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Health Education Activities for
Prevention of Cardiovascular Risk
in the Gibraltar Bay County

Torrecilla, Luis; González, Rafael;
Martelo, Ma. Angeles; Fernández, Martina;
Fernández, Antonio; Bas, Pilar

University School of Health Sciences of Algeciras, University of Cádiz, Algeciras, Spain

· Promote healthy lifestyle, conducts and attitudes in the population of our County.
· Educate in the knowledge and prevention of cardiovascular risks.
· Calculate the individual risk for cardiovascular disease in the persons attending the activities who offered themselves as volunteers and give them advice.
Background: The promotion of health education regarding preventable cardiovascular risk factors in the general population has been proved to reduce the incidence of cardiovascular disease. We organized a series of activities for health education and prevention of cardiovascular disease in the Gibraltar Bay from 07 to 12 May 2001 under the name of SEMANA DEL CORAZON DEL CAMPO DE GIBRALTAR (Heart Week in the Gibraltar Bay County).
Material and Methods: We organized work groups to elaborate the heath education leaflets and fact sheets. We trained our group in data collection, Arterial Blood Pressure and basic RCP techniques, capillary blood sampling for Cholesterol and Glucose and anthroprometic measurements. As the main venue We used a huge marquee placed in a very popular square in the city of Algeciras.
· Mailing to 10.000 families with children in Primary Education with information regarding cardiovascular risk factors and healthy lifestyle.
· Information Sessions in 5 different Colleges to a total of 500 pupils.
· Basic RCP workshops for college and school age children, police and firemen.
We organized a number of 16 for a total of 800 people.
· Number of visitors to the CARPA 3.700 to 4.000.
· Individual Risk Factor for cardiovascular disease calculations in volunteers: 2.451.
Conclusions: From a Community Health perspective we try to look at the human being not only as a passive main target but also as an active main character in Health Promotion Activities. A well-informed population who takes an active role in the improvement of their Health is paramount for the prevention of cardiovascular disease.


  The region of the Field of Gibraltar is located in Spain, in the Independent Community of Andalucia, the southeast area of the Iberian Peninsula, in the province of Cadiz. It is constituted by these towns: Tarifa, Algeciras, Los Barrios, San Roque, Castellar, Jimena and La Línea de la Concepción. Its Health District, depending of the Andalucian Health Trust (NHS), is formed by Specialized Attention Network, compose by 2 Hospitals (Punta Europe Regional Hospital in Algeciras and La Linea Regional Hospital) and the Primary Health Network, composed by 10 Health Centers (1 Tariff, 2 Algeciras, 1 Los Barrios, 1 San Roque, 1 Castellar, 1 Jimena and 3 La Linea de la Concepcion).

   Cardiovascular Diseases is the first cause of mortality in our region, like an example in 1999, only the Punta Europe Hospital, registered 256 deaths from this cause, over the tumours and respiratory tract diseases.

   Being conscious that the knowledge and the education on the population of the main modifiable factors of risk of the cardiovascular diseases allow its prevention, we celebrated from the 7th - 12th of May of 2001 a hugue promotional activity, health promotion and prevention of the cardiovascular diseases that we denominated SEMANA DEL CORAZON DEL CAMPO DE GIBRALTAR (WEEK Of the HEART Of the CAMPO DE GIBRALTAR).


· Promote healthy lifestyle, conducts and attitudes in the population of our County.
· Educate in the knowledge and prevention of cardiovascular risks.
· Calculate the individual risk for cardiovascular disease in the persons attending the activities who offered themselves as volunteers and give them advice.

   - Previously to the activities, work groups were constituted to prepare all the activities to develop later (conferences, workshops, installation of stands in the tent, and the content of it), to preapair all the material to spread (posters, leaflets, etc) and to train the staff and to unify criteria in the different tasks and techniques that would be carried out (Basic CPR and collection of data: blood pressure, anthropometrics index, weight, height, measurement of cutaneous fold, body mass index, capillary blood sugar levels and capillary cholesterol levels); these groups were set up by School teachers, students and professionals from the Hospitals and from the Health Centers.

   - They were elaborated and spreaded afterwards two posters to advertise "LA SEMANA DEL CORAZON" in all the towns; one of them inviting the citizens to participate in ours activities (1000 copies), and another one, focus on youthness mainly, titled Do you play darts with your Heart?, in which, the dartboard was the heart and the darts were the differents risk factors (1000 copies).

   - We sent about the event to all mass media of local scope and to the Andalucia broadcast television and it was ask for air time in some programs, of higher audience rating, to explain the cardiovascular diseases and to spread healthy advices.

   - We made a videotape for the six local televisions of local scope with advertisings about "LA SEMANA DEL CORAZON" and its purpose.

   - We sent a letter to the Headmasters of the Primary Schools asking for its collaboration to spread between its educative community (parents, students and professors) a leaflet about healthy habits of life for children.
- We asked for the collaboration of Secondary Schools to give conferences, focus on the students, about "Cardiovascular Diseases: Risk Factors and Prevention".

   - We invited to join the workshops of CPR to the Local Police, National Police, Fire Brigade, Civil Guard and students of Secondary Education of each one of the towns of Campo de Gibraltar.

   - A great tent of 1000 m2 were installed, we called "Tent of the Heart", in a strategic place of the city of Algeciras ("Llano Amarillo", located near the Seaport) that could be visited for free by all the public who wished it. In this tent they had the following stands and the following activities:

   Cardiovascular Risks Assessment Stand: We elaborated a big poster to be enquiry by the visitors, titled "How to take correctly the Blood Pressure" and 1 leaflet was made to be distributed between the assistants with this title: "Eight points to have a healthy heart".

   This stand was divided in four areas as well: 1 area dedicated to the measurement of blood pressure, in which 5 points were arranged to do it; 1 area for the determination of the capillary glucose and capillary cholesterol with four points to do it, 1 area for the determination of the anthropometrics index with 3 points to measure it and also to height them and 3 points to measure tricipital cutaneous fold; and 1 area to calculate the cardiovascular risk with 6 points for computer data collection in a special software. The calculation would be made in this way, beside the data collection in the previous areas a questionnaire were performed to he volunteer people, and a calculator that we would process with the software Microsoft Excel 2000. This calculator, once introduced all the data, would provide five levels of cardiovascular risk: minimum, light, moderate, high and elevated. The result it would be given with a series of recommendations to the volunteers depending on which risk status.

   Pacemaker Stands: 1 informative leatlet for pacemaker carriers was made; a big screen was settle to project a video film continuously showing the implantation of pacemakers; and 25 units were obtained, out of service already, to allow the visitors to manipulate them. In the same stand the Andalusian Cardiac Transplant Association, this association was constituted in our region few time ago and its aims were to be known, to provide information and to encourage people to join them.

   Women and Cardiovascular Diseases Stand: We prepared for it a public exhibition of 2 big posters: titled "Pregnant Women and Heart" and the other one was "Menopause and Heart". 2 leaflet "Menopause and Cardiovascular Health" and How to avoid Cardiovascular Problems in the Pregnancy" were made to be distributed; and a survey focus on the female population with menopause was elaborated and offer to volunteer women.

   Cardiovascular Healthy Diets Stand: 2 big posters were made, titled: "Nutritional Pyramid" and "Advices about Cardiovascular Diet", and 2 leaflets to be distributed, titled: "Advices about Cardiovascular Diet" and " Weekly Menus with Healthy Cardiovascular Recipes" ; and a survey was designed to know about the food taken the day before. We asked for the unselfish collaboration to different commercial companies to offer in the own tent, healthy cardiovascular breakfasts for free with bread olive oil, milk with calcium added and juices; and a restaurant from the area, was offered to prepare healthy cardiovascular meals for its daily tasting, for free as well, following our ingredients list.

   Stress and Cardiovascular Disease: We made 4 big poster: "Physiological Aspects of Stress", "Stress in Childhood", "Advices to reduce the Stress" "Optimism / Pessimism"; 2 leaflets, titled "The effects of Stress on Cardiovascular System" and "Relax Techniques" to be distributed; and a survey was elaborated to identify the personality pattern A.
In this stand also a space was enable to perform relaxing massages (unselfish collaboration of a Massage Center of the area); another space to perform Biofeedback Tests (computer software), and another one for the location of an armchair to listening tapes of progressive relaxation and Jacobson's respiratory techniques.

   Tobacco and Cardiovascular Diseases Stand: A survey was made to identify the type of smoker and information was provided to reduce the damage caused by the addiction to tobacco. In order to measure the dependency level the test of Fargerström was used. To all those people with predisposition to leave the tobacco addiction information about where they can find support to give up smoking was offered.

   Fitness and Sports Stand: We made a big poster, titled: "Recommendable Sports for Cardiovascular health" and 2 leaflets were made to be distribute, titled: "Fitness in Elderly People" and "Benefits of Sport Practise in your Cardiovascular Health". A big space was arranged in which a gymnasium for use of the visitors was settled. In this space gymnastics machines were placed, such a static bicycles, walking tapes, machines of handle, climbers, etc. and every afternoon the public could join aerobic sessions, spinning and Tai Chi Chuan.

   Cardiovascular Diseases and Internet Resources Stand: A big poster was made, titled: "Internet Links related with Cardiovascular Diseases"; 3 more posters with Cardiovascular Healthy Advices (comic style), taken from the websites of The Spanish Hearth Foundation, The American Lung Institute and Brazilian Cardiology Society. 2 leaflets were made, titled: "Links of interest about Cardiovascular Diseases" and "Child games", to be distribute; and a big TV screen was installed to show continuously web pages related to hearth and cardiovascular diseases.

   CPR Stand: A poster was made, titled: "How to act in a cardiac arrest"; and an informative leaflets on the same topic was made as well; also a video was projected continuously showing the CPR; and every day practices of CPR were perform (3 times in the morning and 3 times in the afternoon)

   Conference Hall: Installed inside the tent, it was organize, a round-table about Cardiovascular Diseases and Its Prevention" and three conferences: "Cardiovascular Healthy Diet", "Effects of the tobacco in health" and "Tai Chi Chuan".

   The total number of participants in the work groups was:
214; witch 31 were teachers, 30 were professionals and 153 were students of Health Sciences School. During the days 7, 8 and 9 of May, 2001 were made the following activities: Mass media performance to spread measures of prevention of cardiovascular diseases: 4 in television (Los Barrios TV, Algeciras Wave TV, TV Field of Gibraltar and Canal Sur TV), 2 in radio dials (Ser Radio Station and COPE Campo ed Gibraltar Radio Station) and several official notices and information about the subject in 2 newspapers of the zone daily (Europe Sur and Area Campo de Gibraltar).

    Letters with healthy cardiovascular life styles that were sent to the parents of Primary School children's: 10.000 Conferences in Institutes of Secondary School: 5 for a total of 500 students.

    Workshops about CPR: 16 for a total of 800 people (Students, Police and Firemen).
   "The Hearth Tent" was open to the public during the days 10, 11 and 12 of May, between 9:00 am and 9:00 pm, and the next results were obtain:
Total number of visitors: 4.721 (100%)
Total number of stand: 12 (4 of them cardiovascular risk assessment) plus 1 conference hall.
Total number of poster exposed to the public: 15
Total number of leaflets: 13; distributed between the public: 65.000 (5,000 copies published of each one of them).
Number of volunteer people that were asses for the cardiovascular risk: 2.541 (53,82%)
Surveys performed to menopause female population: 310 (6,56%)
Number of people asked about what they ate the day before: 425 (9,8 %)
Number of people assessed for identification of the A personality pattern: 1.232 (26,09%)
Fargerström's Tests performed to measure the dependency to tobacco: 225 (4,76%)

   Collected data of these surveys and questionnaires for the calculation of the cardiovascular risk are being studied at the present time.
Practises of CPR : 18 (6 per day)

   To emphasize the great welcome that the "La Semana del Corazon" had on the population and the interest waked up in academic institutions, police and health ones, without their help help this event had not been possible.

   Hugue activities such as this one lead us to the following conclusion once again, and that is, the human being must be contemplated from two sides of the health: on one side, it is the main object; and on the other side, it must be the main actor of this one. Therefore, a well informed population and an important and active participation are the most important thing to improve the community health and the prevention of the cardiovascular diseases.
Once organized, analysed and validated the data collected in the event, we will be able to identify and to quantify the factors that straight can affect the appearance of the cardiovascular disease in the Campo de Gibraltar population; this will allow us to establish new intervention activities to diminish morbi-mortality in our population.




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2nd Virtual Congress of Cardiology

Dr. Florencio Garófalo
Steering Committee
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Scientific Committee
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Technical Committee - CETIFAC

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