"Heart In Hand" is a traditional folk art motif, associated with the Shakers, the Amish, the Pennsylania Dutch and the Masonic IOOF (International Order of Odd Fellows).
It was widely considered to symbolize charity, "from the heart". The IOOF considered it to represent friendship, love and truth.
The hand of this one was cut from a mailed envelope, quite possibly by the recipient, Miss Margie Hamman of Sparta, Wisconsin.
An example of Scherenschnitte.