Instructional Design Project:Instructional Design Project:Whole Grains & Whole Grains &

Cardiovascular DiseaseCardiovascular Disease

By: Christine Rymsha, RD, LDNBy: Christine Rymsha, RD, LDN

Who, What, Where?Who, What, Where? Topic: Whole GrainsTopic: Whole Grains

Audience: Patients with Audience: Patients with cardiovascular disease cardiovascular disease (CVD)(CVD)

Location: Location: Marlborough HospitalMarlborough Hospital

Educator: Registered Educator: Registered DietitianDietitian

AudienceAudience

Age: 65+Age: 65+

Most live in Marlborough or surrounding Most live in Marlborough or surrounding towns or citiestowns or cities

Mostly maleMostly male

Large Portuguese populationLarge Portuguese population

Marlborough HospitalMarlborough Hospital

Community hospitalCommunity hospital Part of the Umass Memorial Health Care systemPart of the Umass Memorial Health Care system Opened in 1890Opened in 1890 79 bed facility 79 bed facility Admits 3,800 people annuallyAdmits 3,800 people annually Mission: “to improve the health of the individuals and Mission: “to improve the health of the individuals and

the community we serve as an integral part of the the community we serve as an integral part of the UMass Memorial Health Care system”UMass Memorial Health Care system”

Why?Why?

According to the According to the American Heart American Heart Association (AHA), Association (AHA), cardiovascular disease cardiovascular disease (CVD) is the leading (CVD) is the leading cause of death in males cause of death in males and females (Heart and females (Heart Disease and Stroke Disease and Stroke Statistics, 2008). Statistics, 2008).

(Heart Facts 2007: All Americans)

Why?Why?

The prevalence The prevalence of CVD is 1 in of CVD is 1 in 3 Americans 3 Americans which which increases with increases with ageage

2400 people 2400 people deaths each deaths each dayday

(Heart Disease and Stroke Statistics, 2008)

What?What? Whole grains have been shown to significantly decrease Whole grains have been shown to significantly decrease

cholesterol levels (Mozaffarian et al, 2003; Behall, cholesterol levels (Mozaffarian et al, 2003; Behall, Scholfield, & Hallfrisch, 2004) Scholfield, & Hallfrisch, 2004)

Based on the new food pyramid by the Center for Based on the new food pyramid by the Center for Nutrition Policy and Promotion, at least three servings of Nutrition Policy and Promotion, at least three servings of whole grains are recommended daily for a healthy diet (whole grains are recommended daily for a healthy diet (http://mypyramid.govhttp://mypyramid.gov))

How many servings of whole grains does the average How many servings of whole grains does the average American consume daily? (Heart Disease and Stroke American consume daily? (Heart Disease and Stroke Statistics, 2008)Statistics, 2008)

Less than 1

How?How?

Health Belief ModelHealth Belief Model

Target Behavior: Whole grain intakeTarget Behavior: Whole grain intake

Verbal teaching, hands-on activities, and handouts Verbal teaching, hands-on activities, and handouts with large fontwith large font

One-on-one teachingOne-on-one teaching Mobility issuesMobility issues PrecautionsPrecautions

Goals & ObjectivesGoals & Objectives

Instructional GoalInstructional Goal To improve heart health To improve heart health

in patients with in patients with cardiovascular disease at cardiovascular disease at Marlborough HospitalMarlborough Hospital

Educational ObjectiveEducational Objective Patients will increase Patients will increase

their intake of whole their intake of whole grainsgrains

Educational StrategyEducational Strategy

Part 1: What is a whole grain?Part 1: What is a whole grain? Motivational PhaseMotivational Phase

Patient will be able to Patient will be able to definedefine whole grainwhole grain

Patient will be able to identify why whole grains are Patient will be able to identify why whole grains are heart healthyheart healthy

Patient will be able to identify the health benefits of Patient will be able to identify the health benefits of whole grainswhole grains

Educational StrategyEducational Strategy

Part 2: How does your intake compare to the Part 2: How does your intake compare to the recommendations?recommendations?

Motivational PhaseMotivational Phase Patient will be able to recall how many whole grains Patient will be able to recall how many whole grains

are recommended per dayare recommended per day

Patient will be able to identify the whole grains s/he Patient will be able to identify the whole grains s/he eatseats

Patient will be able to analyze how many whole grains Patient will be able to analyze how many whole grains s/he consumes dailys/he consumes daily