Partnering to Reduce Risks and Improve Cardiovascular Outcomes
2009; Lippincott Williams & Wilkins; Volume: 119; Issue: 2 Linguagem: Inglês
10.1161/circulationaha.108.191328
ISSN1524-4539
AutoresDaniel W. Jones, Eric D. Peterson, Robert O. Bonow, Raymond J. Gibbons, Barry A. Franklin, Ralph L. Sacco, David P. Faxon, Vincent J. Bufalino, Rita F. Redberg, Neil M. Metzler, Penelope Solis, Meighan Girgus, Kathy Rogers, Patrick Wayte, Timothy J. Gardner,
Tópico(s)Global Public Health Policies and Epidemiology
ResumoHomeCirculationVol. 119, No. 2Partnering to Reduce Risks and Improve Cardiovascular Outcomes Free AccessReview ArticlePDF/EPUBAboutView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citationsPermissions ShareShare onFacebookTwitterLinked InMendeleyReddit Jump toFree AccessReview ArticlePDF/EPUBPartnering to Reduce Risks and Improve Cardiovascular OutcomesAmerican Heart Association Initiatives in Action for Consumers and Patients Daniel W. Jones, Eric D. Peterson, Robert O. Bonow, Raymond J. Gibbons, Barry A. Franklin, Ralph L. Sacco, David P. Faxon, Vincent J. Bufalino, Rita F. Redberg, Neil M. Metzler, Penelope Solis, Meighan Girgus, Kathy Rogers, Patrick Wayte and Timothy J. Gardner Daniel W. JonesDaniel W. Jones From the University of Mississippi Medical Center, Jackson (D.W.J.); Duke University, Durham, NC (E.D.P.); Northwestern University Medical Center, Evanston, Ill (R.O.B.); Mayo Clinic, Rochester, Minn (R.J.G.); William Beaumont Hospital, Royal Oak, Mich (B.A.F.); University of Miami (R.L.S.); Brigham and Women's Hospital and Harvard Medical School, Boston, Mass (D.P.F.); Midwest Heart Specialists, Elmhurst, Ill (V.J.B.); University of California at San Francisco (R.F.R.); Sinai Hospital of Baltimore (N.M.M.); American Heart Association, Dallas, Tex (P.S., M.G., K.R., P.W.); and Christiana Care Health System, Wilmington, Del (T.J.G.). , Eric D. PetersonEric D. Peterson From the University of Mississippi Medical Center, Jackson (D.W.J.); Duke University, Durham, NC (E.D.P.); Northwestern University Medical Center, Evanston, Ill (R.O.B.); Mayo Clinic, Rochester, Minn (R.J.G.); William Beaumont Hospital, Royal Oak, Mich (B.A.F.); University of Miami (R.L.S.); Brigham and Women's Hospital and Harvard Medical School, Boston, Mass (D.P.F.); Midwest Heart Specialists, Elmhurst, Ill (V.J.B.); University of California at San Francisco (R.F.R.); Sinai Hospital of Baltimore (N.M.M.); American Heart Association, Dallas, Tex (P.S., M.G., K.R., P.W.); and Christiana Care Health System, Wilmington, Del (T.J.G.). , Robert O. BonowRobert O. Bonow From the University of Mississippi Medical Center, Jackson (D.W.J.); Duke University, Durham, NC (E.D.P.); Northwestern University Medical Center, Evanston, Ill (R.O.B.); Mayo Clinic, Rochester, Minn (R.J.G.); William Beaumont Hospital, Royal Oak, Mich (B.A.F.); University of Miami (R.L.S.); Brigham and Women's Hospital and Harvard Medical School, Boston, Mass (D.P.F.); Midwest Heart Specialists, Elmhurst, Ill (V.J.B.); University of California at San Francisco (R.F.R.); Sinai Hospital of Baltimore (N.M.M.); American Heart Association, Dallas, Tex (P.S., M.G., K.R., P.W.); and Christiana Care Health System, Wilmington, Del (T.J.G.). , Raymond J. GibbonsRaymond J. Gibbons From the University of Mississippi Medical Center, Jackson (D.W.J.); Duke University, Durham, NC (E.D.P.); Northwestern University Medical Center, Evanston, Ill (R.O.B.); Mayo Clinic, Rochester, Minn (R.J.G.); William Beaumont Hospital, Royal Oak, Mich (B.A.F.); University of Miami (R.L.S.); Brigham and Women's Hospital and Harvard Medical School, Boston, Mass (D.P.F.); Midwest Heart Specialists, Elmhurst, Ill (V.J.B.); University of California at San Francisco (R.F.R.); Sinai Hospital of Baltimore (N.M.M.); American Heart Association, Dallas, Tex (P.S., M.G., K.R., P.W.); and Christiana Care Health System, Wilmington, Del (T.J.G.). , Barry A. FranklinBarry A. Franklin From the University of Mississippi Medical Center, Jackson (D.W.J.); Duke University, Durham, NC (E.D.P.); Northwestern University Medical Center, Evanston, Ill (R.O.B.); Mayo Clinic, Rochester, Minn (R.J.G.); William Beaumont Hospital, Royal Oak, Mich (B.A.F.); University of Miami (R.L.S.); Brigham and Women's Hospital and Harvard Medical School, Boston, Mass (D.P.F.); Midwest Heart Specialists, Elmhurst, Ill (V.J.B.); University of California at San Francisco (R.F.R.); Sinai Hospital of Baltimore (N.M.M.); American Heart Association, Dallas, Tex (P.S., M.G., K.R., P.W.); and Christiana Care Health System, Wilmington, Del (T.J.G.). , Ralph L. SaccoRalph L. Sacco From the University of Mississippi Medical Center, Jackson (D.W.J.); Duke University, Durham, NC (E.D.P.); Northwestern University Medical Center, Evanston, Ill (R.O.B.); Mayo Clinic, Rochester, Minn (R.J.G.); William Beaumont Hospital, Royal Oak, Mich (B.A.F.); University of Miami (R.L.S.); Brigham and Women's Hospital and Harvard Medical School, Boston, Mass (D.P.F.); Midwest Heart Specialists, Elmhurst, Ill (V.J.B.); University of California at San Francisco (R.F.R.); Sinai Hospital of Baltimore (N.M.M.); American Heart Association, Dallas, Tex (P.S., M.G., K.R., P.W.); and Christiana Care Health System, Wilmington, Del (T.J.G.). , David P. FaxonDavid P. Faxon From the University of Mississippi Medical Center, Jackson (D.W.J.); Duke University, Durham, NC (E.D.P.); Northwestern University Medical Center, Evanston, Ill (R.O.B.); Mayo Clinic, Rochester, Minn (R.J.G.); William Beaumont Hospital, Royal Oak, Mich (B.A.F.); University of Miami (R.L.S.); Brigham and Women's Hospital and Harvard Medical School, Boston, Mass (D.P.F.); Midwest Heart Specialists, Elmhurst, Ill (V.J.B.); University of California at San Francisco (R.F.R.); Sinai Hospital of Baltimore (N.M.M.); American Heart Association, Dallas, Tex (P.S., M.G., K.R., P.W.); and Christiana Care Health System, Wilmington, Del (T.J.G.). , Vincent J. BufalinoVincent J. Bufalino From the University of Mississippi Medical Center, Jackson (D.W.J.); Duke University, Durham, NC (E.D.P.); Northwestern University Medical Center, Evanston, Ill (R.O.B.); Mayo Clinic, Rochester, Minn (R.J.G.); William Beaumont Hospital, Royal Oak, Mich (B.A.F.); University of Miami (R.L.S.); Brigham and Women's Hospital and Harvard Medical School, Boston, Mass (D.P.F.); Midwest Heart Specialists, Elmhurst, Ill (V.J.B.); University of California at San Francisco (R.F.R.); Sinai Hospital of Baltimore (N.M.M.); American Heart Association, Dallas, Tex (P.S., M.G., K.R., P.W.); and Christiana Care Health System, Wilmington, Del (T.J.G.). , Rita F. RedbergRita F. Redberg From the University of Mississippi Medical Center, Jackson (D.W.J.); Duke University, Durham, NC (E.D.P.); Northwestern University Medical Center, Evanston, Ill (R.O.B.); Mayo Clinic, Rochester, Minn (R.J.G.); William Beaumont Hospital, Royal Oak, Mich (B.A.F.); University of Miami (R.L.S.); Brigham and Women's Hospital and Harvard Medical School, Boston, Mass (D.P.F.); Midwest Heart Specialists, Elmhurst, Ill (V.J.B.); University of California at San Francisco (R.F.R.); Sinai Hospital of Baltimore (N.M.M.); American Heart Association, Dallas, Tex (P.S., M.G., K.R., P.W.); and Christiana Care Health System, Wilmington, Del (T.J.G.). , Neil M. MetzlerNeil M. Metzler From the University of Mississippi Medical Center, Jackson (D.W.J.); Duke University, Durham, NC (E.D.P.); Northwestern University Medical Center, Evanston, Ill (R.O.B.); Mayo Clinic, Rochester, Minn (R.J.G.); William Beaumont Hospital, Royal Oak, Mich (B.A.F.); University of Miami (R.L.S.); Brigham and Women's Hospital and Harvard Medical School, Boston, Mass (D.P.F.); Midwest Heart Specialists, Elmhurst, Ill (V.J.B.); University of California at San Francisco (R.F.R.); Sinai Hospital of Baltimore (N.M.M.); American Heart Association, Dallas, Tex (P.S., M.G., K.R., P.W.); and Christiana Care Health System, Wilmington, Del (T.J.G.). , Penelope SolisPenelope Solis From the University of Mississippi Medical Center, Jackson (D.W.J.); Duke University, Durham, NC (E.D.P.); Northwestern University Medical Center, Evanston, Ill (R.O.B.); Mayo Clinic, Rochester, Minn (R.J.G.); William Beaumont Hospital, Royal Oak, Mich (B.A.F.); University of Miami (R.L.S.); Brigham and Women's Hospital and Harvard Medical School, Boston, Mass (D.P.F.); Midwest Heart Specialists, Elmhurst, Ill (V.J.B.); University of California at San Francisco (R.F.R.); Sinai Hospital of Baltimore (N.M.M.); American Heart Association, Dallas, Tex (P.S., M.G., K.R., P.W.); and Christiana Care Health System, Wilmington, Del (T.J.G.). , Meighan GirgusMeighan Girgus From the University of Mississippi Medical Center, Jackson (D.W.J.); Duke University, Durham, NC (E.D.P.); Northwestern University Medical Center, Evanston, Ill (R.O.B.); Mayo Clinic, Rochester, Minn (R.J.G.); William Beaumont Hospital, Royal Oak, Mich (B.A.F.); University of Miami (R.L.S.); Brigham and Women's Hospital and Harvard Medical School, Boston, Mass (D.P.F.); Midwest Heart Specialists, Elmhurst, Ill (V.J.B.); University of California at San Francisco (R.F.R.); Sinai Hospital of Baltimore (N.M.M.); American Heart Association, Dallas, Tex (P.S., M.G., K.R., P.W.); and Christiana Care Health System, Wilmington, Del (T.J.G.). , Kathy RogersKathy Rogers From the University of Mississippi Medical Center, Jackson (D.W.J.); Duke University, Durham, NC (E.D.P.); Northwestern University Medical Center, Evanston, Ill (R.O.B.); Mayo Clinic, Rochester, Minn (R.J.G.); William Beaumont Hospital, Royal Oak, Mich (B.A.F.); University of Miami (R.L.S.); Brigham and Women's Hospital and Harvard Medical School, Boston, Mass (D.P.F.); Midwest Heart Specialists, Elmhurst, Ill (V.J.B.); University of California at San Francisco (R.F.R.); Sinai Hospital of Baltimore (N.M.M.); American Heart Association, Dallas, Tex (P.S., M.G., K.R., P.W.); and Christiana Care Health System, Wilmington, Del (T.J.G.). , Patrick WaytePatrick Wayte From the University of Mississippi Medical Center, Jackson (D.W.J.); Duke University, Durham, NC (E.D.P.); Northwestern University Medical Center, Evanston, Ill (R.O.B.); Mayo Clinic, Rochester, Minn (R.J.G.); William Beaumont Hospital, Royal Oak, Mich (B.A.F.); University of Miami (R.L.S.); Brigham and Women's Hospital and Harvard Medical School, Boston, Mass (D.P.F.); Midwest Heart Specialists, Elmhurst, Ill (V.J.B.); University of California at San Francisco (R.F.R.); Sinai Hospital of Baltimore (N.M.M.); American Heart Association, Dallas, Tex (P.S., M.G., K.R., P.W.); and Christiana Care Health System, Wilmington, Del (T.J.G.). and Timothy J. GardnerTimothy J. Gardner From the University of Mississippi Medical Center, Jackson (D.W.J.); Duke University, Durham, NC (E.D.P.); Northwestern University Medical Center, Evanston, Ill (R.O.B.); Mayo Clinic, Rochester, Minn (R.J.G.); William Beaumont Hospital, Royal Oak, Mich (B.A.F.); University of Miami (R.L.S.); Brigham and Women's Hospital and Harvard Medical School, Boston, Mass (D.P.F.); Midwest Heart Specialists, Elmhurst, Ill (V.J.B.); University of California at San Francisco (R.F.R.); Sinai Hospital of Baltimore (N.M.M.); American Heart Association, Dallas, Tex (P.S., M.G., K.R., P.W.); and Christiana Care Health System, Wilmington, Del (T.J.G.). Originally published5 Jan 2009https://doi.org/10.1161/CIRCULATIONAHA.108.191328Circulation. 2009;119:340–350Other version(s) of this articleYou are viewing the most recent version of this article. Previous versions: January 5, 2009: Previous Version 1 The mission of the American Heart Association (AHA) is summarized by the statement, "Building healthier lives free of cardiovascular disease and stroke." Reaching this goal will take significant advances in both science and clinical care but also will require a new level of engagement and action on the part of the public and patients in their health and health care. Recently, the AHA published "Translating Research Into Practice for Healthcare Providers: The American Heart Association's Strategy for Building Healthier Lives Free of Cardiovascular Disease and Stroke,"1 which summarizes the AHA's efforts to actively foster cardiovascular research and evidence-based clinical care among healthcare providers. Although assisting the work of scientists and clinicians is critical to achieving the AHA's mission, it remains only part of the equation. Consumers and patients must be educated and engaged both to prevent cardiovascular events and to improve their outcomes after events occur. Recognizing this, the AHA has embarked on a robust set of initiatives designed to help individuals understand and modify their cardiovascular risk factors, to seek care when appropriate, to partner with their physicians and healthcare professionals to better treat their disease, and to help make changes in industry and workplaces. This report, the second of a 2-part series, summarizes the AHA's consumer- and patient-related activities to motivate healthy behaviors, improve risk factor control, and manage cardiovascular disease (CVD) and stroke.It is clear that achieving lasting risk factor modification is a challenging endeavor. From a behavioral perspective, the substantive change occurs only after individuals move through several states: from a precontemplative to a contemplative state, from a preparatory to an action state, and finally to a maintenance state. Thus, the AHA has designed a series of initiatives and programs to address each of these states (Figure 1). The public must be made aware of the scope and impact of CVD and stroke, which remain the No. 1 killer and No. 3 killer of both women and men of all race and ethnicities in the United States. Individuals must understand both the general risks of CVD and stroke and their individual risk (and modifiable risk factors) so they can be motivated to take action. Once motivated and ready for change, individuals must be given the tools to take action for themselves or effectively engage in an active partnership with their physicians to promote health maintenance and disease management. At a societal level, regulatory or legislative changes may be needed to support healthy lifestyles and consumer or patient engagement. Download figureDownload PowerPointFigure 1. AHA programmatic approach to addressing stages in consumer and patient behavior in accepting and becoming engaged in personal health management. Organizational strategy follows stages in consumer and patient acceptance from precontemplative to maintenance.One can also visualize the AHA's initiatives as affecting successive strata of a pyramid (Figure 2). At the base are the AHA's cause initiatives. These are directed at various segments of the general public and are designed to raise health awareness regarding CVD and stroke. Consumers and patients also need to be provided with tools to help identify and reduce risks and educational materials to promote healthy habits. The AHA's newest efforts go beyond these general tools to assist individuals, one at a time, to design and carry out a personalized program for modifying risk factors and disease management. Across this entire spectrum, the AHA has sought to use emerging technologies such as the Internet, social media, and personal health records (PHRs) to make information and learning tools more available, portable, and engaging and to facilitate continuous updating. The ultimate goal of these programs is to place the consumer and patients at the center of the AHA's healthcare efforts. By giving individuals a newfound ability to understand their risk factors, view and control their health records, and better monitor, manage, and take personal steps to improve their health, the AHA is positioned at the forefront of a new revolution in healthcare.2Download figureDownload PowerPointFigure 2. AHA strategies to further awareness and education from general health awareness to specific patient education tools, personal health records, and disease management tools. CVWC indicates Cardiovascular Wellness Center.AHA Cause-Initiative ProgramsThe AHA has developed and implemented a series of cause initiatives to extend the brands of the AHA and the American Stroke Association. Organizational entry points have been created to match the faces of the constituents they represent. Women can see themselves as part of the AHA through its Go Red for Women program; blacks have a critical health network via the Power to End Stroke Campaign; children and parents have resources created just for them in the Alliance for a Healthier Generation; and adults can become more physically active by engaging in individualized programs and through the support of their employers in programs such as Start! (Table 1). All of these initiatives are intended to raise public awareness of CVD, stroke, and associated risk factors, to empower individuals with the information and support that they may need to change their health.3 Additionally, each initiative provides a channel for consumers and patients to unite under a common issue, which in turn creates additional momentum for the group toward heart health. Table 1. Cause CampaignsCampaign NameInitiative GoalSignificant AccomplishmentURLGo Red For WomenA movement intended to encourage women to become heart healthy and to "know their numbers" and take action to reduce their risk for CVD• Over 1.3 million women have taken the GRFW heart checkuphttp://www.GoRedforWomen.org• Approximately 70% of women who have joined the "Go Red" movement had important health screeningAlliance for a Healthier GenerationA joint initiative between the AHA, the William J. Clinton Foundation, and Governor Arnold Schwarzenegger; the goal of the Alliance is to stop the increasing prevalence of childhood obesity by 2010 and reduce childhood obesity by 2015• Brokered an agreement with beverage and snack food industries to improve school food and beverage optionshttp://www.healthiergeneration.org• Created with Nickelodeon the "Let's Just Play Go Healthy Challenge"; Approximately 900 000 people have joined the "Go HealthyChallenge"• Implemented a Healthy Schools program• Is developing a program to reimburse individuals for obesity counseling and managementStart!A movement for both men and women to reverse the trend of adult physical inactivity in the United States by creating a culture that supports physical activity. The initiative provides valuable tools and resources for work sites/employers and individuals. START! recognizes companies for developing programs that prioritize the health and well-being of their employees• During its first year, >520 fit-friendly companies participated in the initiativehttp://www.americanheart.org/start• More than 90 000 consumers registered on the MyStart! Online Web sitePower to End StrokeA campaign to increase awareness of stroke and its major modifiable risk factors (high blood pressure and diabetes) among blacks. The campaign hopes to motivate both individual and community actions via Power Ambassadors• 148 173 Individuals enrolled in movementhttp://www.strokeassociation.org• 4679 National, local Power AmbassadorsGo Red for WomenApproximately 460 000 women die of CVD each year, which is more than the next 4 causes of death combined.4 Despite this, many Americans are still unaware that heart disease and stroke are major health issues for American women. To address this gap, the association launched the Go Red for Women (GRFW) program in 2004 (www.GoRedforWomen. org). GRFW is designed to raise heart disease awareness in women and to provide women with knowledge and tools to take positive action to reduce their risks of heart disease and stroke.5 GRFW encourages women to address their cardiac risks factors by getting them to "know their numbers" and to relate their blood pressure, cholesterol, and triglyceride levels to the guideline-recommended values.5More than 1.3 million women have taken the GRFW heart checkup (an online heart risk assessment), and of those joining GRFW, 93% have visited their healthcare provider, 90% had their blood pressure checked, and 75% had their cholesterol levels checked (Fall 2007 GRFW database survey). Of those women who have joined GRFW in the past 12 months, 96% have taken some action, 54% reporting that they have begun exercising more frequently, 53% that they have had their cholesterol checked, and 65% that they eat more healthy foods. Choose to Move, a component of GRFW, is a 12-week online physical activity program. The 2007 Choose to Move Exercise Survey found that exercise goals are a high priority for women but that most do not commit time or use the best tools to succeed. Those who succeeded used tools that were easily accessible and free. The survey also found that women who work on their goal for more than 6 months have a better record of achievement, whereas about half of those who fail have stopped trying in the first 2 months. The 12-week, free online format of Choose to Move was designed to combat these barriers. By assisting women to exercise more, Choose to Move has helped more than 100 000 women tackle a critical CVD risk factor. Thus, GRFW has elevated women's knowledge levels about their cardiovascular risks and has motivated them to take action to address these risks.Alliance for a Healthier GenerationApproximately 1 in 3 children and teens (ages 2 to 19 years), in the United States are obese or overweight.6 When children are overweight, they have a markedly increased risk of developing hypertension, hypercholesterolemia, or type 2 diabetes mellitus and increased odds of becoming overweight adults with an increased risk of CVD.7 The AHA has a long history of providing evidence-based nutritional, physical activity, and obesity prevention and treatment information to professionals and to the public.8,9 As an extension of this effort, in 2005, the AHA joined with the William J. Clinton Foundation to form the Alliance for a Healthier Generation (the Alliance) with a mission to eliminate childhood obesity and inspire all young people in the United States to develop lifelong, healthy habits (see www.HealthierGeneration.org). In May 2007, Governor Arnold Schwarzenegger of California joined former President Clinton and the AHA as co-lead of the Alliance.10 The goal of the Alliance is to stop the increasing prevalence of childhood obesity by 2010 and reduce its prevalence by 2015. Because there is no single identifiable cause for this epidemic, the Alliance has developed a multifaceted approach to address childhood obesity by targeting the places that can make a difference to a child's health (homes, schools, doctors' offices, and communities) and by targeting the children and adolescents themselves. This strategy includes fostering healthier environments and empowering children and adolescents with the information and tools they need to develop healthy habits.During its 3-year history, the Alliance has experienced much success in its efforts. The Alliance's Healthy Schools Program is providing schools with comprehensive tools and solutions to help schools improve in the areas of nutrition, physical activity, and staff wellness. The program, which began in 2006 with generous support from the Robert Wood Johnson Foundation, provides on-site support to ≈2000 schools in 34 states during the 2008 to 2009 school year with a goal to support more than 8000 schools by 2010. Additionally, the Healthy Schools Program is reaching countless additional schools via its online program, with schools registered for the online program in all 50 states.Most notably, the Alliance was able to broker a landmark agreement with the beverage and snack food industries to offer healthier food and drink options in schools. During the first 2 years of implementation, the Alliance for a Healthier Generation School Beverage Guidelines resulted in a 65% decrease in full-calorie carbonated soft drink sales, and nearly 79% of school beverage contracts are in compliance with the Alliance Guidelines; these changes resulted in 58% fewer beverage calories being shipped to schools in the 2007 to 2008 school year than in 2004. These first-ever voluntary guidelines for snacks and beverages sold in schools are providing healthier food choices for nearly 35 million American students.The Alliance has also developed the Go Healthy Challenge, which is motivating and empowering children to take charge of their health and lead their own movement to make their schools, families, and communities healthier. As part of the Go Healthy Challenge, in 2006, the Alliance and Nickelodeon created 2 seasons of the Let's Just Play Go Healthy Challenge, an integrated TV, online, and grassroots program that empowers children to take charge of their own health. To date, the Go Healthy Challenge has engaged nearly 1 million children who pledged to go healthy, and the Alliance continues to engage kids through grassroots and online initiatives. Lastly, the Alliance is working with the healthcare industry to improve the diagnosis, prevention, and treatment of childhood obesity through collaborations with providers, industry, and other stakeholder groups.Start!With the increasing levels of physical inactivity and sedentary behavior and the alarming rate of adult obesity, in 2007, the AHA decided to launch its newest cause, Start! (www. americanheart.org/start), which encourages Americans and their employers to create a culture of physical activity and health.11 The overall goal of Start! is to reverse the trend of adult physical inactivity in the United States by encouraging Americans to make positive lifestyle changes. With the majority of time spent in the workplace, encouraging companies to develop programs that facilitate heart-healthy behaviors makes perfect sense. Programs include company walking programs, Start! online tools and resources, AHA's Start! Heart Walk, and the Start! Fit Friendly Recognition Program, a program that is intended to recognize employers who develop successful programs.12 Each of these programs provides a company with tools to keep their employees active all year. Heart360, as described below, is an important tool that will be offered to companies to assist with disease management. Outside of the workplace, individuals can track their daily physical activity and caloric intake through the MyStart! online tracking tool, which also provides additional resources such as nutritional information.13 In the first year of Start!, more than 520 fit-friendly companies participated in the campaign, and >90 000 individuals registered on the MyStart! Online World Wide Web site.14Power to End StrokeStroke remains the nation's No. 3 killer and a leading cause of long-term disability in the United States. Blacks have a higher prevalence of hypertension and other stroke risk factors and as a result have twice the risk and mortality of stroke as whites. Given these alarming statistics, the American Stroke Association developed the Power to End Stroke campaign, intended to heighten awareness among blacks of the serious impact stroke has in their community and to focus attention on the beneficial effects of control of high blood pressure and diabetes (see www.strokeassociation.org). The Power to End Stroke campaign is designed to engage blacks by encouraging them to make a personal commitment to join the movement. More than 300 000 individuals have joined Power to End Stroke by taking the stroke pledge. More than 4600 Power Ambassadors, individuals with influence, have made a commitment to understand stroke risk factors and to share this knowledge with others in the community. This campaign will empower individuals to take action by doing 1 or more of the following: (1) talk to a doctor, (2) exercise/walk, (3) undergo a stroke risk-assessment test, and (4) participate in a health screening. By 2011, the campaign hopes to mobilize 500 000 blacks to understand their risks for stroke and to take meaningful steps to reduce this risk. The Power to End Stroke campaign has particular significance to improving national health rankings, because all the actionable determinants of health (personal behavior, social factors, healthcare, and the environment) disproportionately affect underserved populations and people with lower socioeconomic status.15AHA's Primary and Secondary Patient Education, Risk Assessment, and Disease Management ProgramsDisseminating healthcare and disease management information in a user-friendly, easily understood format is a challenging but necessary step to empower patients, caregivers, and families, both once risk has developed but an acute event has not occurred and, from a secondary prevention perspective, to attempt to negate additional and perhaps fatal events. In addition to providing public health information designed to prevent CVD and stroke, the AHA has a long history of developing high-quality educational materials for patients with established CVD or stroke. The AHA recently recognized the need to develop expertise in patient health literacy and cultural competency and to create new distribution channels for its educational products. To have the greatest impact, the AHA's health messages should be coupled with an assessment of individual patient health and risk factors. Thus, the AHA has developed innovative tools for personalized cardiovascular risk assessment and the ability to monitor and adjust modifiable risk. These have been developed in close collaboration with healthcare professionals, because they have a fundamental interest in educating their patients and can serve as a key distributor of this information.The AHA uses a variety of different mediums to move its information and educational messages across the continuum of care, from primary prevention to acute treatment interventions to long-term care. The AHA has committed significant resources to the development of patient education materials (in the form of comprehensive print brochures/materials). Overall, the AHA distributes more than 7.3 million printed education materials to patients and caregivers annually, with a specific emphasis on serving special needs populations. The current print product line includes 14 Spanish brochures and 2 targeted to the black community (in addition to those already developed specifically for Power to End Stroke), with a distribution to >312 000 patie
Referência(s)