Effectiveness of a community health worker cardiovascular risk reduction program in public health and health care settings
Open accessAbstract
OBJECTIVES: We evaluated whether a program to prevent coronary heart disease (CHD) with community health workers (CHWs) would improve CHD risk in public health and health care settings. METHODS: The CHWs provided point-of-service screening, education, and care coordination to residents in 34 primarily rural Colorado counties. The CHWs utilized motivational interviewing and navigated those at risk for CHD into medical care and lifestyle resources. A software application generated a real-time 10-year Framingham Risk Score (FRS) and guideline-based health recommendations while supporting longitudinal caseload tracking. We used multiple linear regression analysis to determine factors associated with changes in FRS. RESULTS: From 2010 to 2011, among 4743 participants at risk for CHD, 53.5% received medical or lifestyle referrals and 698 were retested 3 or more months after screening. We observed statistically significant improvements in diet, weight, blood pressure, lipids, and FRS with the greatest effects among those with uncontrolled risk factors. Successful phone interaction by the CHW led to lower FRS at retests (P = .04). CONCLUSIONS: A CHW-based program within public health and health care settings improved CHD risk. Further exploration of factors related to improved outcomes is needed.
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In Colorado Heart Healthy Solutions, community health workers conducted screenings, assessed readiness for change, and provided education and medical referrals to patients with an uncontrolled risk factor for coronary heart disease or a Framingham Risk Score ≥10%; they found significant reductions in Framingham Risk score, blood pressure, and cholesterol at retesting, and in multivariable models,
“In Colorado Heart Healthy Solutions, community health workers conducted screenings, assessed readiness for change, and provided education and medical referrals to patients with an uncontrolled risk factor for coronary heart disease or a Framingham Risk Score $10%.They provided further phone follow-up, and found significant reductions in Framingham Risk score, blood pressure, and cholesterol at ret”
From The CardioMetabolic Health Alliance (2015) · cites this paper as [85]
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References 30 · Cited by 99
- Authors
- Krantz, M. J., Coronel, S. M., Whitley, E. M., Dale, R., Yost, J., & Estacio, R. O.
- Affiliations
- Denver Health Medical Center (US)
- Venue
- American Journal of Public Health
- Publisher
- American Public Health Association
- Published
- 2013-01
- Volume
- 103
- Issue
- 1
- Pages
- e19-e27
- ISSN
- 0090-0036 (ISSN-L)
- 1541-0048
- PMC
- PMC3518330
- OpenAlex
- W2013132661
- Cited by
- 99
- References
- 30
- Citations by year
- 2026: 5 · 2025: 9 · 2024: 13 · 2023: 7 · 2022: 7 · 2021: 7 · 2020: 2 · 2019: 7 · 2018: 7 · 2017: 6 · 2016: 8 · 2015: 9 · 2014: 10 · 2013: 1
- FWCI
- 6.17
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- American Journal of Public Health (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- Funders
- Colorado Health Foundation
- Anschutz Foundation
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Health Promotion and Cardiovascular Prevention
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
- Health Sciences › Health Professions › General Health Professions › Community Health and Development
- Keywords
- community health workers, cardiovascular risk reduction, coronary heart disease prevention, Framingham risk score, motivational interviewing, care coordination, lifestyle counseling, rural population, health system navigation, blood pressure, serum lipids
- MeSH terms
- Adolescent, Adult, Aged, Aged, 80 and over, Colorado, Community Health Workers, Community Health Services, Coronary Disease, Female, Follow-Up Studies, Health Promotion, Humans, Life Style, Male, Mass Screening, Middle Aged, Primary Health Care, Risk Factors, Rural Population, Cohort Studies, Program Evaluation, Risk Reduction Behavior, Young Adult
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