Effectiveness of a Family Heart Health Intervention

家庭心脏健康干预措施的有效性

• 批准号: 7057195
• 负责人: LORI J MOSCA
• 金额: $ 51.82万
• 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/7057195
• 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）：冠心病患者的家庭成员由于共同的基因和生活方式，血管事件的风险增加。因冠心病住院治疗可能是家庭成员确定自身风险并采取行动降低风险的“激励时刻”。我们之前对1500多名冠心病住院患者的家庭成员/朋友进行了筛查，发现近40%的人有3个主要的冠心病危险因素，只有10%的人没有。在一项初步研究中，我们表明，对参与者进行简短的教育干预，3个月后，他们的生活习惯得到了显著改善。本研究的目的是测试心脏健康家庭护照计划的有效性，该计划是一项医院外展筛查和教育计划，旨在识别高危人群，增加对心脏健康生活方式的依从性，并在1年内改善心血管疾病的危险因素。本研究设计为随机对照临床试验。受试者将被分配到对照组，接受关于冠心病的一般健康信息（N=250），或特殊干预组（N=250），接受标准化的冠心病危险因素筛查，个性化教育，医院工作人员定期联系，并将结果通知给主治医生。参与者将包括说英语或西班牙语的个人，他们将访问因急性冠状动脉综合征或血管重建术而住进纽约长老会医院的家人/朋友。干预措施由训练有素的健康教育工作者/营养师提供，并由医生监督。主要结局是SI组与对照组相比，低密度脂蛋白（LDL）胆固醇从基线到1年的平均降低百分比。次要结局包括在1年内达到由国家胆固醇教育计划成人治疗小组III定义的治疗性生活方式改变饮食，其他脂蛋白、血压、体重指数、腰围、Framingham风险评分和高敏感性C反应蛋白（hsCRP）的平均百分比变化。将计算降低低密度脂蛋白水平的干预措施的成本效益，以及从降脂治疗的临床结果试验中预计节省的每生命年的成本。将评估除传统风险因素外的关于hsCRP的信息对实现预防目标的影响。这项研究将提供重要的信息，说明一个新的程序的有效性，以确定有冠心病风险的人，并提高实现健康人2010目标。