• Promoting• Anger Management• Stress Management• Self Concept

FUNDED BY NATIONAL INSTITUTE OF NURSING RESEARCH, R01 NR007910

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Marti Rice, PhD, RN, Principal Investigator Michael Weaver, PhD, RN, FAAN, Co-Investigator

Duck-Hee Kang, PhD, RN, FAAN, Co-Investigator

University of Alabama at Birmingham School of Nursing

Carol Howell, PhD, RN, Co-Principal Investigator

Georgia State UniversitySchool of Nursing

Rand Payton, Physical Education Interventionist

Michelle Nault, Cognitive/Behavioral Interventionist

David White, Research Assistant

Kristi Taylor, Research Assistant

University of Alabama at Birmingham School of Nursing

Findings From PASS Study

• Over 500 4th grade children enrolled

– Over 22% of the children had elevated blood pressure readings at or above the 90th percentile for age, height, and gender

– Elevated readings do not mean the children had hypertension or high blood pressure.

• Purpose: To prevent high blood pressure in children

• What is blood pressure?– Blood pressure is the force or pressure in the

arteries when the heart beats (systolic pressure – the top number) and when the heart is at rest (when heart is filling with blood –diastolic pressure – the bottom number)

R. atriumL. atrium

R. ventricleL. ventricle

Semilunar valves open

Atrioventricular valves open

SystoleSystole

L. ventricle

R. ventricle

R. atrium

L. atrium

Semilunar valves closed

Atrioventricular valves closed

DiastoleDiastole

Circulatory SystemCirculatory System

Arterial BlockageArterial Blockage

• Blood pressure readings in children depend on the age, gender, and height of the child. – Older children would have higher readings up

to a point. – Taller children would be expected to have

higher blood pressure readings up to a point.– Boys would have slightly higher pressures

than girls.

• Blood pressure readings for most boys and girls at age 9 should be less than 115/74 mm. Hg

• Blood pressure readings for most boys and girls at age 10 should be less than 117/75 mm. Hg.

• What is high blood pressure?– High blood pressure, or hypertension, is

elevated blood pressure readings that continue over a period of time.

– Defined as blood pressure that is, on 3 different visits to health care provider, measured at or higher than the 95th percentile for age, sex, and height.

– Less than 120/80 (prehypertension for adults)

– Prehypertension is defined similarly at 3 or more visits, as average blood pressure at or higher than the 90th percentile for age, gender and height, or more than 120/80 mm Hg but less than the 95th percentile.

– For 9 year-old girl at 75 percentile for height:> 114/74

– For 9 year-old boy at 75 percentile for height:> 117/76

• What factors increase a child’s risk of developing high blood pressure?– Family history– Unhealthy eating habits– Increased weight– Lack of physical activity– Too much sedentary activity– Smoking or being around people who smoke– Stress

– Anger and other emotions– Drugs: street drugs, methamphetamines, and

some prescribed drugs

• Methods of prevention– Exercise– Diet– Stress Management/Anger Management– Annual Healthcare Evaluations

Physical Activity

• What did Plato know over 2000 years ago?

– “Lack of activity destroys the good condition of every human being while movement and methodical physical exercise save it and preserve it.”

• Why is physical activity so important?– Regular physical activity, whether in the form of

an exercise program or just part of daily living routines, helps create, improve, and sustain healthy living. This is a controllable part of your health and wellness. In fact it is the single most important aspect of living a healthy life free of controllable diseases.

• How much exercise is needed each day for your children? – 60-90 minutes a day

– Only getting about 20 minutes a day at school during PE

and no Recess anymore • How much exercise is needed each day for

adults? – 30-60 minutes a day (Take a walk at lunch, take the

stairs instead of elevator, park a long way away from your office door, it does not have to be done all at one time)

• What is Sedentary Behavior? – Webster’s dictionary defines Sedentary Behavior as doing

or requiring much sitting; not physically active.– This is what you and your children are doing for most of

the day at school and work. – Doctors from the Obesity Prevention Initiative suggest

that children and adults participate in less than 2 hours of screen time a day, this includes: T.V., video games, and computer time.

– Set a good example for your children when you get home and suggest something active for the family.

– MAKE TIME!!! (this is the biggest excuse)

• Some suggestions for getting active: – Riding bikes, Jumping Rope, Swimming,

Jogging, Walking the Dog, Doing Yard Work or Housework, Sports Activities.

– Remember, these activities don’t have to be performed alone.

– Challenge your entire family to have fun and get fit.

Nutrition

• Why is Nutrition so important?

– You Are What You Eat!

– Food is the fuel that determines how we grow, how we age, and how we perform day to day.

– Our diets must be balanced so that our bodies stay balanced.

• What is a balanced diet?– A balanced diet is composed of foods from each of the

five food groups

Food Group Representative Foods Daily Servings

Grains Cereals, Breads, Rice, Pasta, Oatmeal (1/2 of these should be whole wheat)

6 oz. Every day. 1 slice of bread = 1 oz.

Vegetables Broccoli, Spinach, Carrots, Bell Peppers, Sweet Potatoes

2 ½ cups everyday.

Fruits Bananas, Raisins, Apples, Grapes, Peaches, Pears, 100% Fruit Juice

1 ½ cups everyday.

Dairy Yogurt, Milk, Cheese (Make these low-fat selections)

3 cups everyday.

Meat & Beans Chicken, Beef, Turkey, Fish, Nuts, Seeds, Peas, Beans (try to avoid fried foods)

5 oz. Everyday.

½ the size of your hand

Stress Management

• What is stress?– Stress is the body's reaction to any change that

requires an adjustment or response. The body reacts to these changes with physical, mental, and emotional responses.

– Stress is a normal part of life. Many events that happen to you and around you -- and many things that you do yourself -- put stress on your body. You can experience stress from your environment, your body, and your thoughts.

• In other words:

  “Stress is the trash of modern life- we all generate it but if you don’t dispose of it properly, it will pile up and overtake your life.” - Danzae Pace

• How does stress affect the human body? – The human body is designed to experience stress and

react to it. – Stress can be positive, keeping us alert and ready to

avoid danger. – Stress becomes negative when a person faces

continuous challenges without relief or relaxation between challenges. As a result, the person becomes overworked, and stress-related tension builds.

– Stress that continues without relief can lead to a condition called distress -- a negative stress reaction.

– Research suggests that stress can also bring on or worsen certain symptoms or diseases.

– Stress also becomes harmful when people use alcohol, tobacco, or drugs to try to relieve their stress.

– Unfortunately, instead of relieving the stress and returning the body to a relaxed state, these substances tend to keep the body in a stressed state and cause more problems.

• How can stress be managed?– Keep a positive attitude. – Accept that there are events that you cannot control. – Be assertive instead of aggressive. "Assert" your

feelings, opinions, or beliefs instead of becoming angry, defensive, or passive.

– Learn and practice relaxation techniques. – Exercise regularly. Your body can fight stress better

when it is fit. – Eat healthy, well-balanced meals. – Get enough rest and sleep. Your body needs time to

recover from stressful events. – Don't rely on alcohol or drugs to reduce stress. – Seek out social support. – Learn to manage your time more effectively.

Blood Pressure Monitoring Available Today Following the PASS By High Blood Pressure

Presentation