Decreasing the Risk of Heart

Disease in Post-Menopausal
Women of Kent County, MI

By: Group Member, Group Member, Group Member,
Group Member & Brandie Zimmerman
Planned Community Change Group Project
NURS 340
Planned Community Change
Assessment
Diagnosis
Planning
Intervention
Evaluation
Prevalence of Heart Disease:
Kent County, Michigan, and the US
(The Health of Kent County, 2005)
0
50
100
150
200
250
300
State of Michigan Kent County US
2000
2001
2002
2003
Heart Disease in America
720,000 Americans have a heart attack each year (CDC,
2014)
600,000 people die each year of heart disease (CDC,
2014)
Heart disease is the leading cause of death for both
men and women (CDC, 2014)
380,000 people die each year from coronary heart
disease, making it the most prevalent form of heart
disease (CDC, 2014)
Heart disease kills 292,188 women every year (CDC, 2014)

P
r
o
b
l
e
m

S
t
a
t
e
m
e
n
t

Increased risk of heart disease in post-
menopausal women living in Kent
County related to elevated blood
pressure, high serum cholesterol levels,
and obesity, as demonstrated by
statistics reported in the Kent County
Health Report [KCHR] (2005) and national
statistics reported by the Centers for
Disease Control and Prevention [CDC]
(2014)
(CDC, 2010)
Modifiable Risk Factors and
Contributing Risk Factors:
Leading cause: High
blood pressure (Healthy
People 2020, 2014)
Leading cause: High
serum cholesterol
(HP2020, 2014)
Obesity (HP2020, 2014)
Diabetes (HP2020, 2014)
Tobacco abuse (HP2020,
2014)





Sedentary lifestyle
(HP2020, 2014)
High sodium intake
(HP2020, 2014)
Poor nutrition (HP2020,
2014)
Excessive alcohol use
(CDC, 2014)

Un-modifiable Risk Factors
Congenital heart defects (AHA, 2014)
Menopause (Agrinier, et al., 2009)
Reduced production of estrogen (Honoris &
Budoff, 2012)

Assessment of Kent County:
Programs/Interventions Currently in Place
Cholesterol and blood pressure
screenings (Kent County Health Department [KCHD],
2014)
Nutrition services (KCHD, 2014)
Health improvement program (KCHD, 2014)
Smoking cessation counseling (KCHD, 2014)

Assessment:
Strengths of Kent County
Recognition of the problem
Reduction of heart disease as the goal
(The Health of Kent County, 2005)
Programs, clinics, and educational
opportunities
Kent County Health Department

Assessment:
Barriers of Kent County
Social norms
Cultural influences

Theory of Planned Behavior
A persons perceived
control over skills is
needed to perform a
behavior (Harkness &
DeMarco, 2012, pg. 78)
Overcoming barriers
plays a key role in
changing modifiable
risk factors

Indicators of Success
Active participants in the program
Utilization of community resources
Reduced mortality and morbidity rates
related to heart disease in Kent County
Interventions: Who
Health Care Providers
Community Groups
Community Members
Media
Fitness Facilities
Premenopausal Women

Interventions: What/How
Kent County offers the following resources:
Nutrition Services
Individualized Nutrition Counseling
Grocery Store Tours
Presentation Series
Health Improvement Program
Educational Services
Physical Activity
Take Steps Toward Health
Smoking Cessation
Cholesterol and Blood Pressure Screenings
Interventions: Where/When
Nutrition Services
All nutrition services held at different locations and times.
Health Improvement Programs
Located at Kent County Health Department
Smoking Cessation
Kent County offers multiple resources for smoking cessation.
Please see
http://www.accesskent.com/Health/Publications/pdfs/h_stopsmok
e.pdf
For information or questions about classes call (616) 632-7290
(KCHD, 2014)
Interventions: Where/When
Cont.
Cholesterol and
Blood Pressure
Screenings

Location:
Kent County Health Department
700 Fuller Avenue NE
Grand Rapids, MI 49503

By appointment from
7:00am - 11:00am
Screening Dates:
Thursday, February 6, 2014
Thursday, March 6, 2014
Thursday, May 1, 2014
Thursday, June 5, 2014
Thursday, August 7, 2014
Thursday, September 4, 2014
Thursday, October 2, 2014
Thursday, November 6, 2014
Interventions: Why?
Decrease in ovarian hormones
The major risks for Cardiovascular Heart
Disease (CHD) in women is tobacco use, high
blood pressure, dyslipidemia, diabetes
mellitus, obesity, sedentary lifestyle, and poor
nutrition (Mosca, et al., 1997)
SMART Goals
Be specific with a goal. (Thomassian, 2007)
Having a measurable outcome or goal will
boost confidence. (Thomassian, 2007)
Goals should be achievable. (Thomassian, 2007)
Make goals relevant to your lifestyle
(Thomassian, 2007)
If goals are time-bound they become more
meaningful. (Thomassian, 2007)
Evaluation
Health promotion
evaluation enables the
nurse to improve the
program, to make
choices between
health promotion
activities, and to test
whether a new
intervention with
documented
effectiveness will
translate to practice
(Pender, Murdaugh & Parsons,
2011)
Nursing Sensitive
Outcomes
Category
Biologic
Psychosocial
Functional
Behavioral
Cognitive
Safety
Symptom Control
Goal Attainment
Satisfaction
Costs


(Pender, Murdaugh & Parsons, 2011).

Evaluation method
Wellness screens including:
lab draws for cholesterol levels
blood pressure screenings
obtaining weight
measuring personal BMI
Participant surveys to determine
satisfaction
Health belief model
Health-related behavior is dependent upon: the
severity of illness or potential illness, level of
conceived susceptibility, benefits of taking action
and things that stand in the way of taking action
(Harkness & DeMarco, 2012, pg. 77)

References
Agrinier, N., Cournot, M., Dallongeville, J., Arveiler, D., Ducimetiere, P.,
Ruidavets, J. B. & Ferrieres, J. (2009). Menopause and modifiable
coronary heart disease risk factors: A population based study. Maturitas,
65, 237-243. Retrieved July 14, 2014, from http://0-
www.sciencedirect.com.libcat.ferris.edu/science/article/pii/S03785122090
04484
AHA: Menopause and Heart Disease (2014). American Heart Association.
Retrieved July 15, 2014, from https://www.goredforwomen.org/know-
your-risk/menopause-heart-disease/menopause-and-heart-disease/
CDC: Heart Disease (2014). Centers for Disease Control and Prevention.
Retrieved July 15, 2014, from http://www.cdc.gov/heartdisease/index.htm
Center for Disease Control. (2010). [Image]. Heart disease death rates in
women. Age adjusted average annual deaths. Retrieved from
http://www.cdc.gov


References continued
Doerr,M. (2014). Group Project Overview PPT(Powerpoint
presentation).Retrieved July 3, 2014, from:
https://fsulearn.ferris.edu/webapps/blackboard/execute/displayLearningUnit?cour
se_id=_11047_1&content_id=_581323_1
Harkness, G. A., & DeMarco, R. F. (2012). Community and Public Health Nursing:
Evidence for Practice. Philadelphia, PA: Wolters Kluwer | Lippincott Williams &
Wilkins.
Honoris, L. & Budoff, M. J. (2012). Postmenopausal Hormone Therapy: Does it
have a role in cardiovascular prevention today? Women and Cardiovascular Disease.
6(3), 205-209. Retrieved July 14, 2014, from http://0-
link.springer.com.libcat.ferris.edu/article/10.1007/s12170-012-0235-3
Hugo, C., Souza, D., Geisa, C. S. & Tezini, V. (2013). Autonomic cardiovascular
damage during post-menopause: The role of physical training. Aging and Disease, 4
(6), 320-328. Retrieved July 14, 2014, from
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3843649/

References continued
HP2020: Heart Disease and Stroke (2014). Healthy People 2020. Retrieved July 10, 2014,
from
http://www.healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=21
KCHD: Health Promotion & Education (2014). Kent County Health Department.
Retrieved July 15, 2014, from
https://www.accesskent.com/Health/HealthPromo/default.htm
Pender, N. Mardaug, C. & Parson, M. (2011). Health promotion in nursing pratice. (6
th

ed.) Pearson: Upper Saddle, NJ.
Mosca, L., Manson, J.E., Sutherland, S.E., Langer,
R.D., Manolio, T., Barrett-Connor, E. (1997). Cardiovascular disease in women.
Circulation. (1997). Vol 96. P 2468-2482. Retrieved from:
http://circ.ahajournals.org/content/96/7/2468.full
Thomassian, M. (2007, October 26). S.M.A.R.T. goal setting for healthier lifestyles -.
Retrieved from http://www.healthcentral.com/heart-disease/c/7291/15186/smart-goal/