A Community-based Program for Cardiovascular Health Awareness

Abstract

Objective: The objective of the Cardiovascular Health Awareness Program (CHAP) is to improve the processes of care related to the cardiovascular health of older adults. Participants: Two Ontario communities including family physicians (FP), pharmacists, public health units and nurses, volunteer peer health educators, older adult patients and community organizations. Setting: Community pharmacies and family physician offices. Intervention: CHAP is designed to close a process of care loop around cardiovascular health awareness that originates from, and returns to, the FP. Older patients are invited by their FP to attend pharmacy CHAP sessions. At these sessions, trained volunteer peer health educators (PHEs) assist patients both in recording their blood pressure using a calibrated automated device and in completing a cardiovascular risk profile. This information is relayed to their respective FP via an automated computerized database. Pharmacists and patients receive copies of the results. Based on these cumulative risk profiles, patients are advised to follow-up with their FP. Outcomes: Of the FPs and pharmacists asked, 47% and 79%, respectively, agreed to participate in the project. 39% of older adult patients invited by their FPs attended the CHAP community pharmacy sessions. Of these, 100% agreed to having their risk profile, including their blood pressure readings, forwarded to their FP. Positive feedback about CHAP was expressed by the volunteer PHEs, the FPs and the pharmacists. Conclusion: The community-based pharmacy CHAP sessions are a feasible way of improving patient, physician, and pharmacist access to reliable blood pressure measurements and to cardiovascular health information. A randomized trial is in progress that will assess the impact of CHAP on monitoring of blood pressure.

A scoping literature review of collaboration between primary care and public health

“…Community activities included community engagement and participation (Bennett et al ., 1994; Alexy and Elnitsky, 1996; Billingham and Perkins, 1997; Lundeen et al ., 1997; McDonald et al ., 1997; Ewles, 1999; Harper et al ., 2000; Margolis et al ., 2001; Oros et al ., 2001; Heller et al ., 2003; Carlisle et al ., 2004; Andrews, 2002; Fraser, 2005; Michener et al ., 2005; Rothman et al ., 2005; Asaid and Riley, 2007), community development (Billingham and Perkins, 1997; Heller and Goldwater, 2004; Brown et al ., 2007) and multi-sectoral involvement (Billingham and Perkins, 1997; Arora et al ., 2000; Wilson et al ., 2000). Various types of jointly offered health promotion (Fatchett, 1990; Wiles and Robison, 1994; Wood et al ., 1994; Lasker and The Committee on Medicine and Public Health, 1997; Cook, 2000; Bindman et al ., 2001; Oros et al ., 2001; Heller et al ., 2003; Riley et al ., 2003; Dion, 2004; Kearney et al ., 2005; Rothman et al ., 2005; Brown, 2006; Sanders et al ., 2008), health education (Lambrew et al ., 1993; Bennett et al ., 1994; Alexy and Elnitsky, 1996; Harper et al ., 2000; Record et al ., 2000; Thackway et al ., 2000; Bourdages et al ., 2003; Harris et al ., 2003; Heller and Goldwater, 2004; Ferrari and Rideout, 2005; Kearney et al ., 2005; Mack et al ., 2007; McElmurry et al ., 2009; Sanders et al ., 2008) and illness/injury prevention initiatives (Lasker and The Committee on Medicine and Public Health, 1997; Lundeen et al ., 1997; Crump et al ., 1999; Rogers et al ., 1999; Lemelin et al ., 2001; O'Neil and Clarkson, 2002; Heller et al ., 2003; Heller and Goldwater, 2004; Meyrick, 2004; Chambers et al ., 2005; Kearney et al ., 2005; Brown,…”

“…Various types of jointly offered health promotion (Fatchett, 1990; Wiles and Robison, 1994; Wood et al ., 1994; Lasker and The Committee on Medicine and Public Health, 1997; Cook, 2000; Bindman et al ., 2001; Oros et al ., 2001; Heller et al ., 2003; Riley et al ., 2003; Dion, 2004; Kearney et al ., 2005; Rothman et al ., 2005; Brown, 2006; Sanders et al ., 2008), health education (Lambrew et al ., 1993; Bennett et al ., 1994; Alexy and Elnitsky, 1996; Harper et al ., 2000; Record et al ., 2000; Thackway et al ., 2000; Bourdages et al ., 2003; Harris et al ., 2003; Heller and Goldwater, 2004; Ferrari and Rideout, 2005; Kearney et al ., 2005; Mack et al ., 2007; McElmurry et al ., 2009; Sanders et al ., 2008) and illness/injury prevention initiatives (Lasker and The Committee on Medicine and Public Health, 1997; Lundeen et al ., 1997; Crump et al ., 1999; Rogers et al ., 1999; Lemelin et al ., 2001; O'Neil and Clarkson, 2002; Heller et al ., 2003; Heller and Goldwater, 2004; Meyrick, 2004; Chambers et al ., 2005; Kearney et al ., 2005; Brown, 2006; Harrison et al ., 2006; PHRED, 2006; Stevenson Rowan et al ., 2007) were reported. The most commonly offered health services were general PC services (Alexy and Elnitsky, 1996; Lundeen et al ., 1997; Poulton, 2000; Record et al ., 2000; Andrews, 2002; Heller and Goldwater, 2004; Ferrari and Rideout, 2005; Brown, 2006; Kaufman et al ., 2006; Shirin and Absher, 2006; de Guzman, 2007; Jackson and Marley, 2007; Taylor et al ., 2007), chronic disease management including screening (Alexy and Elnitsky, 1996; Rogers et al ., 1999; Record et al ., 2000; CIHR, 2003; Chambers et al ., 2005; Ferrari and Rideout, …”

Blood Pressure Awareness and Self-Monitoring Practices among Primary Care Elderly Patients

“…Most recent systolic blood pressure (mm Hg), self-report 134 (18) Most recent diastolic blood pressure (mm Hg), self-report 76 (11) In univariate analysis, age, sex, education level, previous diagnosis of hypertension, taking medications for hypertension, and being told one's target blood pressure were significantly associated with blood pressure awareness (p < 0.10). All of these factors, except for gender and taking medications for hypertension, were found to be independent predictors of blood pressure awareness in the multiple logistic regression model.…”

Community Mobilization, Participation, and Blood Pressure Status in a Cardiovascular Health Awareness Program in Ontario

“…Established principles of community-based health promotion and chronic disease prevention were incorporated [28][29][30] and several aspects of the program were tested in pilot studies. 21,[31][32][33] The resulting core program components are outlined in Table 1.…”