December is our traditional time for taking stock of the year about to end; reflecting on what was, what is, and what might have been; and resolving where we might make changes to improve certain aspects of our life. Pondering over any year of our life conjures up a mixture of numerous events and circumstances—some of which we have little or no control over and others fully amenable to our influence. One of the ways that acute, progressive, and critical care nurses and the millions patients they will care for in 2011 and beyond can ensure they are living a healthier life is by investing a few minutes to complete a life check.
Earlier this year, the American Heart Association (AHA) released its national goals for the American public over the next decade: to improve cardiovascular health by 20% while simultaneously diminishing mortality from cardiovascular disorders and stroke by 20%.1 In conjunction with this announcement, AHA also launched an online resource called My Life Check to assist Americans in their individual efforts to improve their cardiovascular health.
Ideal Cardiovascular Health
My Life Check is an assessment tool derived from the AHA Goals and Metrics Committee of the Strategic Planning Task Force’s critical analysis of accumulated research related to the many factors known to influence cardiovascular status. Among these, 2 categories of variables were found to exert the greatest influence on cardiovascular health: health behaviors and health factors. The health behaviors most affecting cardiovascular health related to the following familiar quartet of risk factors2 :
Smoking
Diet
Physical activity
Weight
Likewise, the health factors found to have the greatest influence included another familiar trio2 :
Blood glucose
Blood pressure
Cholesterol
Taken together, these 7 parameters, which the AHA refers to as Life’s Simple 7, represent the evidence-based, core metrics for determining ideal cardiovascular health.2 The committee used these 7 factors to provide specific measurable definitions of ideal cardiovascular health for both adults (Table 1) and children (Table 2).
My Life Check
With these optimal targets defined, the AHA workgroup developed the My Life Check 3 tool to empower all Americans with the ability to
measure their current cardiovascular health in all metric areas;
use their own health data on these parameters to affirm where they are doing well, note where some improvements could be made, and highlight factors that warrant our immediate modification;
design individually tailored action plans based on their own personal health indicators to improve their health;
track and document their health data on each of those factors on an ongoing basis to monitor their status and progress; and
record their commitment to persist in this endeavor.
The My Life Check Web site (www.heart.org/MyLifeCheck) is a user-friendly site that explains the purpose of this assessment tool and facilitates completion of the appraisal. One family-friendly attribute of this tool is that parents can complete assessments for their children or assist other family members in completing it. One of the more adult education–oriented aspects of the site is its enumeration of all data points necessary to fully complete the assessment. Although many of the questions (Table 3) can be readily answered by any adult and virtually all can be answered by any critical care nurse, other inquiries that the user may not anticipate (eg, their approximate daily sodium intake, total cholesterol, or fasting blood glucose level) may require a layperson to contact their nurse, physician, or other health care provider before they can respond. If one or more questions were not completed, results will still be provided with the missing information indicated and a reminder to obtain it for complete results.
Another noteworthy aspect of this site is the attractive, informative, and customized graphics it employs to display results of the Life Check assessment. Completion of all questions generates a 4-page Summary Report, consisting of colorful and effectively formatted outputs that offer answers, feedback, and guidance on achieving and maintaining optimal heart health. The Summary Report includes a Life’s Simple 7 document, an overall heart score, and additional detailed information that extends and reinforces the importance of each factor. The Life’s Simple 7 portion of the report displays a table that lists each metric, explains where the user’s answers indicate they are now relative to each factor, allows users to select among 5 possible next steps they might take to maintain or improve their current status on each factor, and identifies the target goal the user is aiming to achieve for each metric.
The next page displays the user’s calculated “Heart Score” as well as an overall interpretation of that score. The Heart Score is described as an estimate of the user’s heart health on a scale from 1 to 10, where 10 represents the ideal value—that is, having the greatest potential for both a heart-healthy life and the least risk of experiencing heart disease or stroke.3 On a practice run with the program, my heart score of 7.8 generated an overall interpretation stating: “You’re doing well, but consider all the aspects of your behaviors that lead to good health. Make adjustments to strengthen your position.” In addition to the numerical score, this dashboard graphic locates elements from the Where You Are Now portion of the Summary Report in a circle around the score, reminding users of how each of those 7 findings contributes to their overall score.
Following the Heart Score, the next few pages summarize the relevance of each factor, highlight strategies that can improve one’s status for that factor, and sprinkle a bit of background instruction to enlighten and support users as they endeavor to meet their goals.
Supplementary Learning Resources
In addition to these gifts, critical care nurses will also appreciate 2 instructional resources available free at www.heart.org/MyLifeCheck4 :
Lunch & Learn: A 14-slide PowerPoint presentation that nurses may use to teach patients, families, or the general public about the AHA’s recommended guide to healthy living titled “Living Better With Life’s Simple 7.” Each slide includes a scripted narration that reviews the scientific evidence pertaining to the relevance of each factor for cardiovascular health and enumerating specific courses of action that can be employed to advance toward the target goal for that factor.
Patient education materials: A series of brochures that highlights and reinforces important information related to each of the 7 factors, which may be distributed to patients, families, or the lay public.
The AHA strongly encourages health care professionals to assist in dissemination of notice about this program, its availability, and its inclusions via traditional, online, and social networks by providing links to free public service announcement flyers, posters, brochures, Web postings, wallet cards, and links to social media sites.
As you prepare for the new year, make a resolution to take good care of yourself, for your sake as well as that of your family. And to the greatest extent possible in your busy worklife, resolve to empower your patients and their family members to learn and embody the 7 secrets to lifelong cardiovascular health so they may share in those benefits. Our very best wishes to you and your family for an enjoyable holiday season with good health and much success in the year ahead.