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The 130th Annual Meeting of APHA |
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The 130th Annual Meeting of APHA |
Paul L Hebert, PhD, Jane Sisk, Carol R Horowitz, MD, MPH, and Mary Ann McLaughlin. Health Policy, Mount Sinai School of Medicine, 1425 Madison Ave, New york, NY 10029, 212-659-9567, Paul.Hebert@Mountsinai.org
BACKGROUND: Congestive Heart Failure (CHF) is the leading cause of hospitalization for people 65 years of age or older. African American and other non-white populations are burdened disproportionately. This study presents baseline data from an on-going, randomized controlled trial of the effectiveness of nurse management compared with usual care for the treatment of CHF in minority communities. METHODS: Patients are from the largely minority populations of East and Central Harlem. We collected baseline information on health status using the SF-12 Health Survey (SF-12) and the Minnesota Living with Heart Failure (MNLHF) questionnaire. We also collected baseline information on preventive health behaviors, including daily assessment of weight, swelling, monitoring of salt intake, and medication adherence. We report racial differences in these measures, controlling for gender and age. RESULTS: Of the 410 persons who enrolled in the trial, 46% are African American, 32% are Hispanic, 15% are White, and 8% were another non-white race. At baseline, health status was significantly worse for non-white subjects. Age and gender-adjusted SF-12 physical component scores were lower for Hispanic (p=0.018) and African American (p<0.001) subjects compared to Whites. The MLHF score also showed significantly lower functioning for both Hispanic (p<0.0001) and African American (p=0.003) subjects. The mental health component score of the SF-12 was significantly worse for Hispanics (p=0.0012) but not for African Americans (p=0.98). Compliance with recommended health behaviors was low overall but did not differ substantially by race. While 67% of subjects reported monitoring swelling on a daily basis, fewer than 15% weighed themselves daily, fewer than one third reported controlling the amount of salt in their diet, and fewer than one third reported always taking their medications. CONCLUSION: At baseline for this randomized trial, African American and Hispanic persons with CHF have worse physical and mental health status than White subjects. Future research will investigate whether nurse management of CHF improves health status and patient self-management.
Learning Objectives:
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.