Cardiovascular Diseases, Cardiovascular Risk Factor, Diabetes Mellitus
Conditions
Keywords
Healthcare Utilization, Emergency Department, Hospitalization, Low Income, Social Housing, Older Adults, Quality of Life
Brief summary
This project aims to improve the cardiovascular health of seniors living in subsidized housing by implementing the successful community-based Cardiovascular Health Awareness Program (CHAP). CHAP is a patient-centred, interdisciplinary, multi-pronged, community-led CVD and stroke prevention and management program designed to prevent and reduce the impact of cardiovascular disease in older adults. The program addresses common cardiovascular disease risk factors, such as smoking, physical activity and poor diet by raising awareness of health and community resources available to encourage self-care and appropriate management of cardiovascular disease. A randomized controlled trial will be used to evaluate the impact of CHAP on healthcare utilization by older adults living in subsidized housing.
Detailed description
This project aims to improve the cardiovascular health of seniors living in subsidized housing by implementing the successful community-based Cardiovascular Health Awareness Program (CHAP). Residents in subsidized housing are considered to be a vulnerable population because of their low income and tend to be in poorer health; with a multitude of chronic illnesses, such as cardiovascular disease (CVD) and diabetes. This project will build on the success of CHAP in other provinces. The program has been shown to reduce blood pressure and CVD-related hospitalization costs. CHAP is a patient-centred, interdisciplinary, multi-pronged, community-led CVD and stroke prevention and management program designed to prevent and reduce the impact of cardiovascular disease in older adults. The program addresses common cardiovascular disease risk factors, such as smoking, physical activity and poor diet by raising awareness of health and community resources available to encourage self-care and appropriate management of cardiovascular disease. Taking the form of a randomized controlled trial, the sample will be subsidized housing buildings (low income) for those aged 55 years and over. During CHAP monthly assessment sessions, participants will 1) complete a consent form, 2) complete a cardiovascular risk profile form, 3) undergo blood pressure measurement using an automated blood pressure measuring device, 4) receive targeted healthy lifestyle and preventive care materials, 5) be invited to participate in group health education sessions. Those patients identified at high risk will be assessed by a health professional and referred to a family physician for timely and appropriate follow-up.. The impact this program will have on health care utilization (emergency visits, cardiovascular hospitalization rates) will be measured using administrative databases.
Interventions
BEHAVIORALCardiovascular Health Awareness Program
Cardiovascular disease prevention and health promotion
Sponsors
Université de Montréal
McMaster University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
NONE
Intervention model description
Pragmatic cluster randomized controlled trial with parallel intervention and control groups. Randomization will occur at the building level (clusters) and the intervention is open to all building residents.
Eligibility
Sex/Gender
ALL
Age
55 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
Building Inclusion Criteria: * Approximately 50-200 apartment units * Majority of residents are 55 years of age or older. * Unique postal code * Availability of at least one building with similar characteristics for matching/randomization Individual Inclusion Criteria * Resides in a study building * Aged 55 years or older * Speaks and reads English or French Note: Younger residents will be allowed to take part in the program but their data will not be included in the analysis.
Exclusion criteria
* None
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Healthcare Utilization Composite - Change in CVD-related emergency department visits and hospitalizations | Monthly from 1 year pre-intervention to 1 year post-intervention | Change in rate of CVD-related emergency department visits and hospitalizations by postal code from administrative databases (Building-level analysis) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Participant experience of the CHAP intervention | 1 year (post-intervention) | Participant experience of the intervention will be evaluated through qualitative individual interviews and focus groups of residents. |
| Healthcare Utilization - Change in all-cause hospitalizations | Monthly from 1 year pre-intervention to 1 year post-intervention | Change in all-cause hospitalization rates by postal code from administrative data (building-level) |
| Change in quality of life | Baseline and 1 year | Measured using EQ-5D-5L |
| Quality-Adjusted Life Years (QALYs) | 1 year (post-intervention) | Calculated from EQ-5D-5L at two time points and Canadian value sets |
| Cost-effectiveness | 1 year (post-intervention) | Calculated from program cost data and health outcomes |
| Healthcare Utilization - Change in all-cause emergency department visits | Monthly from 1 year pre-intervention to 1 year post-intervention | Change in rate of all-cause emergency department visits by postal code from administrative |
Other
| Measure | Time frame | Description |
|---|---|---|
| Cardiovascular Risk - Change in body mass index | Baseline and 1 year | Change in body mass index calculated from height and weight (self-reported) |
| Cardiovascular Risk - Change in waist circumference | Baseline and 1 year | Change in waist circumference (measured with measuring tape) |
| Cardiovascular Risk - Change in diabetes risk score | Baseline and 1 year | Change in diabetes risk score (CANRISK questionnaire) |
| Cardiovascular Risk - Change in blood pressure | Baseline and 1 year | Change in measured blood pressure (automated, validated device) |
Countries
Canada
Outcome results
None listed