Effectiveness of a Family Heart Health Intervention

家庭心脏健康干预措施的有效性

• 批准号: 6931170
• 负责人: LORI J MOSCA
• 金额: $ 49.04万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-08-01 至 2008-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6931170
• 关键词: acute phase protein; adult human (21+); behavioral /social science research tag; blood pressure; body composition; cardiovascular disorder education; cardiovascular disorder risk; clinical research; clinical trials; coronary disorder; cost effectiveness; diet; education evaluation /planning; family; family genetics; genetic screening; health behavior; human subject; lifestyle; low density lipoprotein; mass screening; nutrition related tag; outcomes research; patient oriented research

DESCRIPTION (provided by applicant): Family members of individuals with coronary heart disease (CHD) are at increased risk of vascular events due to shared genes and lifestyle. Hospitalization for CHD may represent a "motivational moment" for family members to determine their own risk and take action to lower it. We have previously screened over 1500 family members/friends of patients hospitalized with CHD and found that nearly 40 percent had > 3 major risk factors for CHD and only about 10 percent had none. In a pilot study, we showed that a brief intervention to educate participants resulted in significant improvements in lifestyle habits after 3 months. The purpose of this study is to test the effectiveness of the Family Passport To Heart Health Program, a hospital outreach screening and educational program, to identify persons at risk, increase adherence to heart healthy lifestyles, and improve CVD risk factors at 1 year. The design of the study is a randomized controlled clinical trial. Subjects will be assigned to either a control group that receives general health messages about CHD (N = 250) or a special intervention (SI) group (N=250) that receives standardized CHD risk factor screening, personalized education, regular contact by hospital staff, and notification of results to primary physician. Participants will include English or Spanish speaking individuals visiting family members/friends admitted to New York-Presbyterian Hospital with an acute coronary syndrome or revascularization procedure. The intervention is delivered by trained health educators/dieticians and overseen by a physician. The primary outcome is the mean percent reduction in low density lipoprotein (LDL) cholesterol from baseline to 1 year in the SI vs. control group. Secondary outcomes include attainment of the Therapeutic Lifestyle Change Diet at 1 year as defined by the National Cholesterol Education Program Adult Treatment Panel III, the mean percent change in other lipoproteins, blood pressure, body mass index, waist circumference, Framingham risk score, and high sensitivity C reactive protein (hsCRP). Cost-effectiveness of the intervention to reduce LDL levels will be calculated as well as cost per life year saved projected from clinical outcome trials of lipid lowering therapy. The impact of information about hsCRP beyond traditional risk factors on attainment of prevention goals will be assessed. This study will provide important information about the effectiveness of a novel program to identify persons at risk of CHD and increase attainment of Healthy People 2010 Objectives.

描述（由申请人提供）：冠心病患者（CHD）的家庭成员由于共享基因和生活方式而发生血管事件的风险增加。冠心病的住院可能代表家庭成员确定自己的风险并采取行动降低它的“激励时刻”。我们以前曾筛选有1500多名冠心病患者的家庭成员/患者的朋友，发现近40％的冠心病患者的危险因素> 3个主要危险因素，只有大约10％的人没有。在一项试点研究中，我们表明，简短的干预措施教育参与者，在3个月后的生活方式习惯显着改善。这项研究的目的是测试家庭护照到心脏健康计划，医院外展筛查和教育计划的有效性，以确定有风险的人，增加对心脏健康的生活方式的依从性，并在1年时改善CVD风险因素。该研究的设计是一项随机对照临床试验。受试者将被分配给接收有关CHD（n = 250）的一般健康消息的对照组或接受标准化的CHD风险因素筛查，个性化教育，医院工作人员定期联系的特殊干预措施（SI）组（n = 250） ，并向初级医师通知结果。参与者将包括英语或西班牙语的人，拜访家庭成员/朋友，并通过急性冠状动脉综合症或血运重建程序被送往纽约长老会医院。干预措施由训练有素的健康教育者/营养师提供，并由医生监督。主要结果是在SI与对照组中，低密度脂蛋白（LDL）胆固醇的平均降低百分比降低。次要结果包括达到1年的治疗生活方式改变饮食，这是国家胆固醇教育计划成人治疗小组III的定义，其他脂蛋白的平均百分比变化，血压，体重指数，腰围，腰围，弗雷明汉风险评分和高度敏感性C反应性蛋白（HSCRP）。将计算降低LDL水平的干预措施的成本效益，以及从脂质降低治疗的临床结果试验中预期的每年节省的成本。将评估有关HSCRP的信息超出传统风险因素对实现预防目标的影响。这项研究将提供有关新计划的有效性的重要信息，以确定有冠心病风险的人并提高健康人的目标2010年目标。