Rural Public Health Health Promotion Campaign: Hypercholesterolemia

Perangi Kolesterol, Hidup Sejahtera Mac, 2012

Preeti Kaur Gill Lim Li Ann Grace Chew Sutha Rajakumar

Objectives
What is hypercholesterolemia? Causes of hypercholesterolemia How hypercholesterolemia happens Prevention of hypercholesterolemia Objectives & campaign concept Campaign draft (BM) Sponsors

Hypercholestrolemia
Your blood cholesterol level has a lot to do with your chances of getting heart disease. blood cholesterol level, risk for developing heart disease or a heart attack. blood cholesterol does not cause symptoms, so many people are unaware that their cholesterol level is too high.

How does cholesterol affect your health?

Hypercholesterolemia
HDL (Kolesterol baik)
High density lipoprotein helps keep cholesterol from building up in the arteries

LDL (Kolesterol buruk)

Low density lipoprotein the main source of cholesterol buildup and blockage in the arteries

VLDL - Very low density lipoprotein Dyslipidemia elevated total cholesterol or LDL or high HDL or combination of both

Cholesterol levels

Epidemiology
Gender:
Male >60 years (29.3%) Female >60 years (43.8%)

Educational level:
none(28.2%) primary (25.1%) secondary (17.8%) tertiary (16.95%)

Race:
Malays(24.8%) Chinese (19.3%) Indians (21.1%)

Area:
rural (21.9%) urban (19.9%)

Etiology

Diet

Saturated fat Cholesterol

Weight
Physical Activity

Being overweight is a risk factor for heart disease Increases cholesterol in body

Regular physical activity can help lower LDL cholesterol and raise HDL cholesterol levels. 30 minutes, on most if not all days

Age & Gender Heredity

As women and men get older, their cholesterol levels rise After the age of menopause, womens LDL levels tend to rise.

(genetic predisposition) defect in lipid metabolism or transport- results in accumulation of LDL in plasma causing atherogenesis

Conditions causing hypercholesterolemia

Anorexia nervosa Cholestasis Cushings syndrome Growth hormone deficiency Hypothyroidism Obstructive liver disease

Pathogenesis
Dyslipidemia elevated total cholesterol or LDL or high HDL or combination of both Cholesterol - HDL, LDL, VLDL by liver Cholesterol metabolism
intestines > lymphatic system> chylomicrons hydrolysed by enzymes > fatty acids taken up by muscles and tissues excessive LDL deposit outside the cell and vascular endothelium > atherosclerosis

Risk factors
Elevated LDL, reduced HDL
Smoking Hypertension Advancing age Family history of CHD event
Form plaque that block arteries Constricts blood vessels Narrow blood vessel, heart works more Blood vessels will become rigid Genetic predisposition

Prevention
Improving lifestyle diet, exercise Eat more~
Fruit and vegetables Skinless chicken Fiber rich food brown rice

Eat less~
Fried food High fat dairy products Biscuits, cakes and pastries

 Use more~
Margarine instead of butter Low fat cooking methods: steaming, grilling and stir frying

You should~
Make exercise a part of the day (walking) Drink more water Not smoke

Health Promotion Campaign

According to the World Health Organisations Ottawa Charter (1986), health promotion is the process of enabling people to increase control over the determinants of their health and thereby improve their health status.

Campaign Concept - Prevention

The source of disease prevention lies largely with healthprofessional practice. In general, only health professionals can conduct and interpret and provide tertiary preventive services.

Thus, it is important that health professionals provide clinically appropriate preventive services in the practice settings well as at other community locales, where the entire population can acquire access to them.
This is why, important. health promotion in the rural areas are

Objectives of the Health Promotion Campaign

Primary prevention
refers to the prevention of diseases before their biological onset. Awareness of what cholesterol is, what can it do to the body, how to prevent diseases related to cholesterol levels. Behavioural interventions such as maintaining physical exercise, the potential for reducing fatty foods consumption, which would, if achieved, be quite effective in preventing hypercholestrolemia.

 Secondary prevention
Screening Blood lipid screening is an example of secondary prevention. One variation of secondary prevention is to screen for conditions that might be clinically obvious but have gone undetected, increasing exercise may prevent the emergence of heart attack or stroke, even though some atherosclerotic lesions (hardening of the arteries) are already developing.

 Tertiary prevention
Prevention of disease progression and additional disease complications after obvious clinical diseases are manifested. Preventive treatments in symptomatic patients.
Treating high cholesterol levels after a heart attack will decrease risk of future heart attacks and related conditions such as stroke and angina pectoris (chest pain with activity).

Statistic of the promotion area

According to a study on Coronary artery disease done by Y. Khalid, et al., in the Kuala Terengganu area Showed that formal education did not influence positive health behavior. In terms of disease perception, the subjects tended to believe that their illness will be cured. They also lack understanding of their complications.

Perangi Kolesterol Hidup Sejahtera

Draf (Versi Bahasa Melayu)

Draft Kempen Perangi Kolesterol

Tempat sasaran : Pulau Redang, 45 km dari pinggir pantai Kuala Terengganu Golongan sasaran: Penduduk-penduduk di Kampung Baru Pulau Redang,Setiu. Populasi: 200 buah keluarga

 Sosio ekonomi: Kebanyakan nelayan Kerjasama tempatan: Program tersebut telah dianjurkan dengan kerjasama wakil Adun Batu Rakit Yang Berhormat Khazan bin Che Mat. Tempoh: 3 hari

Sebelum Di Pulau Redang Mobile Team dari Klinik Kesihatan Hiliran, Kuala Terengganu akan datang ke klinik untuk mengadakan pemeriksaan kesihatan sebulan sekali.

Selepas Melatih sukarelawan untuk membuat saringan kesihatan seperti memeriksa paras tekanan darah, paras kolesterol dan paras gula darah.

 Program melatih sukarelawan dipantau selepas 3 bulan untuk melihat keberkesanan program tersebut. Penambahbaikan program mengikut keperluan & progresi semasa

 Venue: Community hall of Kampung Baru Pulau Redang Village Number of volunteers:
Pharmacy students (Prep talk) Medical Lab Technology students (6) Nursing students (4) Healthcare students (4) Others (10)

Sponsored health devices:

Blood lipid, blood glucose, blood pressure, weighing machine, height measuring device

Funding from MOH: RM25000

Mass Media
Inform the Head Chief and committee Distribute flyers & posters Banners Word of mouth Focus on grocery and sundry shops, schools, kedai kopi

Programmes arranged
Talk from nutritionist; Hypercholesterolemia Dan Anda Health Screening Session Health Counseling Session Competition
Adults
Cooking Competition Masterchef Setiu Pedometer Challenge Aerobic exercise

Teen & Children

Face Painting A Healthy Heart Pedometer Challenge Aerobic exercise

Health Screening Stations

Height & Weight (BMI) Check Blood Pressure Check Blood Glucose Check

Registration Counter

Counselling Counter

Blood Lipid Check

Masterchef Cooking Competition

Masterchef-style cooking competition to promote the importance of nutrition. The challenge was to make the tastiest Kari Kampung. Each team was provided with a stove, cooking utensils and a range of fresh and healthy ingredients. The dishes produced for the competition are all worth of a prize, though the enjoyment of getting together and cooking for friends and family will be the highlight of the day.

Pedometer Walking Challenge

The person who walks the most on each of the 3 days of the health promotion campaign day will receive a hamper of goods sponsored by the Nestle. Hamper containing cereals.

Aerobic Exercise
According to a study done by George A. et al., (2004) dance aerobic exercise lowers the LDL and increases HDL levels in women. In this activity, the whole family can come together and carry it out.

Sponsorship
RM25000 MOH funding The cooking utensils, fresh food ingredients, dairy products. A health check up room will also be set up in the village with co-operation of the community leader. It will be officiated by the member of the state legislative council for the constituency of Pulau Redang. Pedometer by Anlene

ACCUCHEK Aviva system Blood Glucose Monitor

OMRONBlood Pressure Monitor

Oregon Scientific Easy-to-use Digital Pedometer WA101

CardioChek PA POC cholesterol testing system

References
Goodman and Gilman Pharmacotherapy Handbook,7th Ed. NHMS III, 2006