Discussion

366 Presentation LESSONS LEARNED FROM THE HEALTHY HEART COMMUNITY PREVENTION PROJECT IN REACHING THE AFRICAN AMERICAN POPULATION KEITH C. FERDINAND, MD, FACC Heartbeats Life Center Abstract: The Healthy Heart Community Prevention Project (HHCPP) is an ongoing program of cardiovascular risk identification and modification in the African American community in New Orleans, Louisiana . The program targets low socioeconomic status African American populations, which continue to have higher rates of coronary heart disease, stroke, and overall cardiovascular mortality than the general population. Among the HHCPP's initiatives have been the use of barbershops and beauty salons as blood pressure screening sites. Church-based programs, in which ministers provide "healthy heart sermons," as well as screenings at sports events, where volunteers provide health advice, have proven to be successful aspects of the program. The HHCPP has also offered educational sessions to a broad cross-section of health professionals, including physicians as well as nurse practitioners and nutritionists. Future initiatives include the establishment of cholesterol screening programs. Key words: African Americans, cardiovascular disease, risk factors, low socioeconomic status, hypertension, hyperlipedimia The Healthy Heart Community Prevention Project (HHCPP) is an ongoing program of cardiovascular risk identification and modification in the African American community in New Orleans, Louisiana, that targets low sodoeconomic status populations. It was initially conceived as a one-year pilot program funded by the National Heart, Lung and Blood Institute (NHLBI) of the National Institutes of Health. The program is maintained by unrestricted educational grants and voluntary support by health professionals in the New Orleans community. A detailed report of the various aspects of the Healthy Journal of Health Care for the Poor and Underserved · Vol. 8,No. 3 · 1997 Ferdinand 367 Heart Community Prevention Project has been previously published.1 This update serves as further reflections on practical considerations for the application of community-based interventions in the African American population. In addition to the prindpal investigator (Keith Ferdinand), the program has a project dirertor, Daphne Ferdinand, MN, RN, administrator of Heartbeats Life Center, a community-based cardiovascular center, of which Keith Ferdinand is medical director. With the termination of NHLBI funding, a full-time program achrunistrative assistant is no longer available. NHLBI support remains in the form of expertise and educational materials provided by Robinson Fulwood, MSPH, of the NHLBI's Office of Prevention, Education, and Control, who previously served as the project officer. Recommendations for others who desire to duplicate similar programs will be reported and described in detail herein. Rationale for the HHCPP Community-based programs have been shown to induce favorable changes in health knowledge.2 However, programs have not been widely or effectively applied in all communities. One important mission of the Healthy Heart Community Prevention Project is to ensure wider appUcation of cardiac risk reduction in the African American community, espedally those of lower socioeconomic status. Prevention efforts in the area of coronary heart disease and stroke are one of the primary factors related to the decline of heart disease, stroke, deaths, and disability in the United States. However, cardiovascular morbidity and mortality declines have not been as substantial in African Americans as in the general population. The prevalence of excess body wdght in African Americans , especially females, appears to have continued or increased in some sectors. The African American community, other minority communities, and populations of lower sodoeconomic status continue to have higher rates of coronary heart disease, stroke, and overall cardiovascular mortahty.2 The HHCPP/Barbershop/Beauty Shop Intervention One of the most innovative components of the Healthy Heart Community Prevention Project was a blood screening program using barbers and beauticians serving lower sodoeconomic African American communities. This project was extremdy labor-intensive and required a total of 10 hours of intervention training conducted by a registered nurse. During training, beautidans and barbers were taught to effectively measure blood pressures in their clients. Only those shop operators who were able to complete the appropriate training were allowed to take sphygmomanometers back to their salons and barbershops to partidpate in this aspect of the program. A written test was administered using the Fifth Joint National Commission on the Detection, Evaluation , and Treatment of High Blood Pressure Report (JNC-V). A passing score 368 The Healthy...