Barbara Ann Graves

EBP Design and Translation: Teaching How to Begin a Scholarly Practice Project

This column shares the best evidence-based strategies and innovative ideas on how to facilitate the learning and implementation of EBP principles and processes by clinicians as well as nursing and interprofessional students. Guidelines for submission are available at https://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1741-6787.

Heart Health and Children

Abstract The problem of the early development of cardiovascular disease (CVD) risk factors is negatively affecting the nations health and placing a tremendous burden on the economy. Early identification and reduction of risk for CVD in children and adolescents has the potential to reduce the burden of adult cardiovascular disease. Improvements in the current status of health among US children in the areas of tobacco smoke exposure, diet, physical activity levels, serum lipid and blood sugar levels, and blood pressure have the potential to decrease the future proportion of American adults affected by CVD. By identifying cardiovascular risk factors early in life, primary health-care providers have opportunity to educate parents about lifestyle choices that promote heart health. The objective of this review is to provide current evidence and best practices for the identification of children at risk for the development of CVD. Updated information regarding lifestyle changes, parental roles, and prevention strategies for heart health is provided. The review concludes the importance of optimizing long-term heart health beginning in childhood by limiting exposure to tobacco smoke, improving diet and exercise habits, improving child weight, and monitoring child blood pressure, cholesterol, and glucose levels. Activities that prevent (primordial prevention) or reduce (primary prevention) the development of modifiable CVD risk factors, are centered in the family unit, and the primary care providers that identify and treat them (secondary prevention). Families, health-care systems, and community all have significant roles to play in CVD prevention and risk reduction in children.

Motivating parents to promote cardiovascular health in children.

Background:Identifying risk factors for cardiovascular disease (CVD) early in life gives advanced practice nurses an opportunity to educate parents about choices that promote long-term heart health. The addition of universal lipid screening to 9- to 11-year-old well-child examinations opens a time interval that is adequate for conversations related to cardiovascular health. Objective:The objective of this study was to determine if the use of a 10-minute health promotion plan that includes identification of child modifiable CVD risk factors would have an effect on parental intent to engage in lifestyle changes that promote heart health in 9- to 11-year-old children. Methods:The quasi-experimental pilot study involved 26 English-speaking parents of 9- to 11-year-old children during routine well-child examinations. Participants completed questionnaires before and after receiving a health promotion plan and the child’s modifiable CVD risk screening results. The advanced practice nurse-researcher analyzed the questionnaires to evaluate parental intent to promote lifestyle changes. Results:Increases were seen in concern for the child’s future heart health and in awareness of diet and exercise recommendations. Participants were likely to encourage more fruits and vegetables (100%), limit “screen time” (96%), encourage physical activity (92%), and limit sugar-sweetened beverage intake (96%). Factors identified as most influential on participant decision to encourage change were the child’s body mass index (38.46%), lipid screening results (23.08%), and “other”–tobacco smoke exposure (15.38%), which closely approximate national prevalence for each risk category. Conclusions:The American Academy of Pediatrics recommends lipid screening once for all children between 9 and 11 years of age. In this study, outlining recommendations for good health and identifying modifiable CVD risk factors showed a positive effect on parental intent to encourage lifestyle changes. Further research is needed to advance the science of CVD prevention and risk reduction in children.