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Primary Care Partnerships to Prevent Heart Disease in Women
Primary Care Partnerships to Prevent Heart Disease in Women

Jacobs Neurological Institute
Primary Care Partnerships to Prevent Heart Disease in Women
Targeting Rural Western New York

Challenge:

To successfully perform the Primary Care Partnerships to Prevent Heart Disease in Women project within the six rural counties of Western New York. The rural area of Western New York has a vastly different population of both patients and primary care providers (PCP). The rural challenges that these PCPs face on a daily basis needed to be integrated into the outreach strategy of the Research Center for Stroke & Heart Disease (Research Center).

Strategies:

Formed a strategic partnership with Western New York Rural Area Health Education Center (WNY R-AHEC), a non-profit, independent facilitation resource that creates community partnerships to educate and place health care professionals in the underserved areas where they are needed most. WNY R-AHEC assisted the Research Center in:

  • Compiling a PCP roster and mailing list.

  • Identifying state primary care leaders in the region. Meetings and calls were set-up with each regional primary care leader to inquire about each region's specific challenges and needs.

  • Making connections with the various rural health networks and area hospitals. The Research Center contacted each health network in the region to discuss the program, our aims, and how they would be able to work with us during this program.

Activities/Tactics:

  • Created a program-specific website with multiple tools and resources: www.primarycarepartnerships.org

  • Hosted several educational interventions (continuing medical education (CME) sessions) with local heart disease experts presenting The Heart Truth® slide sets on the American Heart Association's Evidence-based Guidelines for Cardiovascular Disease Prevention in Women, 2007 Update (Guidelines). These sessions also featured local primary care physicians to discuss best practices in office systems improvement and integration of the Guidelines in clinical practice.

  • Contacted targeted region's nursing, physician's assistant, nurse practitioner, and medical school program directors and provided The Heart Truth materials for possible integration into curriculum.

Results:

The following results data includes the CME educational interventions during Year 1. The Research Center has compared the results of eight knowledge questions contained on both the pre- and post-test. There was significant improvement in knowledge about heart disease in women among the group of providers that attended the interventions to date. These results reflect the need for this education, as well as the effectiveness of the interventions and the use of local speakers. The following results represent the change in number of correct responses by those providers who completed both a pre- and post-test (n= number correct for each):

  • Which of the following conditions places a woman at high risk (> 20% over 10 years) for a coronary artery disease event? Answer: All of the above (Established coronary artery disease; Cerebrovascular disease with carotid artery involvement; End stage renal disease) place a woman at high risk for a coronary artery disease event. (Pre-test n=86, Post-test n=99) 15% improvement

  • Which of the following foods is the usual major dietary source of trans-fatty acids? Answer: Baked products made with partially-hydrogenated vegetable oil. (Pre-test n=61, Post-test n=91) 49% improvement

  • Which of the following is true about the use of HMG CoA-reductase inhibitors (statins) in women? Answer: Women with diabetes should receive statin therapy to lower their level of low-density lipoprotein cholesterol (LDL-C) to < 100 mg/dL. (Pre-test n=34, Post-test n=70) 106% improvement

  • Which of the following is currently recommended to prevent coronary artery disease events in women? Answer: None of the above (Post-menopausal hormone therapy with transdermal estrogen, antioxidant vitamin supplements; Both transdermal estrogen and antioxidant vitamin supplements) is currently recommended to prevent coronary artery disease events in women. (Pre-test n=52, Post-test n=95) 83% improvement

  • Which of the following is true regarding the incidence of diabetes in women? Answer: None of the above (Asian-Americans; African Americans; Latinas, have a low risk of type 2 diabetes mellitus) are correct. (Pre-test n=45, Post-test n=91) 102% improvement

  • Which of the following is true regarding race/ethnicity and heart disease in women? Answer: Among women of all races and ethnicities, African American women are the most likely to die from heart disease. (Pre-test n=68, Post-test n=99) 46% improvement

  • Which of the following is true about counseling women about smoking cessation? Answer: All of the above (Women respond to the same treatments as men; Depression is a more common barrier to smoking cessation in women compared to men; Concern about weight gain is a more common barrier to smoking cessation in women compared to men) are true statements. (Pre-test n=42, Post-test n=74) 76% improvement

  • Which of the following is true about the treatment of hypertension to prevent heart disease in women? Answer: None of the above (Thiazide diuretics should be avoided in women with diabetes; Except for sodium restriction, diet changes are effective only if weight loss occurs; Increasing alcohol intake to two drinks per day is recommended, unless contraindicated) are true statements. (Pre-test n=55, Post-test n=88) 60% improvement

Last Updated: February 29, 2012

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