Introduction
We are proposing a summer program to reduce cardiovascular risk for adults age 45-75 in Medical Lake, WA, with a $8,000 budget. This trauma-informed program will have a primary focus on exercise, with secondary focuses on heart health education and cooking skills. Additionally, vouchers will be given to participants for an online tobacco cessation program via American Lung Association.
With education and discussion at the start and end of the summer program, we will measure heart health knowledge, self-reported health behaviors, and cardio self-efficacy. We will have 8 exercise events at Waterfront Park where participants may choose kayaking on Medical Lake or powerwalking on the paved trail around the lake for that day’s session with trained staff. Our two evening cooking events will be at a local bakery restaurant that normally closes mid-afternoon, and will emphasize heart healthy options for breakfast and dinner, including affordable, rural Inland-Northwest culturally appropriate ingredients.
Trauma-Informed Principles
It has been found that Adverse Childhood Experiences (a type of traumatic experiences) may contribute up to 1.9 million heart disease cases (CDC, 2021). So we understand our attendees may have childhood, cultural, and low SES related trauma in childhood and in their adult lives, as well as being a racial/ethnic minority and have minority stress. Following the black feminist author and speaker Kimberle` Crenshaw, we are starting at an intersectionality point and adjust as needed so it is more accessible (Crenshaw, 2016).
This program will use all six of the SAMHSA trauma-informed principles of (1)Safety, (2) Trustworthiness and Transparency, (3) Peer Support, (4) Collaboration and mutuality, (5) Empowerment, Voice and Choice, and (6) Cultural, Historical, and gender issues (SAMHSA, 2014). Safety will be emphasized with having multiple staff with trauma informed training, kayaking on a small lake where powered boating is not permitted and kayaks can be launched from a beach, and appropriate safety gear. The power walking parallel program will be on a paved trail that does not intersect with cars. Participants will be encouraged to raise their heartrate to the pace that feels comfortable for them. Our trauma-informed staff will pay attention to any indicators if a participant may feel unsafe or if there could be use to address any additional perceived barriers. We will build trustworthiness and transparency by understanding our participants are individuals and that our staff is there for their independent concerns and to help them achieve their self-set exercise goals. Peer Support will be naturally be fostered in our group exercise groups as well as cooking events; additional communication skills be taught in group kayaking. Empowerment, Voice and Choice will be a cornerstone of our program as participants choose their own exercise activity and goals. Our staff will be diverse in gender identity (including one staff that happens to be transgender/nonbinary); particularly in the walking group there will be at least one cis-woman and one cis-man so walking will be celebrated as appropriate exercise for people of any gender. Our staff has had LGBTQ+ and racial/ethnicity diversity inclusivity training so all participants will be able to authentically participate and belong.
Social Ecological Model
This program will focus on the Individual and Community level of the Centers for Disease Control and Prevention’s Social Ecological Model (CDC, 2022). Our program has individuals exercise at two-thirds of the meetings. In addition to building exercise into the individual’s routine, our program’s heart health presentations will inform the individual, and help build self-efficacy for all related health behaviors. Our cooking events will bring in the community level as they are held at one of the town’s favorite restaurants and will highlight affordable rural, Inland Northwest culturally relevant foods.
Public Health Framework
Public Health is largely focused on preventing illness; this recognizes three prevention levels of Primary Prevention so diseases process never starts, Secondary Prevention catering to persons who may be asymptomatic, but disease is developing, and Tertiary Prevention to stop disease progression and preserve quality of life for the individual (Institute for Work & Health, 2022). Since we are working with adults 45-75 who are at risk of having CVD, this program will focus on secondary level of prevention, although we may have attendees that do not have the disease yet but this program will help them prevent from developing cardiovascular disease.
References
Centers for Disease Control and Prevention. (2022, January 18). The social-ecological model: A framework for prevention |violence prevention|injury Center|CDC. Centers for Disease Control and Prevention. Retrieved March 23, 2023, from https://www.cdc.gov/violencepr...ecologicalmodel.html
Crenshaw, K. (2016, December 7). The urgency of Intersectionality | Kimberlé Crenshaw. YouTube. Retrieved March 4, 2023, from https://www.youtube.com/watch?v=akOe5-UsQ2o
Institute for Work & Health. (2022). Primary, secondary and tertiary prevention. Retrieved April 22, 2023, from https://www.iwh.on.ca/what-res...-tertiary-prevention
SAMHSA’s Trauma and Justice Strategic Initiative, U.S. Department of Health and Human Services. (2014, July). Samhsa's concept of trauma and guidance for a trauma-informed approach. SAMHSA. Retrieved January 18, 2023, from https://www.samhsa.gov/resourc...ma-informed-approach
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