Integrating public health, clinical care, and community approaches can improve the clinical, social, and economic burdens of cardiovascular disease. Bhupathiraju SN, Hu FB. ; American Heart Association Council on Cardiovascular and Stroke Nursing; Council on Cardiovascular Disease in the Young; Council on Clinical Cardiology; and Stroke Council. J Clin Hypertens (Greenwich) 2012;14(1):51–65. Because of their broad impact at the population level, a public health approach is needed to address the challenges of these common, critical and costly conditions. What are the implications for public health practice? The approach greatly expanded self-management options and resources for patients across a large rural area, throughout nontribal health systems and within the Choctaw Nation. Public health systems and policies to improve outcomes in people with CHD. Ultimately, other funding streams and strategies such as health care payer reimbursement are needed to sustain these programs and take them to a national scale. Circ Cardiovasc Qual Outcomes 2017;10(6):e000025. Too often, factors and circumstances that shape our health are devalued or ignored. Public health systems and policies for equitable access and utilization of care for CHD. New York. Our report highlights a framework of systems-change levers that addresses key areas for program sustainability and reach. Pharmacy hypertension clinic; Choctaw Nation health system and pharmacists; academic partnership with University of Oklahoma Health Sciences Center College of Pharmacy. Centers for Disease Control and Prevention. Annually the national non-profit organizations and four federal agencies involved in the leadership of the Congenital Heart Public Health Consortium (CHPHC) that each organization contributes to addressing the gaps and opportunities presented in the public health for congenital heart disease framework. Explaining the decrease in U.S. deaths from coronary disease, 1980-2000. Science of improvement: testing changes. Partnership with Humana to improve quality of care. Examples include using electronic health record systems to drive identification of undiagnosed and uncontrolled hypertension; implementation of protocols for treatment, referrals, and follow-up to ensure clinical practices are standardized across public health; and formation of partnerships between community organizations and local clinics that help expand networks and self-management support. J Am Coll Cardiol 2018;71(19):e127–248. Learn the facts about congenital heart defects. Adopted and implemented hypertension treatment protocols; home blood pressure program with clinical support; and systems for tracking and follow-up. The public, elected officials, and some health providers tend to focus narrowly on lifestyles and behaviors. The learning collaborative also used a rapid quality improvement process focused on the “plan,” “do,” “study,” and “act” (PDSA; Institute of Health Improvement ) model to improve program implementation in a rapid, yet systematic fashion. People born with a congenital heart defect and living with congenital heart disease have very different symptoms, risk factors, and quality of life. Thirty-one state and territorial public health agencies participated in a learning collaborative to improve diagnosis and management of hypertension in clinical and community settings. Data from electronic health records used to identify patients with uncontrolled hypertension for referral (counseling or management). Register for the CHPHC Webinar scheduled for Thursday, September 12 at 1 pm ET. This learning collaborative shows that health agencies in various jurisdictions can improve communication between community health organizations and public health and leverage technical and financial resources to support programs for patients to self-manage their blood pressure. Logic model for ASTHO/CDC Heart Disease and Stroke Prevention Learning Collaborative. Each state used a comprehensive approach to improve hypertension identification and control by working across all 4 systems-change levers in our framework (Table). J Public Health Manag Pract 2014;20(2):264–6. Abbreviations: ASTHO, Association of State and Territorial Health Officials; CDC, Centers for Disease Control and Prevention; PDSA, Plan, Do, Study, Act; PH, public health; QI, quality improvement; TA, technical assistance. Author Affiliations: 1Association of State and Territorial Health Officials, Arlington, Virginia. Findings from these case studies support early reports that integration of public health, clinical care, and community health centers can help health systems address the clinical, social, and economic burdens of CVD (8,9). It provides public health practitioners with a menu of potentially usable theories, models and frameworks to support capacity building efforts. We also thank Kelsey Donnellan and Allen Rakotoniaina for providing insight and expertise during the development of this publication. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the CDC. between different public health needs. framework, such as the Public Health Skills and Knowledge Framework, to help carry out a skills-audit for your team • We welcome your feedback on this document and always looking to improve. PROGRAM EVALUATION BRIEF â Volume 16 â August 26, 2019. 6NU38OT000161-05-03 funded by the CDC. i) A common language Public health encompasses a wide variety of activities and structures within health and related services systems. Please enable scripts and reload this page. J Gen Intern Med 2015;30(4):454–61. Corresponding Author: Rose Anne Felipe, MPH, Association of State and Territorial Health Officials, 2231 Crystal Dr, Suite 450, Arlington, VA 22202. Oklahoma joined the collaborative during the third year (Phase 2) of implementation under an expansion of the initiative to address hypertension disparities in American Indian/Alaska Native populations. In 2017, the American College of Cardiology and the American Heart Association released new blood pressure guidelines that suggest lowering the optimal blood pressure target from below 140/90 mm Hg to below 130/80 mm Hg; however, among people with high blood pressure in the United States, only half were in compliance with the previous guidelines, and fewer will meet the new ones (4). The working paper can be used in its current form by public health practitioners to give context to the complexity of their work and the elements needed to enact change. Reductions in deaths from CVD are largely due to decreased use of tobacco products, improvements in blood pressure and cholesterol control, and advances in medical treatment (1,2). Please email your comments to: firstname.lastname@example.org View Frameworks in partnership with Developed a referral process; established a pharmacist–provider collaboration; educated and counseled patients; calculated arteriosclerotic cardiovascular disease risk; and conducted blood pressure monitoring and follow-up. In 2005, the National Institute for Health and Clinical Excellence (NICE) began to produce public health guidance.
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