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| Name | Class |
|---|---|
| Université de Montréal | OTHER |
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This project aims to improve the cardiovascular health of seniors living in subsidized housing by implementing the successful community-based Cardiovascular Health Awareness Program (CHAP). CHAP is a patient-centred, interdisciplinary, multi-pronged, community-led CVD and stroke prevention and management program designed to prevent and reduce the impact of cardiovascular disease in older adults. The program addresses common cardiovascular disease risk factors, such as smoking, physical activity and poor diet by raising awareness of health and community resources available to encourage self-care and appropriate management of cardiovascular disease. A randomized controlled trial will be used to evaluate the impact of CHAP on healthcare utilization by older adults living in subsidized housing.
This project aims to improve the cardiovascular health of seniors living in subsidized housing by implementing the successful community-based Cardiovascular Health Awareness Program (CHAP). Residents in subsidized housing are considered to be a vulnerable population because of their low income and tend to be in poorer health; with a multitude of chronic illnesses, such as cardiovascular disease (CVD) and diabetes.
This project will build on the success of CHAP in other provinces. The program has been shown to reduce blood pressure and CVD-related hospitalization costs. CHAP is a patient-centred, interdisciplinary, multi-pronged, community-led CVD and stroke prevention and management program designed to prevent and reduce the impact of cardiovascular disease in older adults. The program addresses common cardiovascular disease risk factors, such as smoking, physical activity and poor diet by raising awareness of health and community resources available to encourage self-care and appropriate management of cardiovascular disease.
Taking the form of a randomized controlled trial, the sample will be subsidized housing buildings (low income) for those aged 55 years and over. During CHAP monthly assessment sessions, participants will 1) complete a consent form, 2) complete a cardiovascular risk profile form, 3) undergo blood pressure measurement using an automated blood pressure measuring device, 4) receive targeted healthy lifestyle and preventive care materials, 5) be invited to participate in group health education sessions. Those patients identified at high risk will be assessed by a health professional and referred to a family physician for timely and appropriate follow-up.. The impact this program will have on health care utilization (emergency visits, cardiovascular hospitalization rates) will be measured using administrative databases.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| CHAP Intervention | Experimental | The Cardiovascular Health Awareness Program (CHAP) intervention is an on-site drop-in, monthly, cardiovascular risk assessment program run by trained volunteers with community-led group health sessions that deliver education and information about access to community health resources. The education sessions will be delivered by national and provincial and local community organizations utilizing already developed material as much as possible, but maintaining consistency across both provinces. Health education sessions will include topics such as: Physical Activity, Healthy Eating, Stress, Tobacco Use, High Blood Pressure, Role of Pharmacist: How they can assist people, and Appropriate use of 9-1-1. This intervention will be held in a common room in selected subsidized housing buildings. |
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| Control | No Intervention | The control buildings will receive usual care which will be wellness programs already present in the building prior to the RCT if these are present. Not all control buildings will have wellness programs. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Cardiovascular Health Awareness Program | Behavioral | Cardiovascular disease prevention and health promotion |
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| Measure | Description | Time Frame |
|---|---|---|
| Healthcare Utilization Composite - Change in CVD-related emergency department visits and hospitalizations | Change in rate of CVD-related emergency department visits and hospitalizations by postal code from administrative databases (Building-level analysis) | Monthly from 1 year pre-intervention to 1 year post-intervention |
| Measure | Description | Time Frame |
|---|---|---|
| Healthcare Utilization - Change in all-cause emergency department visits | Change in rate of all-cause emergency department visits by postal code from administrative | Monthly from 1 year pre-intervention to 1 year post-intervention |
| Healthcare Utilization - Change in all-cause hospitalizations |
| Measure | Description | Time Frame |
|---|---|---|
| Cardiovascular Risk - Change in blood pressure | Change in measured blood pressure (automated, validated device) | Baseline and 1 year |
| Cardiovascular Risk - Change in body mass index | Change in body mass index calculated from height and weight (self-reported) |
Building Inclusion Criteria:
Individual Inclusion Criteria
Note: Younger residents will be allowed to take part in the program but their data will not be included in the analysis.
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Gina Agarwal | McMaster University | Principal Investigator |
| Janusz Kaczorowski | CHUM (Université de Montréal) | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Centre de recherche du CHUM | Montreal | Quebec | H2X 0A9 | Canada |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 31870415 | Derived | Agarwal G, Girard M, Angeles R, Pirrie M, Lussier MT, Marzanek F, Dolovich L, Paterson JM, Thabane L, Kaczorowski J. Design and rationale for a pragmatic cluster randomized trial of the Cardiovascular Health Awareness Program (CHAP) for social housing residents in Ontario and Quebec, Canada. Trials. 2019 Dec 23;20(1):760. doi: 10.1186/s13063-019-3806-5. |
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There is currently no plan for individual participant data to be shared. Aggregate data will be shared upon request.
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| ID | Term |
|---|---|
| D002318 | Cardiovascular Diseases |
| D003920 | Diabetes Mellitus |
| D004630 | Emergencies |
| ID | Term |
|---|---|
| D044882 | Glucose Metabolism Disorders |
| D008659 | Metabolic Diseases |
| D009750 | Nutritional and Metabolic Diseases |
| D004700 | Endocrine System Diseases |
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Pragmatic cluster randomized controlled trial with parallel intervention and control groups.
Randomization will occur at the building level (clusters) and the intervention is open to all building residents.
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Change in all-cause hospitalization rates by postal code from administrative data (building-level) |
| Monthly from 1 year pre-intervention to 1 year post-intervention |
| Change in quality of life | Measured using EQ-5D-5L | Baseline and 1 year |
| Quality-Adjusted Life Years (QALYs) | Calculated from EQ-5D-5L at two time points and Canadian value sets | 1 year (post-intervention) |
| Cost-effectiveness | Calculated from program cost data and health outcomes | 1 year (post-intervention) |
| Participant experience of the CHAP intervention | Participant experience of the intervention will be evaluated through qualitative individual interviews and focus groups of residents. | 1 year (post-intervention) |
| Baseline and 1 year |
| Cardiovascular Risk - Change in waist circumference | Change in waist circumference (measured with measuring tape) | Baseline and 1 year |
| Cardiovascular Risk - Change in diabetes risk score | Change in diabetes risk score (CANRISK questionnaire) | Baseline and 1 year |
| D020969 | Disease Attributes |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |