Running head: COMMUNITY HEALTH PROMOTION PROJECT: HEART HEALTH

Community Health Promotion Project: Heart Health

Karen Lin
Binghamton University

COMMUNITY HEALTH PROMOTION: HEART HEALTH

Community Health Promotion Project: Heart Health

This particular community health promotion project focused on providing content that
would promote and encourage heart health. For instance, a trifold board was incorporated to
display the nutritional importance of eating a diversity of fruits and vegetables. Diagrams and
step-by-step procedures of exercise activities were also included to emphasize the value of being
physically active. In addition, to stimulate involvement and interest, there was a stethoscope
station that allowed children to hear their heart beat before and after physical activity. For the
parents, a list of popular signs and symptoms of a heart attack were provided so they could also
participate in the promotion of heart health. Finally, as a physical reminder of the promotion
project, children were encouraged to take home stress balls for the purpose of reducing stress for
themselves and their family, ultimately aiding heart health.
Description of the Learner
The targeted audience for the heart health promotion project is school age children (5 to
12 years old). There are several important developmental theories that help describe the expected
behavior and skills for children of this age group. They include Eriksons Psychosocial Stages,
Piagets Stages of Development, and Kohlbergs Stages of Moral Development. In order to
provide the best assessment of the targeted audience, it is important to incorporate all aspects of
each theory in order to obtain a comprehensive understanding of the learner.
According to Eriksons theory, the targeted learner is at the stage of Industry vs.
Inferiority. At this stage, the learner feels obligated to demonstrate their competency in order to
gain approval and experience satisfaction (McLeod, 2013). Repetitive and constant stimuli to
motivate and encourage are necessary to instill enough confidence in the learners to perform at
their best abilities. Otherwise, failure to develop the appropriate skill may result in a sense of

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inferiority (McLeod, 2013). Some key examples of learners at this stage include a student giving
a school science fair presentation with the support of their friends and family. This demonstrates
the high value of the learners ability to deliver a successful presentation in order to achieve a
feeling of competency. Other tasks include performing well in competitive activities because it
illustrates their desire to master a skill, particularly to perform better than their peers.
Based on Piagets stages of development, the targeted learners of the project are in the
Concrete Operational stage. The typical age range of this stage is between 7 to 11 years old. At
this stage of development, the learner can apply logical operations to physical objects. This
includes the ability to understand that an objects mass or volume will remain constant even if its
shape changes (McLeod, 2013). For example, they can comprehend that the volume of liquid
will conserve no matter what size container it is poured into. In other words, they understand that
although the appearance of the object may change, the object itself does not (McLeod, 2013). In
addition to this enhanced cognitive ability, learners at this age become less egocentric and as a
result more aware of their environment. This psychosocial change may even contribute to their
development of object conservation (McLeod, 2013).
The final theory is Kohlbergs Stages of Moral Development. The targeted audience (512 years old) would be expected to be at Level 1: Pre-conventional Morality. The age range
varies from infancy to just before adolescence. There are two stages associated: obedience and
punishment, and instrumental exchange. Depending on environmental and biological factors,
learners can be one or the other (Jacobs, 2013). The stage of obedience and punishment assumes
that behaviors are avoided due to the mere threat of disciplinary action. There is no moral
reasoning at this stage yet. The biggest priority for learners at this level is to obey (Jacobs, 2013).
People at this stage would fear cheating not because it is wrong per se but because there will be

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punishment if caught. The next stage is more egocentric because compliance is dictated by the
value of personal rewards (Jacobs, 2013). In other words, the priority goes from obedience to
self-interest. In this case, rather than fear the possibility of punishment for cheating, a student
may participate in cheating because it serves their personal interests. To add on, the concept of
revenge is recognized here as a moral duty in order to compensate for personal humiliation or
loss (Jacobs, 2013).
In addition to cognitive development, learners of the targeted age group (5-12 years old)
are expected to grow at an average of 2 inches every year and 6.5 pounds for both boys and girls
(American Academy of Pediatrics, 2014). Usually, girls have a tendency to experience puberty
earlier than boys. This leads to breast growth and enlargement, acne growth, development of hair
in the axillary and public areas, as well as menstruation (Brown, 2013).
Description of the Community Health Learning Need
With a rate of 600,000 deaths per year, heart disease has been the leading cause of death
in the United States (Center for Disease Control and Prevention, 2014). As a result, one of the
national goals for Healthy People 2020 is to Improve cardiovascular health and quality of life
through prevention, detection, and treatment of risk factors for heart attack and stroke
(Healthy People, 2014). Therefore, an appropriate learning need would be heart health,
especially since prevention and education at an early age would help reduce the statistics of heart
related deaths. Specifically, there is a need to educate the public about signs and symptoms of a
heart attack and what to do. According to a 2005 survey, only 27% [of the public] were aware
of all major symptoms and knew to call 9-1-1 when someone was having a heart attack (CDC,
2014). On a related note, there is an increasing prevalence of physical inactivity in youths (CDC,
2014). According to the Youth Risk behavior Survey (YRBS), there is an increasing trend of

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computer use while the percentage of youth participating in sports teams from 1999-2013 has
been steadily decreasing (CDC, 2014). This statistic is a concern because it can lead to a
sedentary lifestyle in adulthood. The lack of an active lifestyle is one of the major contributing
factors for developing heart disease, in addition to inadequate nutrition and diet (CDC, 2014). In
fact, the New York Department of Health has even proposed dietary changes in schools in an
effort to address these concerns, including serving only healthful foods in the cafeteria, school
stores and vending machines, and enforcing healthy classroom snack policies. (NYS
Department of Health, 2013). Evidently, there is a need to raise awareness about heart health by
promoting good nutrition and an active lifestyle in school age youths.
Teaching Goals

Learners will reduce their risk factors for developing heart related diseases

Learners will have a better and longer quality of life due to improved heart health
Behavioral Objectives

Learners can name at least one healthy food from every color of the rainbow (red, orange,
yellow, green, blue, indigo, and violet) by end of the presentation.

Learners can demonstrate two exercises that can improve heart health by the end of the
presentation.

Learners can identify two signs and symptoms of a heart attack by the end of the
presentation.

Learners can list two healthy snacks to substitute for cookies and chips by the end of the
presentation.

COMMUNITY HEALTH PROMOTION: HEART HEALTH

Learners can restate two group activities to do with friends and family (bike riding,
stretching, jumping jacks, jumping rope, community service walks, or playing sports) by
the end of the presentation.
Description of Health Promotion Teaching Methods
Understanding of the developmental theories influenced the type of teaching methods we

executed for the project. Since the targeted learners are in Eriksons Industry vs. Inferiority
stage, it was imperative that the presentation incorporated a reward system. As a result, stickers
were provided for the learners when they met some of the project objectives. Likewise,
throughout the presentation, the facilitators all encouraged and praised the learners responses
with a great job! or a well done! Also, according to Kohlbergs obedience and punishment
stage, the discussion of the consequence of developing heart disease was enough to persuade the
learners to participate in heart healthy habits. Similarly, there was an emphasis on personal
benefits like having a fit body and living a happier, longer life that served as a better motivator
for learners at Kohlbergs instrumental exchange. These methods helped stimulate and maintain
learner interest throughout the project.
The project presentation was also structured based on Social Learning Theory.
Considering that the learners have yet to develop their own sense of identity or own morals and
values, they are more likely to learn through observation. Social learning includes observation of
role models followed by the learners reinforcement (Bastable, 2014, p. 91). This learning theory
was implemented during the exercise activity station where a facilitator did jumping jacks with
the learner. Other stretches and body exercises were role modeled so that the learners can repeat
and follow along in this fashion. This method of demonstration and return demonstration helped
actively engage the learner while reinforcing confidence, and competence (Bastable, 2014, p.

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485). While discussion and lecturing are other learning methods, they would not be appropriate
because these methods do not constantly stimulate and engage their senses which are necessary
for the participation of the target audience (McLeod, 2013).
At the same time, it was important to take into account the age variation, gender
differences and culture diversity of the learners. To ensure that each learner comprehended and
enjoyed the presentation, a humanistic style of learning was necessary. This learning theory
provides the best opportunity for self-growth and potential while being creative and playful
(Bastable, 2014, p. 92). Consequently, the facilitators consistently reassured the learners during
activity stations and respected freedom of choice when the learners did not want to participate. In
essence, one to one instruction was one of the most effective teaching method because it is
specific to the individual learners need (Bastable, 2014, 483).
Description of Health Promotion Materials
In the age group from 5 to 12 years old, creative displays is a recommended way to aid in
learning (Raising Children Network, 2011). According to an Australian parenting website, most
school-age children take a keen interest in art and artistic activities, (Raising Children Network,
2011). For this reason, there was a heart health book mark coloring station available.
Additionally, the project included a post board with many visual aids and pictures of fruits and
vegetables because [school age] children learn best through their senses which include visual
(Euromed info, 2014). Moreover, stethoscopes were used so that learners could listen to their
heart beats before and after exercise, actively engaging them in heart health activities by
stimulating their auditory senses. There was also a make-your-own-stress-ball station where
learners could draw and take them home. This interactive activity was actually a recommended
principle for teaching school age children (Euromed info, 2014). Also, as Piagets theory

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predicted, the audience at this age are concrete operational learners. It is suggested that childs
learning would be enhanced through the use of concrete materials especially since teaching
should move from the concrete to the abstract (Euromed info, 2014). Accordingly, there was a
live model of a human heart with flaps covering the chambers and valves. The display of this
concrete object gave learners the opportunity to interact with the project itself via tactile senses
under the psychomotor domain.
Description of Health Promotion Evaluation of Objectives
There are several ways to evaluate the effectiveness of the health promotion project. In
the short term, the easiest way to determine the effectiveness of the project would be to
determine if the learning objectives were met or not met for each learner. For this project, all the
learning objectives were met for each learner In the long term, assessment is more complex. For
example, to evaluate whether the learners health risks were reduced, a local community health
survey would need to be conducted. Then the data would be collected and compared with
previous years to see if the rates of hypertension, obesity, and physical inactivity decreased.
Another method could involve obtaining hospital records for patient mortality rates and
distinguish those who died from heart related illnesses to establish if the percentage has declined.
To evaluate whether the learners have lived longer and happier lives due to improved
health, another survey can be distributed where people can rate their life satisfaction. These can
be compared with previous generations satisfaction rates to see if there was an increase. Also,
accessing health information records about average life expectancy for the learners who
participated in this project and comparing it with those who did not to assess for trends is another
potential evaluation method. If the life expectancy increased for those who participated in the
project, it demonstrates that the project was effective and successful.

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Reflection and Paper Conclusion

Planning and implementing this project was very fun. It definitely involves a different
approach than if I were to prepare a PowerPoint presentation for an audience for my professor
and peers. Initially, it was a challenge to compete with the other projects in the room for the
same audience. When we were finally able to attract potential learners, it was due to the reward
of stickers and unique display of pumpkin stress balls. The learners enjoyed drawing faces on
them which was a pleasure because it meant that we effectively applied what we learned in
lecture into this project. Developing an in depth understanding of the different developmental
stages was a strategic necessity for attracting, engaging, and maintaining audience interest.
Furthermore, competence in the types of learning theories and teaching strategies was key to
ensuring that the project content was both educational and exciting for the learners. It allowed
them to enjoy what they learned.
Before embarking on the project, I understood there are financial barriers and cultural
traditions that may interfere with this lifestyle change. Therefore, I was skeptical about making a
real difference in changing peoples behavior to incorporate healthy lifestyles. However, my
experience with the project helped me realize that there can be a high potential to incorporate
healthy behaviors in peoples lifestyles if introduced at an early age. All the participants of the
presentation were enthusiastic about the idea of being active, and maintaining heart healthy
behaviors. Our presentation board also had affordable alternatives for providing good nutrition,
and time efficient ways to include exercise in their lives. By proposing these ideas at an early
age, participants became more aware of their options, more willing to incorporate new behaviors,
and as a result more likely to engage in a healthier lifestyle. As adults, these same participants
will have a greater potential to adapt to heart healthy behaviors and lead a longer, happier life.

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10

One of the take away messages this projects helped me realize is the need to be flexible
with each individual. What I noticed with each learner that came to our project station is that we
had to use different teaching methods in order to induce learning and enthusiasm in the
presentation. This highlights the diversity and variety of the population in terms of cognition,
development, and even emotion. This project taught me how I should interact with patients in my
nursing career. For example, I will be sure to approach each person and situation with an open
mind and flexible attitude. Likewise, I will definitely remember to apply basic principles of
Eriksons, Piagets and Kohlbergs theories to nursing practice to ensure the best cooperation and
learning environment for each patient.

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References
American Academy of Pediatrics (2014). Caring for Your School-Aged Child: Ages 5-12.
American Academy of Pediatrics. Retrieved from
http://www.healthychildren.org/English/ages-stages/gradeschool/puberty/Pages/PhysicalDevelopment-of-School-Age-Children.aspx
Bastable, S. B. (2014). Nurse as Educator (4th ed.). Burlington, MA: Jones & Barlett Learning
Brown, N (2013). Puberty: Changes for Females. Palo Alto Medical Foundation. Retrieved from
http://www.pamf.org/teen/health/puberty/girlschanges.html
Centers for Disease Control and Prevention (2010). National Center for Chronic Disease
Prevention and Health Promotion, Division for Heart Disease and Stroke Prevention.
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Euromed Info (2014). Patient Teaching Into Practice: Teaching School Age Children. Euromed
Info. Retrieved from http://www.euromedinfo.eu/teaching-school-age-children.html/
Health People (2014). 2020 topics and Objectives: Heart Disease and Stroke. U.S. Department of
Health and Human Services. Received from http://www.healthypeople.gov/2020/topicsobjectives/topic/heart-disease-and-stroke
Jacobs, R. M. (2013). Kohlbergs Stages of Moral Development and Their Relationship to
Leadership Ethics. Villanova University. Retrieved from
http://www83.homepage.villanova.edu/richard.jacobs/MPA%208300/theories/kohlberg.h
tml.
McLeod, S. (2013). Developmental Psychology: Erik Erikson. Simply Psychology. Retrieved
from http://www.simplypsychology.org/Erik-Erikson.html

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New York State Department of Health (2013). New York State Programs and Tools to Address
Cardiovascular Health. New York State. Retrieved from
http://www.health.ny.gov/diseases/cardiovascular/heart_disease/programs_and_tools.htm
Raising Children Network (2014). School-age Creative and Artistic Development: What to
Expect. Raising Children Network (Australia). Retrieved from
http://raisingchildren.net.au/articles/creative_arts_school_age.html