of type 2 diabetes and coronary artery disease: A prospective study in 2 cohorts of US

women and men. The American Journal of Clinical Nutrition, 100(2), 667-675. doi:10.3945/

ajcn.114.084129

Centers for Disease Control and Prevention. (2015a, August 10). About heart disease. Retrieved

from http://www.cdc.gov/heartdisease/about.htm

Centers for Disease Control and Prevention. (2015b, August 10). Coronary artery disease (CAD).

Retrieved from http://www.cdc.gov/heartdisease/coronary_ad.htm

Centers for Disease Control and Prevention. (2015c, August 10). Heart disease facts. Retrieved

from http://www.cdc.gov/heartdisease/facts.htm

Gillespie, C. D., Wigington, C., & Hong, Y. (2013). Coronary heart disease & stroke deaths - United

States, 2009. Morbidity and Mortality Weekly Report, 62(3), 157-160. Retrieved from

http://www.cdc.gov/mmwr/pdf/other/su6203.pdf

Jahangir, E., De Schutter, A., & Lavie, C. (2014). The relationship between obesity and coronary

artery disease. Translational Research, 164(4), 336-344. doi:10.1016/j.trsl.2014.03.010

Kim, H.-S., Ahn, J., & No, J.-K. (2012, December 31). Applying the Health Belief Model to college

students’ health behavior. Nutrition Research and Practice, 6(6), 551-558. doi:10.4162/nrp.

2012.6.6.551

Mack, M., & Gopal, A. (2014). Epidemiology, traditional and novel risk factors in coronary artery

disease. Cardiology Clinics, 32(3), 323-332. doi:10.1016/j.ccl.2014.04.003

Pg. 16 References
Mozaffarian, D., Benjamin, E. J., Go, A. S., Arnett, D. K., Blaha, M. J., Cushman, M., . & Stroke, S. S.

(2014). Heart disease and stroke statistics—2015 update: A report from the American Heart

Association. Circulation, 131(4). doi: 10.1161/CIR.0000000000000152

Prentice-Dunn, S., & Rogers, R. W. (1986). Protection motivation theory and preventative health:

Beyond the health belief model. Health Education Research: Theory and Practice, 1(3), 153-

161.

South Carolina Department of Health and Environmental Control. (2010). Heart disease & stroke

prevention: Strengthening the chain of survival (SCDHEC Publication No. CR-004470).

Retrieved from http://www.scdhec.gov/Library/CR-004470.pdf

World Health Organization. (2015, January). Cardiovascular diseases (CVDs). Retrieved from

http://www.who.int/mediacentre/factsheets/fs317/en/