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A Massachusetts General Hospital awareness and prevention program aims to improve the cardiovascular health of women in Boston’s low-income neighborhoods.

Creating HAPPY hearts in Chelsea and Revere

17/Feb/2009

When Lennie Lyons first joined Mass General’s HAPPY Heart program last winter, she immediately knew they meant business.

“They tested everything,” says Lyons, who was the program’s first participant. “They did lots of blood work and had me do some exercise tests. It was very thorough; I’ve never had such a complete work-up.”

The tests Lyons underwent will serve as a benchmark for her progress during the two-year Heart Awareness and Primary Prevention in Your Neighborhood (HAPPY) Heart program. Launched in early 2008 in conjunction with MGH Community Health Associates’ Wellness Center, HAPPY Heart aims to improve the cardiovascular health of women in Boston’s low-income neighborhoods.

“I saw a flier in the Revere HealthCare Center about the Wellness Center and the HAPPY Heart program,” says Lyons, a former social worker who has suffered from severe arthritis in recent years. “I knew I was not as active as I used to be and was getting into a rut because of my condition. I decided I needed to get involved in improving my own health.”

Barriers to good health

Malissa Wood, MD, codirector of the Corrigan Women’s Heart Health Program at the Mass General Heart Center, established the HAPPY Heart program with the hope that the corresponding study will find an effective approach to preventing cardiovascular disease for low-income women. Wood’s approach includes screenings and aggressive primary prevention techniques, such as exercise, smoking cessation and stress reduction. She also believes the results will help doctors better understand how heart functions change with education.

“Many of the traditional cardiovascular risk factors, including obesity, hypertension, smoking and diabetes, tend to be more prevalent among low-income women,” says Wood. “We hope this program will provide these women the knowledge and tools to address their individual risk factors.”

Women between the ages of 40 to 60 who had two or more risk factors for cardiovascular disease and had household incomes no greater than 200 percent below the poverty level were eligible to register. Once enrolled, participants underwent various screening procedures and were introduced to a team of experts – including a health coach, cardiologist, nutritionist and physical therapist – to guide them through the two-year program.

“There are so many barriers in the lives of low-income women that can impede their success in improving their health,” says Wood. “One of the unique features of HAPPY Heart is the individual approach. By pairing the women with a health coach and exposing them to a variety of options we will hopefully increase the likelihood of long-term lifestyle changes and success.

As a HAPPY Heart health coach, Donna Slicis, RN, ANP-BC, offers the participants a motivational force and an ear to vent their frustrations. “When I meet with the women, I always consider how I can help make an impact on their life with the resources I have at my disposal,” she says.

Shaping HAPPY hearts

Slicis says her first priority is always to help the women quit smoking. She talks to them about the strategies to quit and supports them through the process. A nutritionist teaches them how to avoid cravings that can lead to weight gain when quitting. Sessions on proper nutrition have also been helpful to debunk the misconceptions some of the women held.

HAPPY Heart also emphasizes mental health by teaching women about the impact of stress hormones on cardiovascular health. “These women come to me with stories about working multiple jobs, their cars breaking down, their kids getting arrested. Their stories are just unbelievable, so to get them to just sit and just breathe can be powerful,” says Slicis. “I’ll take their blood pressure before and after a relaxation exercise to show them that there can be a significant change.”

To get the women moving, HAPPY Heart offers yoga, tai chi and Latin dancing classes through the Wellness Center. Participants also received an exercise tape and resistance bands to help them at home.

“I started walking two mornings a week with my life coach [Slicis] until it got too cold and icy to walk outside. I am looking forward to picking that up again this spring,” says Lyons.

At the end of HAPPY Heart’s first year, the women will undergo another series of tests to chart their progress. So far, Slicis is encouraged by the improvements she has seen among the participants.

“I have seen improvements in their self-appearance. They are coming in with new hairstyles and make-up. The program is instilling a belief that they deserve better – to look better, to move better and to interact better,” says Slicis. “When the program is over, I hope these women will continue to see the value of self care in their lives and be empowered to find their own way.”

For Lyons, HAPPY Hearts has already achieved that goal. “HAPPY Heart has been such a learning experience, and I feel like I am taking away so much from it,” says Lyons. “I feel better. I’m more active. I’ve got places to go and people to see. I’m so thankful. This has been a blessing.”

patient

A tour of the Corrigan Minehan Heart Center

The Corrigan Minehan Heart Center is a multidisciplinary care center made up of specialists from cardiology, cardiac surgery, cardiac imaging, cardiac anesthesia and cardiac nursing.