The purpose of this paper is to outline a six-week program intended to deliver a basic heart health education program to adult Syrian Refugees. A well-delivered health education program supports preventive medicine, reduces health care costs, and helps save lives (U.S. Department of Health and Human Services, n.d.) . The reason for choosing Syrian refugees is because at this point in time, they represent a vulnerable population (Strong, Varady, Chahda, Doocy, & Burnham, 2015). As a group they have been under the stress of civil war for at least five years and are likely to have been displaced internally or externally. In addition, they are likely to be under socioeconomic stress because they may not have been employed during the disruptions of the civil war and may be separated from their usual social support system.
The topic of delivering heart health education program was chosen on the basis of current studies that have demonstrated elevated risk factors for heart disease in this population. The clinical indicators of heart disease are high blood cholesterol, high blood pressure, high triglycerides and diabetes. Lifestyle factors include stress and tobacco consumption (American Heart Association, n.d.). Recent research shows that diabetes, mean systolic blood pressure, cholesterol levels have increased in Syria and tobacco consumption is high among Syrian men (Critchley, et al., 2016). Women’s consumption of tobacco is by water pipes rather than cigarettes, but it poses the same health risk (Mohammad, Kakah, & Mohammad, 2008).
The intervention program will be conducted in spoken and written Arabic as this group may not have had the opportunity to learn English. Further, due to cultural constraints of limiting contact between unrelated men and women, the program will be held during the day for the women and during the evening for men. Child care accommodations will be available during the day program.
The ten objectives of the intervention program will comply with the SMART rules of specific, measurable, action-oriented, realistic, and timely. The program will consist of 10 ninety-minute sessions. Session One will be an introduction, Sessions Two and Three will be information sessions covering the warning signs of heart disease, Sessions Four and Five will be information sessions covering behavioural modifications to reduce the risk of heart disease. Session Six will be a review of the information and conclusion.
Objective 1. Ensure sustainability of the program.
Fostering sustainability of the program can be accomplished by identifying, consulting, and integrating all stakeholders prior to implementation of the program (U.S. Department of Health and Human Services, n.d.). Stakeholders will be authority figures in the Syrian community, religious and political leaders, and local clinics and hospital.
Objective 2. Ensure a productive educational experience for all participants.
Facilitations will review class conduct related to cell phones use and allowing every participant the opportunity to speak. To facilitate learning and provide the opportunity to practice new skills and information, the first half of each of the eight information sessions will provide instruction whereas the second half will provide some form of practical application.
Objective 3. Promote a positive social experience for all participants
The idea behind a positive social experience is that social integration is a health promoting value in itself. To foster a comfortable atmosphere, in the first session participants and facilitators will introduce themselves. Participants will have the opportunity to share their stories. Each session will break in the middle and coffee, tea and cookies will be served. The break is used to encourage social interaction and social connections.
Objective 4. Ensure participants have individual attention and prompt feedback.
Objective 5 Encourage attendance at the program.
Program attendance is encouraged by providing child care during the session. If a participant misses a session, a follow up telephone call will be made to remind the participant or to resolve any problems, such as transportation.
Objective 6. Deliver four educational sessions and educational handouts for the warning signs of heart disease.
Arabic-speaking nurses or health educators will deliver the information. The class format will be informal and allow plenty of time for discussion. The practical parts of the sessions could be the nurse taking everyone’s blood pressure and discussing the results, a visit to the local athletic facilities at the YWCA or YWCA, or a demonstration of healthy cooking styles.
Objective 7: Evaluate the program.
The program is evaluated by a brief and non-intimidating written questionnaire (maybe four questions) conducted in Session One and Session Six. The results will be compared to determine what the participants learned. In the Sixth session, there will be a discussion on what the participants like about the sessions and what did not work well for them.
Objective 8: Familiarize the participants with the local health care delivery system.
Some of the practical sessions will be devoted to visiting the local Emergency Room and clinics in the area to familiarize the participants with the locations. Health insurance may be included in the discussion.
Objective 9. Encourage participants to promote the program within the community.
Providing the participants have a positive experience, they will tell others. Hopefully, there will be enough community enthusiasm to have additional sessions.
Objective 10. Share the “lessons learned.”
The “lessons learned” based on the comparison of the pre- and post-quiz results and the discussion in the final session, a report will be prepared and presented to the stakeholders shortly after the completion of the program.
References
American Heart Association (n.d.). Understand Your Risk of Heart Attack. Retrieved from http://www.heart.org/HEARTORG/Conditions/HeartAttack/UnderstandYourRiskofHeartAttack/Understand-Your-Risk-of-Heart-Attack_UCM_002040_Article.jsp#.V2G3uNIrLcs on June 15, 2016.
Critchley, J., Capewell, S., O'Flaherty, M., Abu-Rmeileh, N., Rastam, S., Saidi, O., Sözmen, K., Shoaibi, A., et al. (2016). Contrasting cardiovascular mortality trends in Eastern Mediterranean populations: Contributions from risk factor changes and treatments. International Journal of Cardiology, 208, 150-161. doi: 10.1016/j.ijcard.2016.01.031.
Mohammad, Y., Kakah, M. & Mohammad, Y. (2008). Chronic respiratory effect of narguileh smoking compared with cigarette smoking in women from the East Mediterranean region. International Journal of Chronic Obstructive Pulmonary Disease, 3, 405-414.
Strong, J., Varady, C., Chahda, N., Doocy, S., & Burnham, G. (2015). Health status and health needs of older refugees from Syria in Lebanon. Conflict and Health, 9, 9:12. doi: 10.1186/s13031-014-0029-y.
U.S. Department of Health and Human Services (n.d.). Making Health Communication Programs Work. Retrieved from http://www.cancer.gov/publications/health-communication/pink-book.pdf on June 15, 2016.
