Publication Date

Winter 3-6-2024

Item Type

Text

Executive Summary

Modifying AHA Stress Management and Physical Activity Modules for Senior Communities

This quarter our group was given the opportunity to partner with two organizations to conduct work surrounding blood pressure and heart health education. One of our partners was a senior living organization whose mission is to transform beliefs about affordable housing through supporting communities where seniors and families can thrive. We also collaborated with the American Heart Association (AHA), which seeks to combat cardiovascular disease and stroke for the improvement and overall health of the population.

For this project, we were tasked with simplifying the AHA “Check. Change. Control.” (CCC) education program on blood pressure management. Our goal was to make it more accessible for the older adult population at the senior living community and in a manner that may be easily replicated at other facilities. The modules that we focused on were physical activity and stress management, and how those topics relate to blood pressure and heart health. The remainder of this work will detail important information about the context of our project, the specific activities we implemented and why, the outcomes of our work, and the final impact.

Background

In collaboration with the American Heart Association (AHA) and our senior living agency, our group, which consisted of six Seattle Pacific University quarter five nursing students, were tasked with devising a comprehensive lesson plan for an older population community under the context of a needs assessment performed by our peers. According to their findings, a large risk factor for the community was their lack of support. There was an absence of awareness of the available services and how to use them, a lack of an emergency action plan if an emergency were to occur, and a sense of danger due to a recent robbery in the area which posed a risk for the many avid walkers of the community. Groups also isolated themselves to the relative building they resided in, restricting community development within the three buildings of the living space. Much of our tasks were approaching these needs and risk factors.

The modules of the lesson plan, organized into digestible weekly content, centered around exercise and stress management in compliance with the AHA CCC program and aimed to better educate the community on active living and promoting healthy aging. According to data collected in 2017 by the AHA, 46% of U.S. adults have high blood pressure, posing as a major health risk factor, and only 1 in 4 have their blood pressure well managed (American Heart Association, 2021). The CCC program by the AHA is an evidence-based blood pressure management program that aims to empower individuals to achieve better heart health through various education or lifestyle adjustments.

Activities with Rationale

For our project, we were tasked with generating lesson plans focusing on two main areas of concern in relation to the CCC implementation guide. As the previous group created education material focused on phases one and two of the AHA guide, blood pressure and nutrition, we centered on phases three and four: stress management and exercise. We created an eight-week outline for future SPU nursing students and educators to implement within their communities with the first four weeks focusing on stress management and the latter four on exercise. Age-appropriate teaching strategies were factors we took into consideration when planning the materials with the intention of increasing receptiveness and effectiveness in a senior population. Recommendations for teaching older adults include approaching them with attitudes of respect and acceptance, focusing on key points, and making the content relevant to daily life and adaptable to a wide range of physical and cognitive abilities (Speros, 2009).

The first and second weeks’ materials were focused on stress management and education on mindfulness through discussions, activities, and community building. This included teaching residents about how stress affects the body through a PowerPoint presentation, discussions, and showing a related video. The material included information about mindfulness, a guided mindfulness breathing exercise, and handouts of easy mindfulness exercises that residents could do at home. Afterward, the curriculum invited residents to participate in a variety of different art activities as an example of ways to destress. This included coloring pages, a group art activity, and emotion mapping. According to Utami et al. (2021), art therapy is effective in reducing stress levels as well as blood pressure in elderly individuals, which was measured through questionnaires and objective blood pressure readings before and after therapies. In the lesson plan, we also provided residents with an emergency contact sheet for them to fill out to promote community development and safety. The third and fourth weeks’ lesson plans revolved around sleep education. According to Newsom and DeBanto (2023), sleep patterns change as we age which affects health. The module encouraged discussions with residents about sleep habits and the meaning of good sleep. Activities for these lesson plans included discussions, breathing exercises to promote good sleep, and creating a sleep journal to track their own sleep.

Our lesson plan for weeks five through eight centered on promoting exercise and active living through education on the importance of activity. Weeks five and seven were structured around building community and encouraging movement through group walks. Each of these weeks included an option of activities the residents could participate in if desired such as a scavenger hunt or a bingo card walk. As part of the educational material for week six, we introduced the topic of exercise through a PowerPoint presentation modeled off the AHA Empowered to Serve lesson, “Get Active!” (American Heart Association, 2022). This lesson focused on the importance of exercise for cardiovascular health and overall well-being and included evidence-based statistics and physical activity recommendations in accordance with AHA guidelines. Following this presentation, we provided an outline for a 15-20 minute demonstration of evidence-based exercises for students to guide the residents through. We also included a handout summarizing the demonstration that would be passed out afterward so the residents may be able to implement the exercises at home. These exercises were chosen in line with the U.S. Department of Health & Human Services (HHS) physical activity guidelines for American older adults in partnership (U.S. Department of Health & Human Services, 2008). Finally, the eighth week ended the topic of exercise through a chair Zumba class. In the lesson plan, we included a video demonstration to be shown following a continued discussion on the importance of exercise and activity and ways to implement it at home.

Outcomes

The outcomes of the project are patient education deliverables on stress management and exercise as directed by the AHA recommendations for blood pressure management. The education is specific to the population of seniors living independently at the site and is intended to be used by nursing students in future quarters. To form the goals for the outcomes of this project, proper evaluation of the population’s needs was necessary. Assessments of the community requisites were completed by nursing students through onsite observation and collaboration between students, SPU faculty, the program manager for health initiatives at the facility, and an AHA representative. The result was the formation of the primary goal of increasing resident’s understanding of stress management and exercise and how these factors correlate to blood pressure. To meet the outcomes, students met each week of a college quarter for seven hours to develop the materials and receive feedback from associates. Additional meetings with collaborators occurred as needed to refine the design and subject matter. A midpoint and final survey was included in the curriculum to be implemented at weeks four and eight for evaluation of the experiences of residents and student nurses who are participating in the project.

Conclusion

Our project successfully achieved the creation of stress management and exercise lesson plans guided by the AHA that future nursing students can use for a senior living facility. Lesson plans included tools such as sleep logs and exercise track sheets. We also included activities for residents to participate in such as mindfulness practices, art, exercise and dance classes, and small group discussions. We maintained awareness of the developmental stage of this age group throughout the making of our lesson plans and were also mindful of the different ranges of mobility to create activities that were senior-friendly. We held community building in high importance throughout the making of our lesson plans. The format of the project encourages future nursing students to continue to make the lesson plans more sustainable and effective as the lesson plans are implemented.

References

American Heart Association. (2021). Check. Change. Control. https://www.heart.org/-/media/files/health-topics/high-blood-pressure/check-change-control/check-change-control-implementation-guide.pdf?la=en

American Heart Association. (2022). Get Active! [PowerPoint slides]. EmPOWERED to Serve. https://www.empoweredtoserve.org/-/media/ETS-files/Community-Resources/Health-Lessons-Amgen-Branded/Get-Active/ETS-Amgen-Get-Active-Presentation.pdf

Newsom, R., & DeBanto, J. (2023, September 19). Aging and sleep: How does growing old affect sleep? https://www.sleepfoundation.org/aging-and-sleep

Speros, C. I. (2009). More than Words: Promoting Health Literacy in Older Adults. The Online

Journal of Issues in Nursing, 14.(3). https://doi.org/10.3912/OJIN.Vol14No03Man05

U.S. Department of Health & Human Services. (2008). Active Older Adults. In HHS, 2008 Physical Activity Guidelines for Americans. (pp. 29-34). https://health.gov/sites/default/files/2019-09/paguide.pdf

Utami, P. A., Sulistiowati, N. M., & Karin, P. A. (2021). The Effect of Creative Arts Therapy on Stress Level and Blood Pressure of The Elderly With Hypertension. Journal of A Sustainable Global South, 5(2).https://doi.org/10.24843/jsgs.2021.v05.i02.p03

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