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The educational program should include approaches to stress awareness/reduction at the environmental level and at the individual level.

Social, physical, and organizational stressors must be explained and methods to ease or elevate stressors must be presented.

At the individual level how changes in attitudes and behaviors help one to cope with stressors; learning techniques to minimize stress response, such as meditation, relaxation response, and exercise.

Content of the program should provide the following -

o  Identifying sources of stress

o  Relationship of stress to health

o  Precisely how the individual experiences stress, personal, family, work

o  Solutions for coping and managing stress

o  Techniques for reducing stress

o  Value of stress, both negative and positive

o  Practical steps of incorporating stress reduction into lifestyle

Personnel conducting stress management programs should’ve training in psychology, behavioral sciences, or related disciplines such as mental health professionals, counselors, health educators, psychologists, and psychiatrists.

Training in a reputable program on how to teach the stress management course including group process skills is a must.

Program is required to provide appropriate interpretation of cholesterol screening results, including a caution that a single measurement neither excludes nor establishes a diagnosis of their blood cholesterol.

Follow national guidelines -

Total Cholesterol

Desirable cholesterol   < 200 mg/dl

Borderline cholesterol   200 – 239 mg/dl

High cholesterol   > 240 mg/dl

HDL

Desirable HDL    > 35 mg/dl

Low HDL    < 35 mg/dl

Refer cholesterol screening participants to medical care as follows -

Total Cholesterol

< 200 mg/dl    Recheck cholesterol in five years, if history of coronary heart illness or if two or more CHD risk factors are detected refers to risk reduction program or health specialists, as appropriate.

200 - 239 mg/dl    When history of CHD or if two or more other risk factors are detected, refer to medical care or risk reduction service within two months; if no stated history of CVD or less than two other risk factors, reassess cholesterol status within 1-2 years.

> 240mg/dl    Refer to medical care within two months.

HDL

> 35 mg/dl   If fewer than 2 risk factors and borderline sum cholesterol, refer to risk reduction service, as appropriate. Reassess HDL in 1-2 years.

Provide the following -

o  The relationship of blood cholesterol, high blood pressure, and other risk factors.    

   o Risk factors include –  high blood pressure (BP) 140/90 or higher or on hypertension medication; current cigarette use of tobacco; family history of premature CHD; diabetes mellitus; age – male > 45 years, female > 55 years or premature menopause without estrogen replacement therapy.

   o Negative risk factor –  high HDL 60 mg/dl or greater (subtract one risk factor).

   o Risk factors such as family history, use of tobacco, high fat or other unhealthy diet, andphysical inactivity lead to the development of cardiovascular disease (CVD).

o  Definitions and causes of high blood cholesterol and HDL, desirable levels, the meaning and limitations of a single measurement, the cause of variability, and the need for multiple measurements before diagnosis.    

o  Wide range of treatment choices, including diet (e.g., importance of controlling fat intake less than 30 percent of total calories from fat, less 10 percent saturated fats), less than 300 mg. of cholesterol per day, well-balanced diet, weight maintenance or reduction, exercise, and medication.    

o  Importance of following prescribed treatment and specialist advice.