Early detection of these cardiovascular risks associated to the lifestyle of these school children endorses the preventive practice of providing health education in schools.

Introduction:The effectiveness of the treatment of chronic diseases depends on the participation of the patient, influenced by different sociocultural factors, which are not fully recognized by the treatment routine. Objective: To search for some of these factors that hinder or facilitate adherence to treatment and use of healthcare resources, approaching patients with ischemic heart disease. Method: A cross-sectional study was conducted using face-to-face interviews. We applied semi-structured questionnaires to 347 individuals and recorded 141 interviews for qualitative analysis. Descriptors were selected to identify eight categories of analyses. The quantitative data were submitted to descriptive analysis of frequency. Results: Only 2% had good medication adherence according to score on Morisky questionnaire. About 23% bought statins; the others obtained statin in the public health institution. Thirty-six speeches were selected and classified according to the following categories: knowledge about disease and medication, difficulty of acquisition, self management of treatment, difficulties of access to health services, side effect of statins, caregiver support, transportation to health services and concerns about the disease progression. However, it was noticed that about 1/3 of the care outside the research institution can be characterized as an attempt to bring rationalization to the health system. Conclusion: The improved adherence to chronic treatment of ischemic heart disease depends on the establishment of effective flows for referral and counter-referral from one care unit to another, relevant information and clarification of the questions for the patients and the attention of health professionals to the many social and cultural factors involved in treatment adherence. New research should be focused on educational groups by integrated multidisciplinary teams in order to share treatment decisions, thereby increasing the patient's commitment to his own health.

Apresenta-se uma proposta pedagógica, não habitual nas escolas médicas tradicionais, que introduz precocemente o aluno de graduação em um estágio de observação da prática médica. Alunos do segundo semestre do curso médico preparados para fazer uma observação participativa do atendimento aos pacientes e entrevistas com profissionais de saúde, desenvolveram a aprendizagem e a reflexão sobre comunicação do profissional de saúde com sua clientela a partir dos fatos observados. Resultados indicam que a experiência com a disciplina propiciou aos alunos um estilo próprio de entrevistar e abordar o paciente, que enfatiza a integridade do ser e as representações do seu mundo, em contraposição à comunicação médico-paciente que acontece durante a anamnese estruturada e na consulta médica feita na rotina ambulatorial com grande demanda.