Current Cardiovascular Risk Reports

, Volume 6, Issue 6, pp 503–510 | Cite as

Community Based Interventions in the Prevention of Cardiovascular Disease

  • Sahar Naderi
  • Aileen Sauris
  • Fátima Rodriguez
  • JoAnne M. Foody
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  • 311 Downloads

Abstract

Cardiovascular disease is the leading cause of death in both men and women in the United States with over 600,000 cardiovascular mortalities in 2008 alone. Given the burden of cardiovascular disease on both the individual and the healthcare system as a whole, substantial resources are invested in determining the most effective way of improving cardiovascular outcomes. As we have begun to better understand the impact of heart disease through epidemiologic data gathered on a national, regional, and city level, community-based interventions (CBI) have been targeted as a potential means of tackling this epidemic. This review focuses on the types of CBIs in terms of the targeted risk factors and setting of the intervention, challenges in their development, and future directions for research focus.

Keywords

Community based interventions Preventive cardiology 

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. 1.
    Heart Disease Facts. Centers for Disease Control and Prevention, 2012. (Accessed at http://www.cdc.gov/heartdisease/facts.htm)
  2. 2.
    Merzel C, D'Afflitti J. Reconsidering community-based health promotion: promise, performance, and potential. Am J Public Health. 2003;93:557–74.PubMedCrossRefGoogle Scholar
  3. 3.
    Elder JP, Schmid TL, Dower P, Hedlund S. Community heart health programs: components, rationale, and strategies for effective interventions. J Public Health Policy. 1993;14:463–79.PubMedCrossRefGoogle Scholar
  4. 4.
    Pearson TA, Bazzarre TL, Daniels SR, et al. American Heart Association guide for improving cardiovascular health at the community level: a statement for public health practitioners, healthcare providers, and health policy makers from the American Heart Association Expert Panel on Population and Prevention Science. Circulation. 2003;107:645–51.PubMedCrossRefGoogle Scholar
  5. 5.
    Stern MP, Farquhar JW, McCoby N, Russell SH. Results of a two-year health education campaign on dietary behavior. The Stanford Three Community Study. Circulation. 1976;54:826–33.PubMedCrossRefGoogle Scholar
  6. 6.
    •• Lloyd-Jones DM, Hong Y, Labarthe D, et al. Defining and setting national goals for cardiovascular health promotion and disease reduction: the American Heart Association's strategic Impact Goal through 2020 and beyond. Circulation. 2010;121:586–613. A concise assessment of gaps in cardiovascular health care and goals for narrowing that gap and improving overall cardiovacular health.PubMedCrossRefGoogle Scholar
  7. 7.
    Stampfer MJ, Hu FB, Manson JE, Rimm EB, Willett WC. Primary prevention of coronary heart disease in women through diet and lifestyle. N Engl J Med. 2000;343:16–22.PubMedCrossRefGoogle Scholar
  8. 8.
    Chiuve SE, McCullough ML, Sacks FM, Rimm EB. Healthy lifestyle factors in the primary prevention of coronary heart disease among men: benefits among users and nonusers of lipid-lowering and antihypertensive medications. Circulation. 2006;114:160–7.PubMedCrossRefGoogle Scholar
  9. 9.
    Stamler J, Stamler R, Neaton JD, et al. Low risk-factor profile and long-term cardiovascular and noncardiovascular mortality and life expectancy: findings for 5 large cohorts of young adult and middle-aged men and women. JAMA J Am Med Assoc. 1999;282:2012–8.CrossRefGoogle Scholar
  10. 10.
    Hozawa A, Folsom AR, Sharrett AR, Chambless LE. Absolute and attributable risks of cardiovascular disease incidence in relation to optimal and borderline risk factors: comparison of African American with white subjects–Atherosclerosis Risk in Communities Study. Arch Intern Med. 2007;167:573–9.PubMedCrossRefGoogle Scholar
  11. 11.
    Terry DF, Pencina MJ, Vasan RS, et al. Cardiovascular risk factors predictive for survival and morbidity-free survival in the oldest-old Framingham Heart Study participants. J Am Geriatr Soc. 2005;53:1944–50.PubMedCrossRefGoogle Scholar
  12. 12.
    Lloyd-Jones DM, Leip EP, Larson MG, et al. Prediction of lifetime risk for cardiovascular disease by risk factor burden at 50 years of age. Circulation. 2006;113:791–8.PubMedCrossRefGoogle Scholar
  13. 13.
    Smith Jr SC, Benjamin EJ, Bonow RO, et al. AHA/ACCF secondary prevention and risk reduction therapy for patients with coronary and other atherosclerotic vascular disease: 2011 update: a guideline from the American Heart Association and American College of Cardiology Foundation endorsed by the World Heart Federation and the Preventive Cardiovascular Nurses Association. J Am Coll Cardiol. 2011;58:2432–46.PubMedCrossRefGoogle Scholar
  14. 14.
    Leon AS, Franklin BA, Costa F, et al. Cardiac rehabilitation and secondary prevention of coronary heart disease: an American Heart Association scientific statement from the Council on Clinical Cardiology (Subcommittee on Exercise, Cardiac Rehabilitation, and Prevention) and the Council on Nutrition, Physical Activity, and Metabolism (Subcommittee on Physical Activity), in collaboration with the American association of Cardiovascular and Pulmonary Rehabilitation. Circulation. 2005;111:369–76.PubMedCrossRefGoogle Scholar
  15. 15.
    Taylor RS, Brown A, Ebrahim S, et al. Exercise-based rehabilitation for patients with coronary heart disease: systematic review and meta-analysis of randomized controlled trials. Am J Med. 2004;116:682–92.PubMedCrossRefGoogle Scholar
  16. 16.
    Pearson TA, Wall S, Lewis C, Jenkins PL, Nafziger A, Weinehall L. Dissecting the "black box" of community intervention: lessons from community-wide cardiovascular disease prevention programs in the US and Sweden. Scand J Public Health Suppl. 2001;56:69–78.PubMedGoogle Scholar
  17. 17.
    Pearson TA, Bales VS, Blair L, Emmanuel SC, Farquhar JW, Low LP. The Singapore declaration: forging the will for heart health in the next millennium. CVD Prev. 1998;1:182–99.Google Scholar
  18. 18.
    Berwick DM. Screening in health fairs. A critical review of benefits, risks, and costs. JAMA J Am Med Assoc. 1985;254:1492–8.CrossRefGoogle Scholar
  19. 19.
    Freedman DS, Mei Z, Srinivasan SR, Berenson GS, Dietz WH. Cardiovascular risk factors and excess adiposity among overweight children and adolescents: the Bogalusa Heart Study. J Pediatr. 2007;150:12–7 e2.PubMedCrossRefGoogle Scholar
  20. 20.
    Gonzalez-Suarez C, Worley A, Grimmer-Somers K, Dones V. School-based interventions on childhood obesity: a meta-analysis. Am J Prev Med. 2009;37:418–27.PubMedCrossRefGoogle Scholar
  21. 21.
    Hayman LL, Williams CL, Daniels SR, et al. Cardiovascular health promotion in the schools: a statement for health and education professionals and child health advocates from the Committee on Atherosclerosis, Hypertension, and Obesity in Youth (AHOY) of the Council on Cardiovascular Disease in the Young, American Heart Association. Circulation. 2004;110:2266–75.PubMedCrossRefGoogle Scholar
  22. 22.
    Sternberg Z, Munschauer 3rd FE, Carrow SS, Sternberg E. Faith-placed cardiovascular health promotion: a framework for contextual and organizational factors underlying program success. Health Educ Res. 2007;22:619–29.PubMedCrossRefGoogle Scholar
  23. 23.
    Delaney C, Barrere C, Helming M. The influence of a spirituality-based intervention on quality of life, depression, and anxiety in community-dwelling adults with cardiovascular disease: a pilot study. J Holist Nurs. 2011;29:21–32.PubMedCrossRefGoogle Scholar
  24. 24.
    Mosca L, Mochari H, Liao M, et al. A novel family-based intervention trial to improve heart health: FIT Heart: results of a randomized controlled trial. Circ Cardiovasc Qual Outcomes. 2008;1:98–106.PubMedCrossRefGoogle Scholar
  25. 25.
    Carnethon M, Whitsel LP, Franklin BA, et al. Worksite wellness programs for cardiovascular disease prevention: a policy statement from the American Heart Association. Circulation. 2009;120:1725–41.PubMedCrossRefGoogle Scholar
  26. 26.
    Prevalence of coronary heart disease--United States, 2006–2010. MMWR Morb Mortal Wkly Rep 2011;60:1377–81Google Scholar
  27. 27.
    Lillie-Blanton M, Maddox TM, Rushing O, Mensah GA. Disparities in cardiac care: rising to the challenge of Healthy People 2010. J Am Coll Cardiol. 2004;44:503–8.PubMedCrossRefGoogle Scholar
  28. 28.
    Davis AM, Vinci LM, Okwuosa TM, Chase AR, Huang ES. Cardiovascular health disparities: a systematic review of health care interventions. Med Care Res Rev. 2007;64:29S–100S.PubMedCrossRefGoogle Scholar
  29. 29.
    Horowitz CR, Robinson M, Seifer S. Community-based participatory research from the margin to the mainstream: are researchers prepared? Circulation. 2009;119:2633–42.PubMedCrossRefGoogle Scholar
  30. 30.
    Becker DM, Yanek LR, Johnson Jr WR, et al. Impact of a community-based multiple risk factor intervention on cardiovascular risk in black families with a history of premature coronary disease. Circulation. 2005;111:1298–304.PubMedCrossRefGoogle Scholar
  31. 31.
    Levine DM, Bone LR, Hill MN, et al. The effectiveness of a community/academic health center partnership in decreasing the level of blood pressure in an urban African-American population. Ethn Dis. 2003;13:354–61.PubMedGoogle Scholar
  32. 32.
    Krieger J, Collier C, Song L, Martin D. Linking community-based blood pressure measurement to clinical care: a randomized controlled trial of outreach and tracking by community health workers. Am J Public Health. 1999;89:856–61.PubMedCrossRefGoogle Scholar
  33. 33.
    Fedder DO, Chang RJ, Curry S, Nichols G. The effectiveness of a community health worker outreach program on healthcare utilization of west Baltimore City Medicaid patients with diabetes, with or without hypertension. Ethn Dis. 2003;13:22–7.PubMedGoogle Scholar
  34. 34.
    Powell-Wiley TM, Banks-Richard K, Williams-King E, et al. Churches as targets for cardiovascular disease prevention: comparison of genes, nutrition, exercise, wellness and spiritual growth (GoodNEWS) and Dallas County populations. J Public Health (Oxf). July 18, 2012.Google Scholar
  35. 35.
    Resnicow K, Campbell MK, Carr C, et al. Body and soul. A dietary intervention conducted through African-American churches. Am J Prev Med. 2004;27:97–105.PubMedCrossRefGoogle Scholar
  36. 36.
    Taylor-Piliae RE, Haskell WL, Froelicher ES. Hemodynamic responses to a community-based Tai Chi exercise intervention in ethnic Chinese adults with cardiovascular disease risk factors. Eur J Cardiovasc Nurs. 2006;5:165–74.PubMedCrossRefGoogle Scholar
  37. 37.
    Christian AH, Mochari HY, Mosca LJ. Coronary heart disease in ethnically diverse women: risk perception and communication. Mayo Clin Proc. 2005;80:1593–9.PubMedCrossRefGoogle Scholar
  38. 38.
    Adams PF, Martinez ME, Vickerie JL. Summary health statistics for the U.S. population: National Health Interview Survey, 2009. Vital Health Stat. 2010;10:1–115.Google Scholar
  39. 39.
    Newby LK, LaPointe NM, Chen AY, et al. Long-term adherence to evidence-based secondary prevention therapies in coronary artery disease. Circulation. 2006;113:203–12.PubMedCrossRefGoogle Scholar
  40. 40.
    De Bacquer D, De Backer G, Cokkinos D, et al. Overweight and obesity in patients with established coronary heart disease: are we meeting the challenge? Eur Heart J. 2004;25:121–8.PubMedCrossRefGoogle Scholar
  41. 41.
    Balady GJ, Ades PA, Comoss P, et al. Core components of cardiac rehabilitation/secondary prevention programs: A statement for healthcare professionals from the American Heart Association and the American Association of Cardiovascular and Pulmonary Rehabilitation Writing Group. Circulation. 2000;102:1069–73.PubMedCrossRefGoogle Scholar
  42. 42.
    Harris DE, Record NB. Cardiac rehabilitation in community settings. J Cardiopulm Rehabil. 2003;23:250–9.PubMedCrossRefGoogle Scholar
  43. 43.
    Clark AM, Hartling L, Vandermeer B, McAlister FA. Meta-analysis: secondary prevention programs for patients with coronary artery disease. Ann Intern Med. 2005;143:659–72.PubMedGoogle Scholar
  44. 44.
    DeBusk RF, Miller NH, Superko HR, et al. A case-management system for coronary risk factor modification after acute myocardial infarction. Ann Intern Med. 1994;120:721–9.PubMedGoogle Scholar
  45. 45.
    West JA, Miller NH, Parker KM, et al. A comprehensive management system for heart failure improves clinical outcomes and reduces medical resource utilization. Am J Cardiol. 1997;79:58–63.PubMedCrossRefGoogle Scholar
  46. 46.
    Shaw LW. Effects of a prescribed supervised exercise program on mortality and cardiovascular morbidity in patients after myocardial infarction. The National Exercise and Heart Disease Project. Am J Cardiol. 1981;48:39–46.PubMedCrossRefGoogle Scholar
  47. 47.
    Turner SC, Bethell HJ, Evans JA, Goddard JR, Mullee MA. Patient characteristics and outcomes of cardiac rehabilitation. J Cardiopulm Rehabil. 2002;22:253–60.PubMedCrossRefGoogle Scholar
  48. 48.
    Digenio AG, Padayachee N, Groeneveld H. Multivariate models for compliance with phase 3 cardiac rehabilitation services in Johannesburg. Ann Acad Med Singap. 1992;21:121–7.PubMedGoogle Scholar
  49. 49.
    Pirraglia PA, Peterson JC, Williams-Russo P, Gorkin L, Charlson ME. Depressive symptomatology in coronary artery bypass graft surgery patients. Int J Geriatr Psychiatry. 1999;14:668–80.PubMedCrossRefGoogle Scholar
  50. 50.
    Mallik S, Krumholz HM, Lin ZQ, et al. Patients with depressive symptoms have lower health status benefits after coronary artery bypass surgery. Circulation. 2005;111:271–7.PubMedCrossRefGoogle Scholar
  51. 51.
    Exploring the Digital Nation: Computer and Internet Use at Home. In: Commerce USDo, editor. http://www.ntia.doc.gov. Accessed July 2012.
  52. 52.
    Smith A. Americans and Text Messaging. Washington, D.C.: Pew Research Center; 2011.Google Scholar
  53. 53.
    Swartz J. Facebook says membership has grown to 750 million. USA Today. July 26, 2011.Google Scholar
  54. 54.
    Bercovici J. Is Twitter's User Growth Slowing Down Already? Forbes, May 31, 2012.Google Scholar
  55. 55.
    Topol E. The Creative Destruction of Medicine: How the Digital Revolution Will Create Better Health Care: Basic Books, 2012.Google Scholar
  56. 56.
    Tate DF, Wing RR, Winett RA. Using Internet technology to deliver a behavioral weight loss program. JAMA J Am Med Assoc. 2001;285:1172–7.CrossRefGoogle Scholar
  57. 57.
    Etter JF, Perneger TV. Effectiveness of a computer-tailored smoking cessation program: a randomized trial. Arch Intern Med. 2001;161:2596–601.PubMedCrossRefGoogle Scholar
  58. 58.
    • Neubeck L, Ascanio R, Bauman A, et al. Planning locally relevant Internet programs for secondary prevention of cardiovascular disease. Eur J Cardiovasc Nurs. 2011;10:213–20. One of the few papers focusing on the challenges of developing effective internet-based inteventions. It also touches on groups that may be most impacted by internet-based health interventions.PubMedCrossRefGoogle Scholar
  59. 59.
    Neubeck L, Redfern J, Fernandez R, Briffa T, Bauman A, Freedman SB. Telehealth interventions for the secondary prevention of coronary heart disease: a systematic review. Eur J Cardiovasc Prev Rehabil. 2009;16:281–9.PubMedCrossRefGoogle Scholar
  60. 60.
    Whittaker R, Borland R, Bullen C, Lin RB, McRobbie H, Rodgers A. Mobile phone-based interventions for smoking cessation. Cochrane Database Syst Rev. 2009;CD006611.Google Scholar
  61. 61.
    Patrick K, Raab F, Adams MA, et al. A text message-based intervention for weight loss: randomized controlled trial. J Med Internet Res. 2009;11:e1.PubMedCrossRefGoogle Scholar
  62. 62.
    Chow CK, Redfern J, Thiagaligam A, Jan S, Whittaker R, Hackett M, Graves N, Mooney J, Hillis GS. Design and rationale of the tobacco, exercise and diet messages (TEXT ME) trial of a text message-based intervention for ongoing prevention of cardiovascular disease in people with coronary disease: a randomised controlled trial protocol. BMJ Open. 2011;2.Google Scholar
  63. 63.
    •• Redfern J, Thiagalingam A, Jan S, et al. Development of a set of mobile phone text messages designed for prevention of recurrent cardiovascular events. Eur J Prev Cardiol 2012. A study looking at the development of effective text-messages pertaining to cardiovascular health and its impact on study subjects. Google Scholar
  64. 64.
    Prochaska JJ, Pechmann C, Kim R, Leonhardt JM. Twitter = quitter? An analysis of Twitter quit smoking social networks. Tob Control. 2012;21:447–9.PubMedCrossRefGoogle Scholar
  65. 65.
    •• Hoch DB, Watson AJ, Linton DA, et al. The feasibility and impact of delivering a mind-body intervention in a virtual world. PLoS One. 2012;7:e33843. This article discusses the technical aspects of developing a "virtual world" to impact health. It also assesses the the impact it had on the pilot study subjects.PubMedCrossRefGoogle Scholar
  66. 66.
    Watson A, Bickmore T, Cange A, Kulshreshtha A, Kvedar J. An internet-based virtual coach to promote physical activity adherence in overweight adults: randomized controlled trial. J Med Internet Res. 2012;14:e1.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • Sahar Naderi
    • 1
  • Aileen Sauris
    • 2
  • Fátima Rodriguez
    • 3
    • 4
  • JoAnne M. Foody
    • 2
    • 5
  1. 1.Heart and Vascular InstituteCleveland Clinic FoundationClevelandUSA
  2. 2.Division of Cardiovascular MedicineBrigham and Women’s HospitalBostonUSA
  3. 3.Department of MedicineBrigham and Women’s HospitalBostonUSA
  4. 4.Harvard Medical SchoolBostonUSA
  5. 5.Cardiovascular Wellness ProgramBrigham & Women’s HospitalBostonUSA

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