A theme analysis of a personalized "Healthy Hearts" education curriculum for homeless adults
BACKGROUND: Homeless individuals have higher rates of cardiovascular disease when compared to the general population. Educational curricula in such communities have the potential to decrease the morbidity and mortality associated with hypertension and hypercholesterolemia. However, lifestyle changes from these educational sessions can be difficult for homeless individuals to implement because of competing priorities. OBJECTIVES: The objectives of the “Corazones Sanos” community project are to increase participant knowledge of hypertension and hypercholesterolemia and to counsel individuals on barriers to implementation of therapeutic lifestyle changes in the homeless population. Additional objectives include providing reinforcing support for implementation of lifestyle changes and creation of educational materials related to cardiovascular risk and lifestyle changes for the homeless population. METHODS: This community health education project was implemented with 66 patients from an urban transitional housing facility for homeless individuals recovering from substance abuse. Spanish-speaking patients >18 years old with unstable or lack of housing were eligible to participate in this study. Fifteen minute educational sessions were led by the project coordinator with the end knowledge goal of normal blood pressure and cholesterol values, daily exercise requirement, importance of medication compliance, and healthy diet practices. A reflective approach was utilized to assess participant quotations and themes of barriers to heart healthy living in the homeless population. RESULTS: Participants gained a better knowledge of cardiovascular disease risk factors after participating in education sessions. The main barriers to therapeutic lifestyle changes for prevention of cardiovascular disease included decreased access to healthy foods and fitness opportunities, mental health challenges, lack of social support, and recovering from addiction. About 30% of participants completed a follow-up individual education session. CONCLUSIONS: Casa Esperanza community members gained a better understanding of normal blood pressure and cholesterol ranges, healthy dietary practices, daily exercise requirement, and the importance of medication compliance through this education program. The findings from this project should assist healthcare clinicians with providing effective education for the homeless population to overcome the barriers identified and implement therapeutic lifestyle changes.