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

Abstract

Cardiovascular diseases are the world’s leading cause of mortality, with a high burden especially among vulnerable populations. Interventions for primary prevention need to be further implemented in community and primary health care settings. Context is critically important to understand potential implementation determinants. Therefore, we explored stakeholders’ views on the evidence-based SPICES program (EBSP); a multicomponent intervention for the primary prevention of cardiovascular disease, to inform its implementation. In this qualitative study, we conducted interviews and focus groups with 24 key stakeholders, 10 general practitioners, 9 practice nurses, and 13 lay community partners. We used adaptive framework analysis. The Consolidated Framework for Implementation Research guided our data collection, analysis, and reporting. The EBSP was valued as an opportunity to improve risk awareness and health behavior, especially in vulnerable populations. Its relative advantage, evidence-based design, adaptability to the needs and resources of target communities, and the alignment with policy evolutions and local mission and vision, were seen as important facilitators for its implementation. Concerns remain around legal and structural characteristics and intervention complexity. Our results highlight context dimensions that need to be considered and tailored to primary care and community needs and capacities when planning EBSP implementation in real life settings.

A community health worker led approach to cardiovascular disease prevention in the UK—SPICES-Sussex (scaling-up packages of interventions for cardiovascular disease prevention in selected sites in Europe and Sub-saharan Africa): an implementation research project

“…This may show that this type of intervention is particularly well suited to people with mental health concerns for whom talking to someone can make a real difference. This was also observed in the SPICES consortium partner sites including Brest (France) ( 58 ), and Antwerp (Belgium) ( 59 ). Most non-specialist or non-clinical people do not think of their health siloed into CVD, mental health, digestive health etc ( 60 ).…”

The association between county-level premature cardiovascular mortality related to cardio-kidney-metabolic disease and the social determinants of health in the US

“…As prior research has also clearly demonstrated, public health initiatives and community driven measures can effectively promote healthy lifestyle practices. 20 The US Department of Health and Human Services therefore has an initiative 'Healthy People 2030' that is a data driven community-based health initiative to promote health and well-being in the next decade. 21 Our study, therefore, provides readers with the state-and county-level rates of CKM related premature aaCVM in the US.…”

Morbimortalidad de las enfermedades cardiovasculares: causas, pruebas diagnósticas y prevención.

“…Vol .7-N° 3, 2023, pp. 957-994 Journal Scientific MQRInvestigar 981 saludables, realizan ejercicio físico por un intervalo de 10-60 minutos a la semana y eliminan las grasas trans y saturadas (Reamy, Williams, & Kuckel, 2018), pero también existen otras medidas como programas de intervención (Aerts, Anthierens, Van Bogaert, Peremans, & Bastiaens, 2022), educación alimentaria (Mendoza Suárez, Concha Pazmiño, Cevallos Jaramillo, & Granda Alvarez, 2019), control de la presión arterial y del perfil lipídico (Avezum, y otros, 2018) y tratamiento de reducción de colesterol LDL con estatinas (Herdy, y otros, 2014). Estos resultados concuerdan con el estudio de Karunathilake y Ganegoda (Karunathilake & Ganegoda, 2018), que destaca las dietas, el ejercicio regular (30-60 minutos), el tratamiento con estatinas, cese completo del tabaco, restricción de grasas, educación sobre la enfermedad, mantener una presión arterial normal y llevar el control del perfil de lípidos como medidas de prevención ideales contra las ECV.…”