Home-based Settings

Home-based interventions attempt to involve the entire family in efforts to prevent and rehabilitate heart disease and stroke. For example, through interactions between children and parents or guardians, families can help to provide meals and snacks that include nutritious foods, they can go for walks or bike rides as a family, they can discourage tobacco use, or they can all participate in the monitoring of blood pressure or cholesterol levels and medication taking (e.g., including charts on the refrigerator). Likewise, the family is a useful source of social support for heart disease and stroke prevention or maintenance behaviors (e.g., social acceptance, reinforcing healthy lifestyles).

Home-based interventions are most effective when linked to interventions in other settings:

  • Community-based settings (e.g., encourage individuals or families to advocate or vote for legislation to increase access to health services and resources)
  • School-based settings (e.g., educate parents on how to support their children by increasing their self-confidence in their ability to prevent heart disease and stroke)
  • Worksite-based settings (e.g., provide flex-time policies at work so that people have time to spend with their families offering education and support)
  • Health care facility-based settings (e.g., encourage trained health care providers to counsel individuals on how to prevent or manage heart disease and stroke)
  • Faith-based settings (e.g., increase outreach to families in the faith-based community and improve access to information about heart disease and stroke through lay health educators)

Previous work in home-based settings has found:

  • Given the evidence for the efficacy of home-based interventions in improving parenting skills of lower income parents of preschool children, a home-based heart disease and stroke intervention may be the most developmentally appropriate of delivering health education to lower income, inner-city families.
  • Responsibility for day-to-day heart attack and stroke rehabilitation rests with the caregivers. Previous studies suggest that providing education and support to caregivers can improve quality of life for both the caregiver and the patient.
  • Lack of transportation, schedule conflicts and busy parental lifestyles can be reasons that may limit participation in community-based health interventions. Home-based interventions that can be modified to meet the needs of individual families may help overcome many of these barriers.
  • Intervention strategies in home-based settings often emphasize emotional support (e.g., encouragement for dealing with the psychosocial challenges) alone or in addition to other forms of support (e.g., tangible assistance with transportation, role modeling appropriate behaviors), including parent/family participation in activities together (e.g., homework assignments, special classes for caregivers while patients are in the hospital, support groups for parents).
  • Interventions delivered to individuals in their homes can provide effective heart disease and stroke management and education and may be more cost effective than other strategies.
  • Home-based interventions are particularly pertinent to community members who are unable to access heart disease and stroke education classes offered in the community (e.g., individuals with physical or mental disabilities, limited mobility, no access to transportation).
  • The Internet is becoming an increasingly popular information vehicle for the home-based settings, particularly for those living in rural areas with limited reach and availability of interventions as well as those who are homebound. While the Internet can provide access to heart disease and stroke information, risk factors and recommendations, some individuals may not have access to computers or internet in their homes.

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