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BMC Cardiovascular Disorders, 2011
Objectives. We evaluated whether a program to prevent coronary heart disease (CHD) with community... more Objectives. We evaluated whether a program to prevent coronary heart
disease (CHD) with community health workers (CHWs) would improve CHD risk
in public health and health care settings.
Methods. The CHWs provided point-of-service screening, education, and care
coordination to residents in 34 primarily rural Colorado counties. The CHWs
utilized motivational interviewing and navigated those at risk for CHD into
medical care and lifestyle resources. A software application generated a real-time
10-year Framingham Risk Score (FRS) and guideline-based health recommendations
while supporting longitudinal caseload tracking. We used multiple linear
regression analysis to determine factors associated with changes in FRS.
Results. From 2010 to 2011, among 4743 participants at risk for CHD, 53.5%
received medical or lifestyle referrals and 698 were retested 3 or more months
after screening. We observed statistically significant improvements in diet,
weight, blood pressure, lipids, and FRS with the greatest effects among those
with uncontrolled risk factors. Successful phone interaction by the CHW led to
lower FRS at retests (P = .04).
Conclusions. A CHW-based program within public health and health care
settings improved CHD risk. Further exploration of factors related to improved
outcomes is needed. (Am J Public Health. 2013;103:e19–e27. doi:10.2105/AJPH.
2012.301068)
BMC Cardiovascular Disorders, 2011
Objectives. We evaluated whether a program to prevent coronary heart disease (CHD) with community... more Objectives. We evaluated whether a program to prevent coronary heart
disease (CHD) with community health workers (CHWs) would improve CHD risk
in public health and health care settings.
Methods. The CHWs provided point-of-service screening, education, and care
coordination to residents in 34 primarily rural Colorado counties. The CHWs
utilized motivational interviewing and navigated those at risk for CHD into
medical care and lifestyle resources. A software application generated a real-time
10-year Framingham Risk Score (FRS) and guideline-based health recommendations
while supporting longitudinal caseload tracking. We used multiple linear
regression analysis to determine factors associated with changes in FRS.
Results. From 2010 to 2011, among 4743 participants at risk for CHD, 53.5%
received medical or lifestyle referrals and 698 were retested 3 or more months
after screening. We observed statistically significant improvements in diet,
weight, blood pressure, lipids, and FRS with the greatest effects among those
with uncontrolled risk factors. Successful phone interaction by the CHW led to
lower FRS at retests (P = .04).
Conclusions. A CHW-based program within public health and health care
settings improved CHD risk. Further exploration of factors related to improved
outcomes is needed. (Am J Public Health. 2013;103:e19–e27. doi:10.2105/AJPH.
2012.301068)