HEALTH EDUCATION AND COMMUNITY 9.

Health education is a slow continuous

ORGANIZATION: CARDIOVASCULAR DISEASES process.
PREVENTION AND CONTROL PROGRAM 10. Health education makes use of
supplementary aids and devices (helps
HEALTH EDUCATION verbal instructions).
 A process whereby knowledge, attitude and 11. Health education utilizes community
practice of people are changed to improve resources.
individual, family and community health 12. Health education is a creative process.
 Basic health service and every member of 13. Health education helps people attain health
the health team shares responsibility in through their own efforts.
providing health education
 Means of improving the health of the people TEACHING METHODS AND STRATEGIES
by employing various methods of scientific 1. Interviewing
procedure to show the most healthful ways 2. Counselling
of living 3. Lecture-discussion
 Consists of techniques that stimulate, 4. Open forum
arouse and guide people to live healthfully 5. Workshop
 Sum of activities in which health agencies 6. Case study
engage to influence the thinking, 7. Role-play
motivation, judgment and action of the 8. Symposium
people of the community 9. Community assembly
10. Use of IEC (information, education and
STEPS IN HEALTH EDUCATION communication) materials such as leaflets,
 Include creating awareness, motivation and brochures, handouts and flyers
decision-making action to practice health 11. Use of publication
services 12. Use of audio-visual aids, billboards, posters,
1. INFORMATION radio and TV
o Provision of knowledge 13. Other IEC support (umbrellas, t-shirt,
2. COMMUNICATION keychains, folders)
o Exchange of information
3. EDUCATION QUALITIES OF A GOOD HEALTH EDUCATOR
o Change in knowledge, attitude and skills 1. Knowledgeable or mastery of subject
matter
PRINCIPLES OF HEALTH EDUCATION 2. Credible
1. Health education considers the health 3. Good listener
status of the people. 4. Can empathize with others
2. Health education is learning. 5. Possess teaching skills
3. Health education involves motivation, 6. Flexible
experience and change in conduct and 7. Patience
thinking. Health education stimulates an 8. Creative and innovative
active interest in people. 9. Effective motivator
4. Health education should be recognized as a 10. Ability to rephrase and summarize
basic function of all health workers. 11. Encourages group participation
5. Health education takes place in the home, 12. Good sense of humor
in the school and the community.
6. Health education is a cooperative effort. COMMUNITY ORGANIZATION
7. Health education meets the needs, interests  Process by which people health services and
and problems of the people affected. agencies of the community are brought
8. Health education is achieved by doing. together to:
 1. Learn about the common problems MIDDLE AGE
2. Identify these problems as their own  Smoking
3. Plan the kind of action needed to solve  Hypertension
these problems Coronary Artery  Hyperlipidemia
4. Act on the basis Disease;  Obesity
MI (Heart attack)  Stress
THE CARDIOVASCULAR DISEASE PROBLEM IN THE  Diabetes mellitus
PHILIPPINES  Sedentary lifestyle
 Cardiovascular Diseases (CVD) have ELDERLY
become the greatest threat to Filipinos Cerebrovascular
 Hypertension
today. Accident (Stroke)
 Smoking
 Man faces the risk of CVD throughout his Peripheral
 Hyperlipidemia
life: Vascular Disease
1. At birth, congenital heart disease and
vascular malformation are possible HEALTH EDUCATION IN CVD
afflictions.  CVD mainly arise from human behavior
2. In early childhood, the risk of which is modifiable through health
rheumatic fever or heart disease education.
starts.
3. In early adulthood, arteriosclerotic CARDIOVASCULAR DISEASES IN CHILDREN
changes in blood vessels may set in and CONGENITAL HEART DISEASE
progress to the development of  Primary prevention measures against CHD
hypertension. are directed to women belonging to the
4. During the middle age, coronary artery reproductive age group.
disease or ischemic heart disease  The following points are to be stressed in
develops and leads to myocardial health education:
infarction (heart attack) in many, 1. Pregnant women should:
particularly males. o Avoid exposure to viral infection
5. Among the elderly, cerebrovascular o Avoid intake of drugs
accident (CVA, stroke) is a o Refrain from smoking and avoid
complication of hypertension. exposure to environmental
tobacco smoke
CAUSES OF COMMON CARDIOVASCULAR DISEASES o Refrain from drinking alcoholic
Disease Cause or Risk Factors beverages
BIRTH o Avoid unnecessary exposure to x-
 Maternal infections rays
Congenital Heart  Drug Intake 2. Consanguineous marriage between
Disease  Maternal disease relatives to the third degree should be
avoided
 Genetics
3. Pregnancy in females above 35 years of
EARLY CHILDHOOD
age should be discouraged because of
Rheumatic Fever
 Streptococcal sore the possibility of chromosomal
or Rheumatic
throat anomalies which may be associated with
Heart Disease
CHD
EARLY ADULTHOOD
4. The importance of proper nutrition and
 Heredity
an adequate supply of vitamins
Essential  High salt intake 5. Women planning for a pregnancy but
Hypertension  Lack of physical who are susceptible to German measles
exercise
 should be vaccinated at least 8 weeks
before pregnancy
6. Pre-natal check-up
 Specific protection measures:
o All existing maternal illness must be
controlled
o A couple with a child who has
congenital heart disease should
consult a physician when planning
another child
RHEUMATIC FEVER/RHEUMATIC HEART DISEASE
 Disease of young children which extends to
adulthood
 In health education, the following points
should be stressed:
1. Prevent recurrent sore throat
2. Treat sore throat adequately
3. Manage recurrent sore throat properly
CARDIOVASCULAR DISEASES IN ADULTS
 The most common CVD in adults are:
1. Hypertension
2. CAD or heart attack
3. CVA or stroke
 Disease begin early (genetic predisposition
or familial tendency
 Prevention of SVD in young adulthood and
middle life should begin during early
childhood
HYPERTENSION
 Persistent elevation of the arterial blood
pressure
 Systolic BP is persistently above 140 mmHg
or Diastolic pressure is above 90 mmHg
 Primary (Essential Hypertension) or
Secondary Hypertension
 Principal modifiable risk factors in essential
hypertension are salt intake and lack of
physical exercise
GUIDE TO A HEALTHY HEART
 Seven simple ways toward a healthy heart
which every Filipino should know and
practice:
1. Don’t smoke cigarettes or any form of
tobacco
2. Eat food that are low in fat and salt and
rich in vitamins, minerals and fibers
3. Maintain a normal blood pressure and
have it checked periodically
4. Exercise regularly
5. Maintain ideal body weight
6. Have adequate rest and relaxation
7. If you drink alcoholic beverages, drink
moderately
SMOKING CESSATION
 Cigarette smoking is a form of addiction
 Smoking counselling is a helping process
that discusses values, attitudes and needs
with reference to the smoking problem
SALIENT TIPS TO STOP SMOKING
A. Tips for preparing to stop
1. Decide positively that you want to stop
2. Try to avoid negative thought about how
difficult it might be
3. List all reasons for stopping
4. Develop strong personal reason in
addition to your health and obligation to
others
5. Begin to condition yourself physically
(exercise, water, rest)
 Know what to expect:
o Withdrawal symptoms
o Relapse
B. Tips before stopping
1. Practice going without cigarettes in your
pocket
2. Don’t think of never smoking again
3. Stop carrying cigarettes with you at
home and work
4. Make it difficult to get a cigarette
C. Tips for the day you stop
1. Throw away all cigarettes and matches
2. Hide your lighters and ashtrays
3. Clean your clothes to get rid of the
cigarette smell which can linger a long
time
 4. Develop a clean, fresh, non-smoking
environment
5. Visit the dentist and have you teeth
cleaned to get rid of tobacco stains
6. Make a list of thing you want to buy
7. Keep very busy on the big day
8. Stay away from other smokers
9. Remember that alcohol will weaken
your power
10. Refuse to allow anything to change your
mind
HEALTH PROBLEMS ASSOCIATED WITH SMOKING
MAJOR RISKS OF SMOKING
 Major cause of lung cancer
 Predominant cause of chronic lung disease
 More often the cause of death throughout
wither lung cancer or chronic lung disease
 On the average, 30-35 years old smokers
who smoke 10-20 cigarettes per day will die
about 5 years sooner than non-smoker
GUIDE TO HELPFUL DIET
 HPT and hypercholesterolemia and their
bad consequences are often result of
unhealthy diet.
 Disease process begins early in life.
 Proper nutrition should start early, as soon
as solid food are introduced to infant’s diet.
 A good or balanced diet is low in fat and salt
and rich in vitamins, minerals and fibers.
WHAT TO EAT?
1. FAT and CHOLESTEROL
A. Consume liberally, as often as one wants
but not to exceed his total food needs,
food low in fat and cholesterol such as:
o Lean meat, lean steak, chicken,
fish, skimmed milk, low-fat
cottage cheese, yogurt
B. Consume 2 or 4 times a week foods with
moderate fats such as:
o Milk and milk products, eggs
C. Consume in limited amounts, once a
week, food with high fat, cholesterol
content such as:
o Medium fat meat, chicken, duck,
cheese, nuts (peanut, cashew),
fats and oils, butter, margarine,
potato chips and other
commercial snacks like kropeck,
corned beef, ham, organ meat,
clam, squid, oyster, mussels,
shrimp, crab meat and fat,
prawn
D. Consume only sparingly, once or twice a
month, food that are with high fat
content like:
o Whipped cream, cream, sauces,
gravies, snacks with fat dipping,
butter, whole milk, coconut
milk, deep fried food, chicharon,
lechon, bacon, pork ribs,
shoulder, tail, ears, feet, egg
yolk as an ingredient
CLASSIFICATION OF PHILIPPINE FOOD
ACCORDING TO CHOLESTEROL CONTENT
1. VERY HIGH CHOLESTEROL (≥300mg per
100g edible portion)
o Meat: carabao brain, cow brain,
carabao lungs
o Eggs: quail, duck, chicken,
balut, salted duck’s egg
 2. MODERATELY HIGH CHOLESTEROL (200-
299mg per 150g edible portion)
o Meat: cow spleen, pig spleen,
cow lungs, carabao spleen, pig
lings, cow kidney, carabao liver
o Poultry: chicken liver
3. LOWER AMOUNT OF CHOLESTEROL
(100-199mg per 100g edible portion)
o Meat and poultry: cow liver pig
liver, carabao kidney, chicken
heart, gizzards, pig small
intestines, pig uterus, pig large
intestines, pig heart, pig tongue
o Fish and shellfish: fresh water
prawn, large crab, small shrimp,
spade fish
4. LOWEST CHOLESTEROL CONTENT
(99mg and <100g edible portion)
o Meat: cow/carabao tongue,
uterus, pork liempo, lean beef
and pork, librlyo
o Fish and shellfish: talangka,
swaha, alimasag, karpa, talaba,
tulya, hito, tahong, banak, dilis,
tilapia, tanigue, lapu-lapu, tuna
o Poultry: chicken meat, egg white
2. FIBER and VITAMIN RICH FOOD
A. Consume liberally:
o Dark green leafy and yellow
vegetables, e.g. malunggay,
sayote, carrots
o Crackers: soda, graham, pretzels
o Fresh fruit juice
o Raw vegetable sticks and dips
made with low fat, yogurt and
cottage cheese
o Gelatin or sherbet instead of ice
cream for dessert
o Vitamin A and C rich fruits and
vegetables, e.g. potatoes,
camote, guava, papaya,
mangoes, apple
o Legumes
o Fruits and vegetables e.g.
bananas, chico
o Whole gram cereal e.g.
oatmeal, unpolished rice, corn
B. Eat less of the following:
o Empty calorie food like candy,
soft drinks
o Commercial cookies, pies,
pastries, donuts
o Fruit cakes and other rich cake
mixtures
o Simple sugars like syrups, jellies,
caramel
C. Limit intake of salty food such as:
o Salt cured food like tocino,
sausage, ham, tuyo
o Smoked food like tinapa, smoked
ham or bacon
o Table salt and salty condiments
like bagoong, patis, MSG
HOW TO COOK AND EAT
GUIDELINES ON COOKING
1. Boil, pan broil or bake meat and poultry
rather than frying
2. Poach or cook eggs in the shell in simmering
3. Discard the fat that cooks out of the meat
4. Trim off visible fat in meat
5. Chill soups and stews then skim off the fat
before reheating
6. Remove skin from poultry before cooking
7. Use one egg white and teaspoon of corn oil
instead of one whole egg when cooking and
baking
8. Baste meals with wine, tomato juice or
bullion instead of using fat drippings
9. Steam rather than sauté vegetables; try raw
in salads
GUIDELINES ON EATING HABITS
1. Do not eat new food without reading the
label
2. Do not eat as an outlet of tension, anger and
fatigue
3. Avoid nibbling while watching TV or a movie
4. Avoid dining out in restaurants where fried
food are a specialty
5. If possible, avoid skipping breakfast
6. Avoid irregular eating hours
7. Limit dining out
8. Avoid ordering food whose ingredients and
method of cooking is unknown
9. Eat just enough
 10. Have a simple breakfast eaten leisurely
without fatty meat, chocolate beverages
and sweet rolls
11. Have satisfying lunch or dinner consisting of
clear soup, lean meat, plain rice or roll,
vegetables and fresh fruit
12. Dine out where broiled food and varied
salad are offered
13. Have at least 2 servings of vegetables and 3
servings of fruit per day
o One serving of vegetable = ½ cup
cooked or 1 cup raw
MAINTENANCE OF NORMAL BLOOD PRESSURE
 ELEVATED BLOOD PRESSURE or HPT
o A state in which too much force is
exerted by the flow of blood through the
arteries
o The walls of the peripheral arteries tend
to be narrower, making it more difficult
for blood to pass through
o Most cases are asymptomatic
RISK FACTORS
Four things to remember about high blood
pressure:
1. No symptoms in the early stage
2. Early stages, HPT – elevated BP reading
3. No way of finding out a person is
hypertensive except by having the blood
pressure measured
4. All high blood pressure cases must be
treated
EXERCISE
 Essential to keep the body in fine condition
 Promotes vitality of the cardio-respiratory
system and strengthens the muscles as well
as improved persons agility
 Reduces risk of HPT, heart attack and stroke
 Key player in the management of weight
 Science
Four components:
1. Warm up/ Stretching - Joint movement (10
mins.)
2. Muscle Conditioning – Strengthening
exercise – Push-ups and sit-ups (5+ mins.)
3. Aerobic Exercise – fast walking, jogging,
running, swimming, cycling, dancing, stair-
climbing (20+ mins.)
4. Warm down/Stretching – immediately after
aerobic exercise, blood tend to pool around
the actively moving muscles. Warming down
allows for blood to recirculate adequately
to the vital organs of the body like the brain
(5+ mins.)
Choice of exercise:
 Purpose of exercising
 Risk of injury
 Convenience or access to facilities
 Social value of exercise
GUIDELINES IN EXERCISING:
1. There is no one best form of exercise. It
depends on what the individual wants to
achieve.
2. The individual should choose exercise(s)
which he/she likes and enjoys.
3. Exercise 30-60 minutes regularly, 3-5x a
week.
4. Wear light, comfortable clothes and shoes.
5. Exercise either in the early morning or late
afternoon when it is not so hot.
6. If the individual is a beginner, a graduated
exercise program starting with light
exercise and gradually increasing the
intensity should be followed.
7. For individuals 35 years or older, consult
physician.
8. Severe exercise must be avoided unless the
individual is young and athletic.
1. Start gradually – climb stairs, brisk walk for
5-10 minutes
2. Choose enjoyable activities
3. Anticipate obstacles and plan around them
4. Encourage support from family, friends, and
co-workers
5. Level of CV health from the following
exercise is very high – basketball, bicycling,
dancing (aerobic), jogging/running, tennis
WEIGHT REDUCTION
OBESITY
 a condition in which the natural energy
reserve, stored in the fatty tissue of humans
and other mammals, is increased to a point
where it is associated with certain health
condition or increased mortality.
 Is both an individual clinical condition and is
increasingly viewed as a serious public
 health problem. Excessive weight has been
shown to predispose to various diseases
particularly cardiovascular diseases,
diabetes mellitus type 2, sleep apnea, and
osteoarthritis
OBESITY AND OVERWEIGHT
 The term “overweight” and “obesity” refer
to a person’s overall body weight and where
the etra weight comes from.
 Overweight is having extra body weight
form muscle, bone, fat, and/or water
 Obesity is having a high amount of extra
body fat. The most useful measure of
overweight and obesity is the body mass
index (BMI). BMI is used for adults, children,
and teens
BODY MASS INDEX (BMI)
o A new term to most people. However, it
is the measurement of choice for many
physicians and researchers studying
obesity. BMI uses a mathematical
formula that takes into account both a
person’s height and weight
 BMI is equal to a person’s weight in
kilograms divided by height in meters
squared
𝑩𝑴𝑰 =
𝒌𝒈
𝒎𝟐
WEIGHT CONTROL STRATEGY
 Eating too much or not being physically
active enough will make you overweight. To
maintain your weight, the calories you eat
must equal the energy you burn. To lose
weight, you must use more calories than you
eat.
 A weight control strategy might include:
o Choosing low-fat, low-calorie
foods
o Eating smaller portions
o Drinking water instead of sugary
drinks
o Being physically active
GUIDELINES: WEIGHT REDUCTION
1. Skip junk foods such as extra cocktails, fats,
sugar and sugary foods like canned fruit, soft
drinks, sugarcoated breakfast cereals,
honey, syrups, cakes, and ice cream
2. Substitute more nutritious, less fattening
food like fish and poultry, fruits and fruit
juice, vegetable, clear soup, non-fat milk,
cereals, whole grains, vegetable, green
beans
3. Eat slowly to hasten the feeling of satiety
and cut down on the amount usually eaten
4. 15-30 minutes of exercise daily may burn
extra calories taken in
5. The overweight and obese individuals should
lose 1-2 pounds per week and not more; the
rate of weight loss can be maintained by
supplementing the diet with an exercise
regimen
6. Crash dieting every few months should be
avoided and may cause more harm than good
7. Diet pills w/c are just temporary weight
reduction measures must be avoided. Watch
what you eat on a continuing basis
PERSONALITY/STRESS
 Stress – well-recognized risk factor in the
development of coronary artery disease
(CAD)
 Personality type of an individual influences
the way he/she responds to given situation
BASIC PERSONALITY TYPES
1. TYPE A PERSONALITY
o Impatient, hates waiting,
competitive, easily irritated,
suspicious, hostile, rude, speaks
rapidly and loudly, often interrupts
or finishes others’ sentences,
preoccupied with deadlines, cannot
relax, successful in their professions
but never satisfied with their
accomplishments, tries to do more
than one thing at a time, sets high,
often unrealistic standards, do not
take proper holidays
o These individuals are more than twice
as likely to suffer from heart attacks
as people who do not manifest this
behavior pattern
 2. TYPE B PERSONALITY
o Less driven, takes things in a relaxed
manner
o Less competitive
o More easy going
o Plan or organize their lives without
hassles
o Calm, does not panic under pressure
o Flexible; can adjust to almost any
situation
o More successful than their type A
counterparts
3. TYPE AB PERSONALITY
o Able to establish good relationships
o Healthy balanced attitude to life
o Cope effectively with stress
o Can rev up or go for it when they want
to
o Have balanced attitude to life and
can adjust to different situations
of many pleasurable activities such as the
joy experienced on attaining success
 Growth, development and change are all
results of some degree of stress
 Typical connotation of the word stress w/c
is often associated with tension as well as
physical and mental disability only comes
about with prolonged, sustained and
excessive stressors
MYTHS AND TRUTHS ABOUT STRESS
Feeling bad about work gives you stress
*Stress is caused by working too much
*Stress is cured by working less
*Stress is cured by working more
*Stress is normal, it means you’re important
and it’s even good because it pushes you to
perform
STRESS INDICATORS

*An individual’s personality type is not

permanent/unalterable. The bad traits
associated with any type can be
discarded.

DESIRABLE AND UNDESIRABLE TRAITS OF TYPE A

BEHAVIOR
Desirable Traits Undesirable Traits
Ambitious Self-centeredness
Self-confidence Bossiness
Sense of responsibility Restlessness
Punctuality Hostility
Assertiveness Irritability
Persistence Anxiousness
 PHYSICAL INDICATORS
 May affect their own health but that of their
o Muscle aches, stiffness or tension
children
o Profuse swelling or facial flushing
 Type A parents may model Type A behavior
o Cold, clammy hands
for their children who thus imitate the
o Facial tics e.g. rapid eye blinking
pattern
o Headaches
 Help them suppress the negative traits of
o Sleep problems
Type A personality
o Dizziness
o GI symptoms like nausea, stomach
STRESS
pains, diarrhea
 Is by itself not to be regarded all the time
o Cough
as having deleterious and damaging effects
o Fatigue
but rather as something that is necessary to
o Asthma
achieve results
o Increase or decrease in appetite
 Certain amount of stress is desirable since it
 EMOTIONAL INDICATORS
relieves monotony, pushes people to survive
o Anger
for worthwhile goals and is an integral part
o Frustration
o Depression
 o Anxiety Personality type Special interest group
o Irritability Serious injury/illness Spiritual guidance
o Impatience Call up an old/friend
o Difficulty in concentrating
o Forgetfulness, confusion NON-MODIFIABLE STRESSORS AND SUGGESTED
o Feeling of time pressure INTERVENTION
 BEHAVIORAL INDICATORS Non-Modifiable Measures
o Rapid speaking Stressors
o Rapid walking Death in the family Learn to accept
o Chain smoking Marital separation Seek spiritual advice,
o Excessive drinking counselling
o Restlessness, pacing Jail term Relaxation techniques
o Nail biting Serious injury/illness Special interest groups
o Sexual problems Loss of work Call up an old friend
Unwanted pregnancy
Loss of major property
MOST COMMON CAUSES OF EXCESSIVE STRESS
Displacement from
 Death in the family particularly a spouse or
place of residence
child
 Marital separation MODERATION IN ALCOHOL INTAKE
 Jail term
 Partaking in alcoholic beverages is a socially
 Serious injury or illness of then affected
accepted practice in mist countries and
individual
culture. In the Philippines, there is a great
 Loss of work and financial problems
pressure for one especially men, to drink
 Unwanted pregnancy
alcohol during social occasions
 Loss of major property from fire or
 Nothing wrong with occasional social
mortgage drinking
 Trouble with the boss
 Alcohol is medically contraindicated, drive
 Migration
a motor vehicle, person cannot “hold his
 Work related stress; too much work,
drink”
concern about meeting deadlines, inability
to meet expectations, anxiety over work
BENEFICIAL EFFECTS (SMALL AMOUNT)
hazards
 Relaxing effect and can “calm one’s nerves”
 Family problems e.g. problem child, drug or  Makes one sleep better
alcohol problems  Sometimes even brings out the best in a
 Personality type
person (blunting of his inhibition)
 Displacement from place in the case of
 Enhances the circulation of the body by
natural disasters
increasing the heart rate w/c in turn
increases the cardiac output (basis on the
MODIFIABLE STRESSORS AND SUGGESTED
recommendation of one glass of wine during
INTERVENTION dinner)
Modifiable Stressors Measures
Migration Work out the solution
HARMFUL EFFECTS (LARGE OR MODERATE
to the problem
AMOUNT)
Family problem Refer to counselor,
- Cardiovascular System (CVS)
priest, doctor, social
worker or town official - Toxic effect to the brain and liver
Trouble with boss Teach relaxation - Alcohol increases food intake and may lead
techniques to obesity
Loss of work Teach how to adapt a - Alcohol may depress cardiac function
“low stress lifestyle” immediately in susceptible individuals
Work-related stress Advise accordingly-
Type A behavior
EFFECTS OF ALCOHOL
 Alcohol may alter blood lipids and increase
levels of cholesterol and triglycerides 2-3-
fold when taken in large amount
 In person who have already lowered or
controlled hyperlipidemia through exercise
and diet, alcohol may drastically increase
plasma lipids
 Alcohol can precipitate premature arterial
contractions and premature ventricular
contractions in previously normal persons
 Alcohol may reduce cardiac output of a
previously diseased heart
 Alcohol intake may lead to cardiac failure
inn hypertensive patients

ALLOWABLE AMOUNT OF ALCOHOL

Take no more than 60 mL (about 1/4 glass) of 100
proof whiskey per day

240 mL (about 1 glass of wine per day)

720 mL (about 2 averaged sized bottles) of beer per

day