Service Learning Project:

Heart Healthy Foods in the Pediatric

Patient with Cardiovascular
Diseases & Disorders
Haley Higgins
NUR 4636L: Community/Public Health Nursing Clinical
 12 Pediatric Clinics Cardiology Clinic
Maternal Fetal Medicine
Patient population
Pediatric & Perinatal Cardiology Pediatric patients with diagnosed
Neurology cardiac disease/disorders
Pulmonology Pediatric patients with suspected
cardiac issues (consultations)
John Hopkins
Sports medicine
Surgery Small population of pregnant
mothers
All Childrens Urology
PT/OT Nurses role in the outpatient clinic
Outpatient Speech Pathology setting at JHACH
Audiology Care provider
Care - Brandon Critical thinker
Social worker
Communicator
Educator
Coordinator
Supervisor
 10% of patient population between 13 19 years of age diagnosed
with primary hypertension
Educational The first line of recommendations is to modify diet and increase
physical activity in order to lower BP
Need Heart These suggestions were made without parents and/or child
Healthy Foods understanding how to make healthier food choices
Educational Need: nutrition education regarding heart healthy
foods that will assist in lowering blood pressure
 Objectives Nutrition
Increase the proportion of physician office visits that include
counseling or education related to nutrition or weight
Increase the proportion of physician office visits made by patients with
a diagnosis of cardiovascular disease, diabetes, or hyperlipidemia that
include counseling or education related to diet or nutrition
Increase the proportion of physician visits made by all child or adult
patients that include counseling about nutrition or diet
Healthy People Increase the contribution of fruits, vegetables and whole grains to
the diets of the population aged 2 years and older
2020 Reduce consumption of sodium in the population aged 2 years and
older
Objectives Heart Disease & Stroke
Decrease the proportion of persons in the population with
hypertension
3.5% of children & adolescents aged 8-17 have high blood pressure/
hypertension (2005-2008)
Goal is to reduce that number to 3.2% by 2020
 Goal
Patients will gain an understanding of the importance of food in
maintaining a healthy heart and will be able to identify heart healthy
foods prior to leaving appointment

Objectives
After receiving nutrition education, the patient and/or patients
parent/guardian will be able to state the 5 main food groups: dairy,
SLP Goals & fruits, vegetables, grains and protein.
Objectives After receiving education on heart healthy foods, the patient and/or
the patients parent/guardian will be able to identify 1 heart healthy
food from each major food category (dairy, fruits, vegetables,
grains, & protein)
After receiving education on heart healthy food, the patient and/or
the patients parent/guardian will be able to provide healthy
alternatives to 2 junk food items (i.e. carrot sticks as an alternative
to potato chips, water as alternative to soda, fresh strawberries
instead of fruit snacks)
 Original Plan Modifications
Verbal instruction Poster board hung up in clinic
Brochure explaining heart instead of brochure
healthy foods including Recipe for healthy smoothies
examples of heart healthy provided rather than coloring
foods and at least 1 easy sheet
Implementation recipe the family could try Provided nutritional
& Modifications out education to 2 patients 14
years of age and 17 years of
Coloring sheet with examples
age diagnosed with HTN
of healthy foods that the
child can color
Provide nutritional education
to all patients 13-19 years of
age diagnosed with HTN
and/or hypercholesterolemia
 Participant learning was evaluated by asking patient and/or
caregiver to respond to the following questions
Identify the 5 main food groups
Provide a healthy alternative to 2 junk food items commonly
consumed in regular diet
Patient
Overall patients responded well
Response & Staff thought the material was relevant and met a need for their
patient population
Future Patients thought the material provided was helpful and would assist
Modifications them in making healthier choices at school and home

Future modifications
Provide teaching in a more relaxed setting
Provided patient and caregiver with resources they can take home
Include a visual of an ideal school lunchbox
 Health policies are developed in order to achieve specific health
care objectives within a population
Current recommendations are for all children 3 years of age and
older to have BP measured at every health care visit
After 3 consecutive high BP readings, child can be diagnosed with
HTN

Health Policy & First: lifestyle modification diet, exercise, weight loss
Second: pharmacological management if BP not controlled within 3-6
Healthcare months of initiating lifestyle modifications

Childhood HTN is often asymptomatic and

misdiagnosed/underdiagnosed
Attributed to white coat syndrome, something they will grow out
of, lack of follow-up after high BP reading

Increase awareness of childhood hypertension and the problems

associated with HTN
 Childhood nutrition facts. (2017). Centers for disease control and
prevention. Retrieved from
https://www.cdc.gov/healthyschools/nutrition/facts.htm
Heart disease and stroke. (2017). Office of disease prevention and
health promotion. Retrieved from
https://www.healthypeople.gov/2020/topics-
objectives/topic/heart-disease-and-stroke
Moore, L. L., Bradlee, M. L., Singer, M. R., Qureshi, M. M.,
Buendia, J. R., & Daniels, S. R. (2012). Dietary approaches
to stop hypertension (DASH) eating pattern and risk of
elevated blood pressure in adolescent girls. British Journal
References Of Nutrition, 108(9), 1678-1685.
doi:10.1017/S000711451100715X
Nutrition and weight status. (2017). Office of disease prevention
and health promotion. Retrieved from
https://www.healthypeople.gov/2020/topics-
objectives/topic/nutrition-and-weight-status/objectives
Reducing sodium in childrens diets. (2014). Centers for disease
control and prevention. Retrieved from
https://www.cdc.gov/vitalsigns/children-sodium/index.html
Riley, M., & Bluhm, B. (2012). High blood pressure in children and
adolescents. American Family Physician, 85(7),693-700