Reducing heart disease risk factors: Promising outcomes from a prevention program in the state of Colorado

Colorado Heart Healthy Solutions (CHHS) is a statewide cardiovascular disease (CVD) prevention program. Enrollment into CHHS since December 2008 is currently at 8,000, spread across 37 counties. This innovative program is successful through community activation of local partnerships with health departments, safety net clinics, and community resources. These partners describe CHHS as enhancing existing programs, activating communities, and increasing capacity. The target population currently served by CHHS is ethnic minorities, the poor, those with less education, un-/under-insured and those who live far from resources in rural and frontier communities. Twenty four community health workers (CHW) provide CVD and diabetes risk screening and education in venues such as worksites, big box stores, community centers, barbershops and other settings where those not engaged in medical care are likely to be found. The Outreach, Screening and Referral software application guides the CHWs work by providing customized, evidence-based health recommendations based upon the participant's Framingham risk score. CHWs use motivational interviewing to promote healthy living through improved daily diet and increased physical activity, and provide appropriate referrals to community resources and medical providers. Among the first 240 program participants with elevated risk factors to be retested (mean time=150„b60 days), CHHS has seen a mean decrease in the following: total cholesterol: 27.9°"37.0 mg/dL (p=<0.001); systolic blood pressure: 9.8°"15.5 mmHg (p=<0.001); and Framingham Risk Score 3.3°"7.2 (p=<0.001). These improvements show the effectiveness of CHHS in educating the underserved to live healthier lifestyles and reduce the burden of heart disease that plagues the underserved of Colorado.