Community-Based Multiple Risk Factor Intervention for Cardiovascular Risk
An Evidence-Based Practice
This program is a community-based multiple risk factor intervention on cardiovascular risk in African American families with a history of premature coronary disease. This program targets the siblings of an individual diagnosed with coronary heart disease under age 60. Participants in the program have a physical examination and medical history taken by a cardiologist. During community-based care visits at an easily accessible nonclinical site, a nurse practitioner performs physical assessments, evaluates patients for pharmacotherapy, and monitors compliance. A community health worker provides dietary counseling, smoking cessation support, and exercise counseling, with follow-up telephone interventions available. Participants requiring pharmacotherapy are given a pharmacy charge services card that allows them to obtain risk factor therapy prescriptions free of charge at any pharmacy. Sibling participants can also attend 2 free exercise sessions per week at the YMCA.
Goal / Mission
The goal of this program is to reduce the risk of coronary heart disease among African American families with a history of coronary disease.
Results / Accomplishments
In a randomized trial comparing the community-based care group with a group receiving enhanced primary care (offering the same risk-specific materials, recommendations for behavioral changes, pharmacy card, and access to YMCA programming, explained by a primary care provider). At a one-year follow-up, a significantly larger proportion of the community-based care group achieved goal levels of LDL cholesterol and blood pressure when compared to the enhanced primary care group (p < 0.0001 and p = 0.0004, respectively). The intervention group significantly reduced overall coronary heart disease risk, whereas no reduction was seen in the control group (p < 0.0001). Participants in the community-based care group had significant between-group shifts in the 10-year prediction of hard events, with an increased number of individuals in the very-low-risk group, significantly reduced intermediate-risk group, and reduced high-risk group (p < 0.0001).
About this Promising Practice
- Primary Contact
- Diane Becker, ScD, MPH
Division of General Internal Medicine
Johns Hopkins Medical Institutions
1830 E Monument St, Room 8028
Baltimore, MD 21287
Health / Heart Disease & Stroke
Health / Exercise, Nutrition, & Weight
Health / Prevention & Safety
- Johns Hopkins Division of General Internal Medicine
- Date of publication
- Mar 2005
- Baltimore, MD
- For more details
- Target Audience
- Racial/Ethnic Minorities