为等待家庭医生的加拿大成年人实施改良版心血管健康意识计划。

Implementation of Modified Cardiovascular Health Awareness Program for Canadian Adults on a Waiting List for a Family Physician.

机构信息

University of Montreal, Montreal, QC, Canada.

CRCHUM, Montreal, QC, Canada.

出版信息

J Prim Care Community Health. 2020 Jan-Dec;11:2150132720976484. doi: 10.1177/2150132720976484.

DOI:10.1177/2150132720976484

PMID:33243046

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7708698/

Abstract

INTRODUCTION

The Cardiovascular Health Awareness Program (CHAP) was originally developed and evaluated as a community-based cardiovascular diseases (CVD) prevention program in communities where access to family physicians was not a significant issue. Many Canadians now face sub-optimal access to a regular source of primary care. Centralized waiting lists and prioritization based on urgency of medical need were created to address this problem. We aimed to assess the acceptability, CVD risk profile, and potential benefits of offering a modified version of CHAP to adults on the waiting list.

METHODS

The implementation was conducted in Laval (Canada) between March and June 2016, targeting individuals 40 years of age or older who were registered on the waiting list (GACO) and had a priority code of 3. Participants were invited through a personalized letter to attend sessions in community health centers. During the sessions, participants completed CVD risk profiles, risk of type 2 diabetes questionnaire (CANRISK); had their blood pressure, height and weight as well as waist circumference measured. They also received targeted healthy lifestyle and patient education materials and were referred to local programs including a medical follow-up, when required.

RESULTS

A total of 1976 invitation letters were sent resulting in 281 (14.2%) participants. The average age of attendees was 58.1 (SD = 8.2) and a majority were female (58%, n = 163). A third of participants (34.2%, n = 96) had BP ≥140/90 and 11.4% (n = 32) were classified as having a very high risk for developing diabetes. Almost half (41.6%, n = 117) of participants were referred either to health promotion programs offered by local health authorities, to family physicians (4.6%, n = 13) or emergency departments (1.8%, n = 5) for short-term medical assistance.

CONCLUSION

Despite low participation rate, many adults on a waiting list had elevated risk for CVD and would greatly benefit from having a regular source of primary care.

摘要

简介

心血管健康意识计划（CHAP）最初是作为一种基于社区的心血管疾病（CVD）预防计划开发和评估的，该计划在家庭医生可及性不是一个重要问题的社区中进行。现在，许多加拿大人面临着获得常规初级保健服务的机会不足的问题。为了解决这个问题，创建了集中的候补名单和基于医疗需求紧迫性的优先级排序。我们旨在评估向等待名单上的成年人提供经过修改的 CHAP 版本的可接受性、CVD 风险概况和潜在益处。

方法

该实施于 2016 年 3 月至 6 月在拉瓦尔（加拿大）进行，目标是年龄在 40 岁或以上的个人，他们在等待名单（GACO）上注册，并且具有优先级代码 3。参与者通过个性化信件被邀请参加社区卫生中心的会议。在会议期间，参与者完成 CVD 风险概况、2 型糖尿病风险问卷（CANRISK）；测量血压、身高和体重以及腰围。他们还收到了有针对性的健康生活方式和患者教育材料，并被转介到当地的项目，包括医疗随访，必要时。

结果

共发送了 1976 封邀请信，结果有 281 名（14.2%）参与者。与会者的平均年龄为 58.1（SD=8.2），大多数为女性（58%，n=163）。三分之一的参与者（34.2%，n=96）的血压≥140/90，11.4%（n=32）被归类为有很高的患糖尿病风险。几乎一半（41.6%，n=117）的参与者被转介到当地卫生当局提供的健康促进项目，4.6%（n=13）被转介到家庭医生，1.8%（n=5）被转介到急诊部门接受短期医疗援助。