REACH FAR Toolkit

In 2014, CSAAH was awarded a 3-year grant of $1,000,000 by the Centers for Disease Control and Prevention (CDC) to launch the REACH FAR program to prevent cardiovascular disease in Asian Americans living in the New York/New Jersey metropolitan area by increasing access to healthy foods and culturally tailored health coaching efforts to improve high blood pressure management. REACH FAR worked with an established multi-sector partnership coalition including community-based organizations, faith-based organizations, local businesses, health care professionals, health care institutions, and local and state governmental agencies to implement several key strategies: 1. Increasing access to healthy foods and drinks in faith-based organizations; 2. Increasing access to healthy foods and drinks in restaurants and grocery stores; 3. Increasing access to blood pressure screenings and coaching efforts in faith based and community settings; and 4. Increasing access to translated, culturally‐tailored health information disseminated through pharmacists and health care providers.

About REACH FAR

Project REACH FAR partnered with local community‐based organizations (CBOs), places of worship, local restaurants and grocery stores, clinical providers and pharmacists to fight high blood pressure (HBP) and cardiovascular disease in Asian American communities (Bangladeshi, Filipino, Korean, and Asian Indian) in New York and New Jersey. To find out more, click here: https://med.nyu.edu/departments-institutes/population-health/divisions-sections-centers/health-behavior/section-health-equity/research/research-tracks/cardiovascular-health-diabetes/completed-projects

Project Strategies:

1. Work with places of worship to serve healthier foods and drinks to their congregants
2. Work with local restaurants and grocery stores to offer healthier foods
3. Work with places of worship and CBOs to hold blood pressure screenings and help control HBP in their community
4. Work with local pharmacists and health providers like doctors and nurses to give out translated health information about blood pressure to patients and those who visit their offices.
5. Spread information about HBP and heart health to the community.

The REACH FAR coalition included the following community partner organizations:

• DREAM Coalition: https://med.nyu.edu/asian-health/research/dream/dream-about-us[MS1] 
• Kalusugan Coalition: http://www.kcforhealth.org/
• Korean Community Services of Metropolitan, NY Inc.: http://www.kcsny.org/en/
• UNITED SIKHS: www.unitedsikhs.org

Partners

REACH FAR was a multi-sector partnership coalition composed of the following key partners:

Asian & Pacific Islander American Health Forum
Asian & Pacific Islander American Health Forum influences policy, mobilizes communities, and strengthens programs and organizations to improve the health of Asian Americans, Native Hawaiians, and Pacific Islanders.

APartnership
APartnership is one of the leading Asian American advertising agencies in the country. APartnership helps marketers evaluate their assets, identifying those most relevant and compelling, and repurposing them to engage and win the Asian American consumer.

DREAM 
The DREAM Coalition consists of a diverse group of community based organizations, healthcare providers, and academic researchers. The goal of the Coalition is to develop, implement, and test a Community Health Worker program designed to improve diabetes control and diabetes-related health complications in the Bangladeshi community in New York City.

Kalusugan Coalition
The Kalusugan Coalition is a multidisciplinary collaboration dedicated to creating a unified voice to improve the health of the Filipino American community in the New York/New Jersey area.

Korean Community Services
KCS is a non-profit community service organization that serves low income immigrant individuals and families by helping them to address critical needs, solve complex problems, and adapt to a new cultural, economic, and social environment. 

NYC Department of Health and Mental Hygiene
The NYC DOHMH is one of the largest public health agencies in the world, serving 8 million New Yorkers from diverse ethnic, cultural and economic backgrounds. With over 200 years of leadership in the field, we’re also one of our nation’s oldest public health agencies.

UNITED SIKHS
UNITED SIKHS is an UN-affiliated, international non-profit, non-governmental, humanitarian relief, human development and advocacy organization, aimed at empowering those in need, especially disadvantaged and minority communities across the world.

REACH FAR Toolkit

High blood pressure is treatable and heart disease can be prevented!

Help your community prevent and control high blood pressure (HBP) by increasing options for healthy eating, physical activity; and encouraging community members to monitor their blood pressure whether done so at home or in clinical and community settings with trained healthcare professionals with appropriate devices.

Both toolkits below provide guidance and resources for individuals, community based organizations, places of worship, academic research centers and any other types of organizations interested in ways to prevent high blood pressure and cardiovascular disease, especially for those working with Asian Americans in community settings.

Health promotion materials are available in English and seven Asian languages: Bengali, Hindi, Nepali, Punjabi, Korean, Tagalog, Urdu.

REACH FAR Healthy Eating Toolkit

This toolkit outlines how REACH FAR community partners increased access to healthier foods and drinks in places of worship, ethnic grocery stores and restaurants.

The Healthy Eating Toolkit is divided into two sections:
(1) Healthy Eating in Places of Worship  and (2) Healthy Eating in Retail Settings

Healthy Eating in Places of Worship

The Healthy Eating Program at your place of worship promotes communal meals to include:

1. At least one fresh fruit choice
2. At least one leafy green salad or fresh vegetable
3. At least one whole grain option
4. Water (available during meal time at no cost)
5. A low‐fat or non‐fat dairy option
6. Low‐sodium dressings and condiments

Your place of worship may decide to start to offer one nutrition strategy at a time or may plan to include all nutrition strategies during communal meals.

Key Steps

1. Interested in learning about the heart health status of people in your community? You may want to ask your local place of worship… Read more
2. . If you are a member and/or leader at your place of worship, you are in an ideal position to start and sustain a healthy eating program for your congregation. If you are not a part of the faith community cite, but want to be involved in starting a healthy eating program at your place of worship, you will need to devote time to outreach… Read more
3. You may want to adapt the nutrition strategies (listed above) that work best with how your place of worship serves communal meals. Examples from our mosques, churches, and gurdwaras partners included… Read more 

Regardless of your different approaches to implement the Healthy Eating program, health education is a crucial component to bring awareness about the program and for congregants and volunteers to understand the relationship between healthy eating and blood pressure. These materials may be used as an education tool and/or for personal use.

Health Promotion Materials

4. Get the word out: It is important to develop education activities to promote build awareness of the nutrition strategies, and to cultivate buy-in from congregants who may not be involved or aware of the Healthy Eating program activities… Read more
5. Things to Consider: This collection of best practices for implementing a healthy eating program in places of worship summarizes feedback from REACH FAR Project community partners who worked closely with 12 diverse places of worship… Read more

Healthy Eating in Retail Settings

Key Steps

1. Define the problem: A number of population-wide approaches to improve nutritional practices at restaurants and grocery stores in NYC are in place. However, these approaches may not reach certain Asian Americans (AA)… Read more
2. Find the right partners: Small business owners are incredibly busy with many competing priorities; above all, they are focused on making and keeping their businesses profitable. In order to start the Healthy Eating program at retail sites, you must cultivate buy-in from ownership and management… Read more
3. How to implement the program: When you have discussions with retailers to starting the Healthy Eating program at their business sites, you may want to emphasize how the program can improve the community’s health WHILE positively affecting sales at their small businesses. Please consider the following talking points… Read more
4. Get the word out: You may want to host interactive events with customers to highlight a retailer’s participation in the Healthy Eating program using culturally adapted health promotion items. Not only do these events generate interest from customers, but they are also excellent ways to generate publicity for the retailer in the community they conduct business in… Read more

Health Promotion Materials

5. Things to Consider: REACH FAR Community Partners who worked with Healthy Eating partners at retail settings since 2015 have provided some of the following best practices and lessons learned… Read more     

REACH FAR Blood Pressure Monitoring Toolkit

This toolkit outlines how REACH FAR community partners carried out the NYC Department of Health and Mental Hygiene’s Keep on Track (KOT) [MS16] blood pressure monitoring program and the US Department of Health and Human Services’ Million Hearts Initiative® in places of worship, community providers’ offices, and local pharmacy settings. It also provides links to materials, tools, and provides detail instructions on how you, too, can implement this program in these same settings in your own community to improve heart health!

The Blood Pressure Monitoring Toolkit is divided into two sections:
(1) Blood Pressure Monitoring Program in Places of Worship and
(2) Blood Pressure Education in Pharmacy or Doctors’ Offices

Blood Pressure Monitoring program in Places of Worship

Since 2007, the NYC Department of Health & Mental Hygiene (NYC DOHMH) has offered a blood pressure screening and health counseling program to help community members improve their blood pressure and health.  This program, called is offered in over a hundred churches throughout New York City.  In 2015, the NYC DOHMH worked with the NYU Center for the Study of Asian American Health (CSAAH) researchers and local community-based organizations (CBOs) to offer the KOT program for the first time in Asian communities, specifically in churches, gurdwaras, mosques, and other faith-based sites in NYC & NJ.

The goal of this partnership was to see if the program could also help Asian community members improve their blood pressure and health. 12 diverse places of worship serving the Bangladeshi, Filipino, Korean, and Asian Indian ethnic communities participated in this REACH FAR project from 2015-2017; 11 out of 12 sites sustain program activities as of today.

After implementing the program at their local place of worship, REACH FAR project sites have reported that some congregants have:

• Discovered for the first time that they had High Blood Pressure
• Experienced for the first time that this type of health program can be successfully maintained at their place of worship and was very helpful for their personal health
• Felt encouraged to openly discussing other health topics [diabetes, mental health, etc.] in addition to heart health during health counseling sessions.
• Noticed an increase in interest from youth congregants in assisting adult volunteers to implement the program 

The results from this initial implementation of the REACH FAR project were a success – and now you, too, can help implement this program in your local community!

Key Steps

1. Define the problem: While there are affordable and effective treatment strategies for improving high blood pressure (HBP), specific Asian American (AA) subgroups have more difficulty controlling HBP and experience higher rates of complications than other groups.  Interested in learning about the heart health status of people in your community? You may want to ask your local place of worship… Read more
2. Recruit and train volunteers: This blood pressure program was designed to be led and sustained by volunteers who want to improve and control high blood pressure in their community. The intention of the Blood Pressure (BP) monitoring program is NOT to replace a clinical provider and health professional’s role in managing your heart health, but instead, it is a program available to community members to monitor their blood pressure in familiar settings… Read more
3. How to implement the program: After you’ve recruited and trained volunteers, you may want to implement the BP monitoring program in ways that work best with how your place of worship is structured as an organization. Examples from our mosques, churches, and gurdwaras included… Read more
4. Get the word out! Community members play a key role in planning and sustaining a program like Keep on Track (BP Monitoring program). Developing advertising/marketing activities to support and promote the BP Monitoring program at your local place of worship may help to cultivate openness, trust, and comfort among congregants… Read more

Regardless of your different approaches to implement the Blood Pressure Monitoring program, health counseling is a crucial part of blood pressure screening events. These materials may be used as education tools and are recommended to be free to take for personal use at home.

Health Promotion Materials 

4. Get the word out! Community members play a key role in planning and sustaining a program like Keep on Track (BP Monitoring program). Developing advertising/marketing activities to support and promote the BP Monitoring program at your local place of worship may help to cultivate openness, trust, and comfort among congregants in getting their blood pressure checked at their place of worship… Read more
5. Get the word out! Community members play a key role in planning and sustaining a program like Keep on Track (BP Monitoring program). Developing advertising/marketing activities to support and promote the BP Monitoring program at your local place of worship may help to cultivate openness, trust, and comfort among congregants in getting their blood pressure checked at their place of worship… Read more

Blood Pressure education in Pharmacy or Provider Office Settings

The Million Hearts® Initiative was a federal program that aims to prevent 1 million heart attacks and strokes in the United States by 2017. One part of the Million Hearts program was providing educational materials at pharmacy and doctor office settings, such as informational brochures or pamphlets, to patients, especially those at high risk for cardiovascular disease or who have been identified as having high blood pressure. As part of the REACH FAR campaign, CSAAH and community partners translated these educational materials into several Asian languages and distributed them to local pharmacists, nurses, primary care providers, and other health professionals, to specifically target Asian communities at high risk for cardiovascular disease and/or for high blood pressure.

You can share these educational materials in your own community’s pharmacies or doctor office settings to help address these health issues in your community, and to encourage individuals to learn more about these health topics. Here is how you can get started: 

Key Steps

1. Find community partners: Pharmacists, doctors and other health professionals are trusted by members of the community for healthcare information. Working with these trusted health leaders in your own community may be a great way to start… Read more
2. Develop partnerships: Once the right partners have been identified, schedule a short meeting to briefly review the available resources for patients that are neatly outlined in the “Addressing Blood Pressure Control” binder. You will want to explain why distributing these educational materials is important to supporting community health and the work that they already do in your community… Read more
3. Use REACH FAR program materials: The materials included in the “Addressing Blood Pressure Control” binder are pharmacist or physician-directed resources that offer support for health care professionals to improve medication adherence and help patients manage their blood pressure… Read more

• Things to Consider: REACH FAR Community Partners who worked with community partners in pharmacy or doctor office settings since 2015 have provided some best practices… Read more     

Evaluation Toolkit

This toolkit outlines research methods and survey instruments used to evaluate REACH FAR’s nutrition and cardiovascular disease and hypertension prevention strategies. These materials may be helpful for researchers and/or program evaluators.

Research Methods & Instruments for Nutrition

• Nutrition Baseline Survey
  • Bangladeshi community
  • Filipino community
  • Korean community
  • Sikh Indian community
• Nutrition Follow-up Survey
  • Bangladeshi community [English; Bangla]
  • Fillipiino community [English]
  • Korean community [English; Korean]
  • Sikh Indian community [English; Punjabi]
• Faith-Based Organizations Nutrition Quality Check Form (NEMS)
• Faith Based Organizations Quality Check Form
• Grocery Store Organizational Survey
• Restaurants Organizational Survey (NEMS)
• Restaurants Quality Check Form

Research Methods & Instruments for CVD & Hypertension Prevention

• Blood Pressure Monitoring Baseline Survey (Bangla, Korean, and Punjabi coming soon)
• Blood Pressure Monitoring Follow-up Survey (Bangla, Korean, and Punjabi coming soon)
• Blood Pressure Monitoring Organizational Survey
• Key Informant Interview Guide

Culturally and Linguistically Relevant Materials

Working closely with the Asian American advertising agency APartnership, NYC Department of Health & Mental Hygiene and community partners, REACH FAR has developed culturally and linguistically relevant materials to help support our program goal of preventing cardiovascular disease in Asian American communities. Available materials include Keep on Track booklets and a Building a Healthy Plate worksheet to promote use of the Plate Method to enjoy healthy cultural foods for blood pressure management; posters to promote healthy foods and blood pressure monitoring and management; grocery store shelf-danglers and restaurant table cards to promote healthy foods; and Million Hearts® tools and resources to promote healthy blood pressure behaviors. Materials are culturally and linguistically tailored for the following Asian American communities: Bangladeshi, Korean, Filipino, Nepali, and Asian Indian (including Hindi, Urdu, and Punjabi). Please click on the images below to see and download examples of these resources.

Keep on Track

Million Hearts^®

Restaurant Table Cards

Grocery Store Shelf Dangler