Effectiveness of a Family Heart Health Intervention

描述（由申请人提供）：由于共有的基因和生活方式，冠心病（CHD）患者的家庭成员发生血管事件的风险增加。冠心病住院可能代表了一个“激励时刻”，让家庭成员确定自己的风险，并采取行动，以降低它。我们以前筛选了1500多名冠心病住院患者的家庭成员/朋友，发现近40%的人有> 3个冠心病的主要危险因素，只有约10%的人没有。在一项试点研究中，我们发现，对参与者进行简短的教育干预，3个月后生活习惯得到了显着改善。这项研究的目的是测试家庭护照心脏健康计划的有效性，这是一项医院外展筛查和教育计划，旨在识别风险人群，增加对心脏健康生活方式的坚持，并在1年内改善CVD风险因素。研究设计为随机对照临床试验。受试者将被分配到接受关于CHD的一般健康信息的对照组（N = 250）或接受标准化CHD风险因素筛查、个性化教育、医院工作人员定期联系并将结果通知主治医生的特殊干预（SI）组（N=250）。参与者将包括讲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运重建手术而入住纽约长老会医院的家人/朋友。干预措施由受过培训的健康教育工作者/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）胆固醇从基线至1年的平均降低百分比。次要结局包括在1年时达到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、Fragrance风险评分和高敏C反应蛋白（hsCRP）的平均百分比变化。将计算降低LDL水平的干预措施的成本效益，以及从降脂治疗的临床结局试验中预测的每生命年节省的成本。将评估关于hsCRP的信息超出传统风险因素对实现预防目标的影响。这项研究将提供重要的信息，一个新的程序，以确定冠心病的风险和增加实现健康的人2010年的目标的有效性。

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.