Frequently Asked Questions
1. What is the Healthy Heart Schools Program?
2. What happens in the Healthy Heart Schools Program?
3. If I have a question about a referral that was sent to my office who do I contact?
4. What are the referral criteria you use?
5. What are the target results?
6. How accurate is a non-fasting cholesterol test?
7. Does Heart Niagara do follow up on the students identified with risk factors?
8. Can I download a copy of the questionnaire?
9. How many students are involved each year?
10. How many participants are involved in your research?
11. Is all information kept confidential?
12. Do you have any publications?
13. What is the data used for?
14. Are there pediatric CV risk assessment and treatment guidelines?
1. What is the Healthy Heart Schools Program?
For almost 25 years Heart Niagara and our partners have provided a curriculum enrichment program to help students and their families to better understand possible risk factors for future heart disease. The four main areas of interest in the program are education, health promotion and health care, and, research.
High School Education
The Program includes teacher lead classroom education on the heart and heart healthy lifestyle choices, and, a personal assessment of fitness. Teachers are supported to provide bystander CPR training and AED education in grade seven and nine.
Health Promotion and Health Care
Grade five and nine students review their current lifestyle choices and assessment results with a nurse and/or nurse practitioner one on one, and receive targeted health counseling specific to their risk factor result(s). With this kind of assessment there are students who present with one or more major cardiovascular risk factors, e.g., high blood pressure, high cholesterol, high weight/waist circumference measurements, who are referred to their family physician or nurse practitioner for further assessment and advice.
Research
Heart Niagara research is nationally important because the population sample size in Niagara is large enough to be representative of all Canadian adolescents. The research team consists of a clinical research program assistant, epidemiologist, executive director, family doctor, kinesiologist, pediatric cardiologist, pediatric nurse practitioner, primary care nurse practitioner, registered dietitian, and a registered nurse.
2. What happens in the Healthy Heart Schools Program?
Grade 5
There is 1 class for the Healthy Heart Schools Program. On the Assessment Day students learn about cholesterol, blood pressure and body measurement tests. There is also a healthy lifestyle questionnaire and consent that teachers give the student to take home to fill in with their parent before they can participate. The student receives a take home sheet with all the results.
Grade 7
There is 1 class for the Healthy Heart Schools Program. On the CPR/AED day the student learns about saving lives. There is also a healthy lifestyle questionnaire and consent that teachers give the student to take home to fill in with their parent before they can participate.
Grade 9
There are 2 classes for the Healthy Heart Schools Program. On the CPR/AED Day the student learns about saving lives and on the Assessment Day the student learns about cholesterol, blood pressure and body measurement tests. There is also a healthy lifestyle questionnaire and consent that teachers give the student to take home to fill in with their parent before they can participate. Students will receive a CPR certificate and take home sheet with all their individualized results.
Before Heart Niagara comes to the school the teacher may have already had classes on the heart, heart disease and not smoking. We do not test for blood sugar and diabetes in this program.
3. If I have a question about a referral that was sent to my office who do I contact?
Please contact Heart Niagara at 905-358-5552 or email the Healthy Hearts Schools' Program Administrator, schools@heartniagara.com to discuss letters sent to family doctors and nurse practitioners.
4. What are the referral criteria you use?
Adiposity referrals
BMI: greater than 95th percentile plus Waist Circumference: male greater than/equal to 98cm; female greater than/equal to 82.9cm. (Both BMI and waist circumference must be above the cutoff limits to generate a referral.)
Cholesterol referrals
HDL/non-HDL ratio: less than 0.22
Blood Pressure referrals
Systolic Blood Pressure: greater than 95th percentile
Family History referrals
Family History: positive history of cardiovascular disease for mother and/or father less than 60 years old
5. What are the target results?
Adiposity targets
BMI: less than 85th percentile
For BMI percentiles please see the CDC growth charts (http://www.cdc.gov/growthcharts/clinical_charts.htm) or click here to download the male and female CDC charts.
Waist Circumference: male less than the 92nd percentile; female less than the 72nd percentile. Click here for more detail on waist circumference measurements for 12 to 18 year olds.
Cholesterol (fasting) targets
Total Cholesterol: less than 5.2 mmol/L
LDL: less than 3.4 mmol/L
Triglycerides: less than 1.7 mmol/L
HDL: greater than 0.9 mmol/L
TC/HDL Ratio: less than 5.71
HDL/non-HDL ratio: greater than 0.22
Blood Pressure target
Systolic Blood Pressure: less than 90th percentile (NIH table)
6. How accurate is a non-fasting cholesterol test?
The cholesterols are assessed using the Cholestech LDX System (www.cholestech.com). Please click here for a technical bulletin regarding equipment accuracy and the slides from a presentation done at the 2011 National Obesity Summit.
7. Does Heart Niagara do follow up on the students identified with risk factors?
No, unless the student/family has no family health care provider. The nurse practitioner at Heart Niagara will see the student and family and also assist them in locating a family health care provider.
8. Can I download a copy of the questionnaire?
Please do:
Grade 5 questionnaire booklet
Grade 7 questionnaire booklet
Grade 9 questionnaire booklet
9. How many students are involved each year?
There are over 4,000 students involved in the Health Heart Schools' Program each year and approximately 10% (>400) are referred for follow up. Please see the 2010-11 summary report for a more complete breakdown in participation and referrals.
10. How many participants are involved in your research?
Each year, the Healthy Heart Schools' Program sees over 4,000 grade nine students (2010-11 summary report). To date, there are over 20,000 participants contributing data in this program.
11. Is all information kept confidential?
All information is handled in a confidential manner and is stored in a secure and private location. No information is shared with researchers unless we have a written agreement with them and ethics fundamentals are met.
12. What is the data used for?
Our primary research area is adolescent lifestyles and cardiovascular health. Due to the vast amount of information collected from a large population of adolescents, our data is useful in areas including heart disease, stroke, cancer, diabetes, high blood pressure, adiposity, smoking tobacco, high cholesterol and physical inactivity. There is a very good potential to do longitudinal research with multiple cohorts.
13. Do you have any publications?
Heart Niagara has many publications in journals, conference posters and conference oral presentations. Please have a look at our research publications timeline and publications reference list.
14. Are there peadiatric CV risk assessment and treatment guidelines?
Not yet. There are many recommendations but a comprehensive consensus guideline is not available to holistically assess, diagnose and treat pediatric CV risk. In 2008 Heart Niagara assembled a set of expert opinions and recommendations. This booklet will be updated when the American Heart Association publishes their Pediatric CV Risk Guidelines in December 2011.
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