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Program "Learning to Take Care of the Heart"
Prevention of Cardiovascular Diseases since
Childhood. Is it Possible?

Diego Carlos Garófalo, MD

FAC Foundation, Argentine Federation of Cardiology, Rosario, Argentina


INTRODUCTION
   It has been clearly established by international scientific agreement that preventive strategies of diseases must begin at childhood.

   This statement has never been so truthful as it is in the case of cardiovascular diseases.- Its development is closely connected to the action of harmful factors, many of them acquired as habits of life.- These habits settle down during childhood due to the behavior of the family nucleus and even of the community the child integrates.

   This is why in the Prevention Committee of Cardiovascular Diseases since Childhood of FAC Foundation we consider that a prevention program at this level should aim at:

· Encouraging children to incorporate healthy life habits at a very early stage in life
· Reaching the family nucleus with the message through the child and
· in this way reaching the community
Fig. 1 and 2

Figura 1

Figura 2

METHODOLOGY
   We have adapted the program "Learning to look after your heart" EDUCOR proposed by Dr. Igolnikof and we started its development in 1997 training primary teachers of EGB (General Basic Education) on the problematic of cardiovascular diseases and its prevention in 3 schools in the city of Rosario.

Why have we chosen this plan of action?
When we talk about encouraging healthy habits we believe teachers are an essential factor. They share long hours every day with the child and we think each child answers back to the responsibilities derived from his teacher.

   Teachers are as well a multiplying factor of their message because each of them can reach an average of 4 people (family group) per pupil that is to say almost 80 people in a 20 pupils' classroom.

   The initial answer was very favorable and pupils worked enthusiastically. One of the participating schools won the 2nd EDUCOR prize by the Argentine Cardiologic Foundation that year.

   Since then we have decided to extend the program to all the schools of our city.

   But we were discouraged by the present condition of our teachers - poorly paid and unwilling to train devoting extra time with no government acknowledgement.

   This is why we decided to join the Teacher Training Workshops organized by the Teacher's Investigation Institute supported by our authorities. A new Health Module was thus created together with Mathematics, Grammar, Literature, Ecology which were already in existence.

In this way we were able to achieve two objectives:

· obtain a massive teacher participation as the module gives extra points to their curriculum
· reach teachers from surrounding areas of the Province of Santa Fe
Fig. 3

Figura 3

DEVELOPMENT OF TRAINING
   During a whole month every Saturday for 12 hours, theoretical and practical courses were dictated on cardiovascular diseases and its prevention. The subject included:

· Notion of Cardiovascular Anatomy and Physiology.
· Cardiovascular risk conditions: Which are they? How to detect them? How to correct them?
· Symptoms and signs of Cardiovascular disease.
· Healthy nutrition.
· Heart and Exercise.
· Tobacco.
· Cerebro-vascular accidents.
· Basic Cardiopulmonary Resuscitation courses with 4 hours duration and final exam by an authorized instructor appointed by FAC Foundation.

   These subjects were developed by cardiologists, clinical physicians, endocrilogists and nutritionists.

   During the course brochures and leafts were handed out dealing with the prevention of cardiovascular diseases were handed out and a booklet written by the Committee and printed by FAC Editorial was distributed among pupils.

RESULTS
   Once the module was finished the teacher presented a project of didactic download designed by himself as creatively as possible. by means of debate- chats, games, surveys, dramatization, poster competence, creation of healthy snack-bars with the participation of family members.

   The contents were developed throughout the class year, including them in the daily curricula and adapting them to the different contexts for example:

History and Geography: Typical meals of each country - What did our grandparents eat?
Mathematics: nutritional pyramid
Drawing: arteries and veins: red and blue colours
Gymnastics: the way of the red blood cell

   The program basically relied on the teacher, allowing him/her to develop the knowledge acquired through the courses with total freedom.

   Once the contents were evaluated the teachers sent the Committee the results producing new ideas which favored the growth of the program as feed-back.

   The activities developed by the schools were presented to the community during "The Heart Week" which takes place every year.

   From June 1997 up to December 2000 six Teacher Training Courses have been developed. Teachers from 106 schools of Rosario and other surrounding areas (Carcarañá, Villa Constitución, Las Rosas, Pujato, San Justo) took part in them Fig 4

Figura 4

FINAL REFLEXIONS
   During the development of the training courses we were able to obtain certain data which is worthwhile to be reflected upon:

· The majority of teachers couldn't mention more than 2 risk factors before the course
· Many of them didn't know cardiovascular disease is the first cause of death in adults of the Western world, and they also ignored it can be prevented
· Almost all teachers didn't associate stroke to cardiovascular disease completely ignoring the alarm symptoms of this pathology
· Nearly 30% of them smoked

   An this last factor is in no way unimportant assuming that the teacher as well as the family is the mirror where the child is reflected.

   Another surprising fact is the attitude adopted by children as regards the care of the environment.- They are constantly remarking papers must be thrown in litter boxes, electric energy mustn't be wasted, water mustn't be polluted, etc.

   These messages are broadcasted almost permanently through TV channels, where children learn numbers and letters.

   In other words, they give the concept of environment care the same importance as they do to learning reading and counting.

   The question therefore is obvious: why can't we send the same massage to acquire preventive cardiovascular disease habits now that disease has become a " pandemic situation".

   It would be very difficult to release the media from its responsibility as sedentary children are convenient: they watch TV for long hours and consume sponsors' products (crisps, hamburgers, pop corn, etc.) which are sold even within school premises.

   I think the best thing would be to assume our inability to transmit the knowledge that cardiovascular disease can be prevented and try to revert this situation.

   At the Prevention of Cardiovascular Disease Committee of the FAC Foundation we have undertaken this task from the beginning with great responsibility and vocation considering EDUCATION as the fundamental pillar in PREVENTION. Fig 5

Figura 5

   We believe it is necessary that all members of the community join in this commitment, asking every health national and international organization to intercede before the national Authorities of Education in each country to incorporate preventive programs of ECV in their yearly curricula of the first cycle of the Basic General Education. Fig. 6

Figura 6

 

Staff of the Prevention Committee of Cardiovascular Diseases since Childhood of FAC Dr. Diego C. Garófalo, Dra. María C. Armando y Prof. Beatriz Neón

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2nd Virtual Congress of Cardiology

Dr. Florencio Garófalo
Steering Committee
President
Dr. Raúl Bretal
Scientific Committee
President
Dr. Armando Pacher
Technical Committee - CETIFAC
President
fgaro@fac.org.ar
fgaro@satlink.com
rbretal@fac.org.ar
rbretal@netverk.com.ar
apacher@fac.org.ar
apacher@satlink.com

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