Population-Level Reach of Cardiovascular Disease Prevention Interventions in a Rural Community: Findings from the Heart of New Ulm Project

Abstract

This study examines participation by residents of a rural community in programs implemented as part of The Heart of New Ulm (HONU) Project, a population-based cardiovascular disease (CVD) prevention initiative. The study compares participation rates for the various interventions to assess which were the most engaging in the priority community and identifies factors that differentiate participants vs. nonparticipants. Participation data were merged with electronic health record (EHR) data representing the larger community population to enable an analysis of participation in the context of the entire community. HONU individual-level interventions engaged 44% of adult residents in the community. Participation ranked as follows: (1) heart health screenings (37% of adult residents), (2) a year-long community weight loss intervention (12% of adult residents), (3) community health challenges (10% of adult residents), and (4) a phone coaching program for invited high CVDrisk residents (enrolled 6% of adult residents). Interventions that yielded the highest engagement were those that had significant staffing and recruited participants over several months, often with many opportunities to participate or register. Compared to nonparticipants, HONU participants were significantly older and a higher proportion were female, married, overweight or obese, and had high cholesterol. Participants also had a lower prevalence of smoking and diabetes than nonparticipants. Findings indicate community-based CVD prevention initiatives can be successful in engaging a high proportion of adult community members. Partnering with local health care systems can allow for use of EHR data to identify eligible participants and evaluate reach and engagement of the priority population.

Prevention of Cardiovascular Diseases in Community Settings and Primary Health Care: A Pre-Implementation Contextual Analysis Using the Consolidated Framework for Implementation Research

“…PHC teams should therefore continue to use low-cost, practical approaches to detect people at risk [ 61 ]. On the other hand, previous research also demonstrates that relatively high levels of community engagement can be attained by introducing community-based CVD prevention programs [ 62 ], and that it has the potential to effectively reach under-served groups [ 63 ]. Community-based strategies previously have successfully led to an improvement in CVD risk factors [ 64 ], with especially positive impact on improving population knowledge on CVD and risk factors, physical activity levels, and dietary patterns [ 65 , 66 ].…”

Population health interventions for cardiometabolic diseases in primary care: a scoping review and RE-AIM evaluation of current practices

“… RCT, randomized controlled trial; Sig, statistically significant; NM, not measured; CVD, cardiovascular disease; LDL-C, low-density-lipoprotein cholesterol; BMI, body mass index; DM, diabetes mellitus; PMA, Panel Management Assistants; FRS, Framingham Risk Score. a Interventions with separate studies in which additional information was found: 1 Sidebottom et al, 2016 ( 39 ), Sidebottom et al, 2021 ( 21 ); 2 Lewinski et al, 2021 ( 40 ); 3 Jiao et al, 2014 ( 41 ); 4 Strauss et al, 2015 ( 42 ); 5 Smith et al, 2019 ( 43 ). …”

Understanding factors affecting implementation success and sustainability of a comprehensive prevention program for cardiovascular disease in primary health care: a qualitative process evaluation study combining RE-AIM and CFIR

“…In order to improve reach in future program planning and development, literature indeed recommends the integration of health and social care for vulnerable populations through multisectoral and community-based strategies (Richard et al, 2016;Corscadden et al, 2018). Previous studies have shown that this has great potential to increase community engagement levels and the reach of currently under-served populations, resulting in a positive impact on cardiovascular disease and its risk factors (Woringer et al, 2017;Sidebottom et al, 2021;Soltani et al, 2021).…”