Heart disease (HD) is the number one cause of death in the United States. HD cause a thousand deaths in the country every day, many of these deaths happen unexpectedly at home. Lifestyle modification like healthy eating, physical activity, weight loss, smoking cessation and controlling other chronic conditions like diabetes can prevent or delay the serious complications of heart disease. (American Heart Association 2016)

Addressing Heart disease through the socio-ecological model or Bronfenbrenner

At the microsystem level

To begin with I will develop an education/awareness campaign “My Heart –My Future”

Through this campaign I will provide education and awareness for all ages, especially for parents/families. The topics will include: what is heart disease?Causes, complications, How to keep the heart healthy, benefits of physical activity, healthy eating and others. Under causes; beside unhealthy eating habits, lack of physical activity and obesity. I will highlight smoking. According to the article in Huntingtoncity, smoking is common and hard to control. This media campaign will run through TV, radio, websites, bill boards, newspaper, and school bulletins, daycares andparents ‘magazine. Heart issues can be silent in the beginning, therefore, people’s perception of vulnerability and severity to heart disease and its complications can be low. Using real pictures of complications of heart disease like a person developing a stroke or being disabled after experiencing a heart attack or leaving his family because of death due to heart issues (fear appeals) may increase awareness in parents, babysitters, teachers and other close caregiversand will move them to the pre-contemplation and then to the action stage. I will emphasize that heart disease is fatal, but they have the power to change their lifestyle and prevent it, this will help me avoid a defensive motivationfrom the individual, which means that theindividualwill controls the fear rather than the threat. (Diclemente et al., 2013.)

At the Mesosystem level

Human beings learn by repetition, therefore I will keep implementingthe education campaign –My Heart-My Future – but this time I will involvemore than one Microsystemthat influences the individual. For example; beside the family I will involve youth groups from churches, classmates, coaches or role models from school. In Huntington people were developing heart attacks in their 30s, thusinvolving these young leaders can be a good strategy to motivate and influence adolescents to adopt healthier lifestyles. At this level of influence it willbe a good idea to alsoorganize a health and wellness committeeto learn directly from the adolescents and parents their health expectations and health desires. Involving them in the creation of the program will help melearn and better understand their barriers to attend the program like childcare, transportation, disabilities and others.

At the Exosystem level

I will involve workplaces. Employers need to understand that healthier employees are more productive.Havinghealthier employees is less expensive for their insurance program. Healthy employees call in sick less frequently. According to the article, the hospital is the largest employer of Huntington, this is a plus because I can organize a wellness program model there and then implement this wellness model in other business like the government offices. However not all or the most affected families with overweight and heart issues may work in the hospital and government offices, in fact, they may be unemployed. Huntington mentioned that the rate of poverty is 19 percent, much higher than the national average.Therefore, creating an obesity prevention program (OPP)in collaboration with the YMCA, school and hospital will help rich people more from different socio-economical levels. This OPP will be free of charge for all the families and their children. I will apply for a grant to provide healthy cooking classes for children and parents, childcare, transportation and to give incentives to the participants.

At the macro-system level

According to the article there is not much financial or community support for health projects in Huntington. Lack of motivation and a “cultural attitude” to include physical activity in health projects is part of the problem. Not even politicians are enthusiastic about the improvements of health. I wonder how much of this reaction is due to the lack of a culturally sensitive health intervention. Therefore in order to be more accurate with my intervention, Iwill utilize a logic model: The Precede-proceed modelwill help me to do the educational diagnosis of the community, then will guide me to choose the theory and consequently to develop the most appropriate treatment plan/community intervention for the needs of the target population to achieve behavior change. PROCEDE stands for POLICY, REGULATORY AND ORGANIZATIONAL CONSTRUCTS IN EDUCATIONAL AND ENVIRONMENTAL DEVELOPMENT. (US Department of Health and Human Services 2005). In the case of Huntington, it will be necessary to identify policies that support the community with a robust health intervention that includes a public health project for physical activity/walkable areas,a proposal for the school to provide healthier menus, a smoking cessation policy, and an obesity prevention program for kids and adolescents including parents. This program has to make changes in all the levels of intervention: personal, interpersonal, community and institutional /policy.(US Department of Health and Human Services 2005).

Reference

U.S Department of Health and Human Services. National Cancer Institute. (2005). Theory at a Glance a Guide for Health Promotion Practice.

DiClemente, R., Salazar, L., & Crosby, R. (2013). Health Behavior Theory for Public Health. Burlington, MA: Jones and Bartlett Learning

American Heart Association. (2016). AHA Statistical Update. Retrieved from

American Heart Association. (2016). what is Cardiovascular Disease. Retrieved from

MentalHelp.net (2015). Urie Bronfenbrenner and Child Development. Retrieved from