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This project is part of the ACHIEVE GREATER (Addressing Cardiometabolic Health In Populations Through Early Prevention in the Great Lakes Region) Center (IRB 100221MP2A), the purpose of which is to reduce cardiometabolic health disparities and downstream Black-White lifespan inequality in two cities: Detroit, Michigan, and Cleveland, Ohio. The ACHIEVE GREATER Center will involve three separate but related projects that aim to mitigate health disparities in risk factor control for three chronic conditions, hypertension (HTN, Project 1), heart failure (HF, Project 2) and coronary heart disease (CHD, Project 3), which drive downstream lifespan inequality. All three projects will involve the use of Community Health Workers (CHWs) to deliver an evidence-based practice intervention program called PAL2. All three projects will also utilize the PAL2 Implementation Intervention (PAL2-II), which is a set of structured training and evaluation strategies designed to optimize CHW competence and adherence (i.e., fidelity) to the PAL2 intervention program. The present study is Project 3 of the ACHIEVE GREATER Center.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Low CVD risk | Other | PAL2 |
|
| High CVD risk | Other | Center for Integrated and Novel Approaches in Vascular-Metabolic Disease (CINEMA) |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| PAL2 | Behavioral | Low CVD risk participants (CAC < 100) will be followed by their primary care provider accompanied by monthly contact with community health workers provided by ACHIEVE Greater who will screen participants for social determinants of health and implement the PAL2. PAL2 is defined as a community health worked based intervention to mitigate psychosocial and health equity barriers to optimize health promotion coupled with high blood pressure and lifestyle disease state education. |
| Measure | Description | Time Frame |
|---|---|---|
| Triple Goal | Percent reaching triple goal of BP <130/80 mm Hg, HbA1c<5.7% and LDL-C <130 mg/dl (<100 if high-risk) | 12 months |
| Measure | Description | Time Frame |
|---|---|---|
| Change in HbA1c as measured by blood work | Percent change in HbA1c | baseline, 12 months |
| Change in LDL-C as measured by blood work | Percent change in LDL-C |
| Measure | Description | Time Frame |
|---|---|---|
| Health Visits and Lifestyle Changes - Medical/Mental Health Visits | 1-year rate of new medical/mental health visits | 12 months after cessation of intervention or 24 months after enrollment |
| Health Visits and Lifestyle Changes - Smoking Cessation |
Inclusion Criteria:
40 to 75 years of age
Self-identified as Black or African American
Residence in the Cleveland Metro Area
Must have at least two of the following risk factors identified at a UH health fair screenings, with one risk factor being with SBP, A1c, or LDL:
Able to complete a coronary artery calcium score test (CAC)
Willing and able to consent
Willing to have a UH provider and UH care
Currently insured for standard of care procedures
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Sanjay Rajagopalan, MD | Contact | 216-844-5191 | Sanjay.Rajagopalan@uhhospitals.org | |
| Heidi Osborne | Contact | 216-844-2833 | heidi.osborne@uhhospitals.org |
| Name | Affiliation | Role |
|---|---|---|
| Sanjay Rajagopalan, MD | University Hospitals Cleveland Medical Center | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University Hospitals Cleveland Medical Center | Recruiting | Cleveland | Ohio | 44106 | United States |
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| ID | Term |
|---|---|
| D003327 | Coronary Disease |
| ID | Term |
|---|---|
| D017202 | Myocardial Ischemia |
| D006331 | Heart Diseases |
| D002318 | Cardiovascular Diseases |
| D014652 | Vascular Diseases |
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| ID | Term |
|---|---|
| D009040 | Motion Pictures |
| ID | Term |
|---|---|
| D001296 | Audiovisual Aids |
| D018961 | Educational Technology |
| D013672 | Technology |
| D013676 | Technology, Industry, and Agriculture |
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|
|
| CINEMA | Other | High CVD risk participants (CAC ≥ 100) will be followed by specialists in the Center for Integrated and Novel Approaches in Vascular-Metabolic Disease (CINEMA) at UHCMC. While they too will be assessed, by the CHW for SDOH and a plan developed to address them, this plan will be addressed by the usual resources available in the CINEMA clinic. |
|
| baseline, 12 months |
| Change in blood pressure | Percent change in blood pressure | baseline, 12 months |
| Change in weight | Percent change in weight | baseline, 12 months |
1-year rate of smoking cessation
| 12 months after cessation of intervention or 24 months after enrollment |
| Health Visits and Lifestyle Changes - Diet | 1-year rate of changes in diet | 12 months after cessation of intervention or 24 months after enrollment |
| Health Visits and Lifestyle Changes - Activity | 1-year rate of changes in activity | 12 months after cessation of intervention or 24 months after enrollment |