Heart Healthier Community Achieved With Grassroots Effort
Saturday, March 14, 2015 02:37 PM

A community-wide program spanning four decades designed to improve cardiovascular health among residents of a rural, low-income county in Maine accomplished its goal, reducing hospitalizations and deaths from heart attack and stroke, researchers reported.

The outreach to more than 150,000 residents of Franklin County, Maine, from 1970 through 2010 -- which promoted hypertension and cholesterol control, smoking cessation, healthy diet and exercise -- resulted in measurable improvements in community health over the 40-year period, with a 24.7% absolute increase in hypertension control, a 28.5% absolute increase in cholesterol control, and a smoking cessation rate that exceeded the state average.

The FCHP adapted a community-based clinic model that included nurses and trained community volunteers to provide services such as blood pressure monitoring and smoking cessation help at a variety of sites including town halls, church basements, schools, and work sites.  "Early encounters emphasized screening, but FCHP staff also encouraged return for monitoring, counseling, and periodic rescreening.”  Monitoring results were sent to the patient's physician, and people with uncontrolled medically-treatable cardiovascular risk factors were sent to their physician. Electronic tracking helped FCHP staff follow patients, inform physicians, and assess outcomes.

Between 1994 and 2010, more than 150,000 FCHP patient encounters were recorded in Franklin county, which had just 22,444 residents in 1970 and 30,768 in 2010, averaging more than five encounters per resident.  In the first four years of FCHP, about 50% of the county's residents were screened for hypertension. Cholesterol screening was introduced in 1986, and 40% of the county's adults had been screened through the program within 5 years.  Rates of hypertension and cholesterol control improved dramatically, and smoking and cardiovascular hospitalization rates declined during the 4 decade period.

The Franklin County experience shows that community-wide cardiovascular prevention programs can reduce mortality, morbidity, and costs even in poor, high-risk areas. 

Source: http://www.medpagetoday.com/Cardiology/Prevention/49531