Colorado Heart Healthy Solutions

Colorado Heart Healthy Solutions (CHHS) helps people live healthier lives in their communities.

CHHS is a collaborative program created by Colorado Prevention Center and Denver Health Community Voices.

CHHS trains community health workers to provide heart disease and diabetes screening and education to minorities and the medically underserved across Colorado. Community health workers (CHWs) go out into the communities to barber shops, shopping centers and worksites to reach those not in the healthcare system. CHWs test for high blood pressure, cholesterol, blood sugar and weight, at no cost to participants. CHWs are supported by an interactive software application, designed by nurses, a cardiologist and public health experts, to guide data collection. The software program provides a heart disease risk calculation and guideline-based recommendations for every participant. It also stores resource information for referrals into health care and healthy living programs.

The CHWs apply motivational interviewing skills to guide at-risk individuals into medical care and healthy living programs such as smoking cessation programs, walking clubs or diabetes classes. At-risk individuals are followed and supported for up to one year through follow up phone calls, resource referrals and retesting of heart disease risk factors at six months and one year to demonstrate progress. All educational materials are available in both Spanish and English.

CPC also supports health care providers in every county where CHHS is delivered.  Monthly internet education related to up-to-the minute standards in heart disease prevention and clinical guidelines is available to participating health care providers at no cost.

CHHS is active in 36 counties across Colorado through partnerships with local health departments, community health care networks, hospitals and county nursing services. Each partner hosts a CHW, who screens about 600 participants from the surrounding communities each year. Since at-risk individuals must receive help in both the medical arena and lifestyle changes, our community health workers help people connect to resources in their community. CHHS improves access to care by activating participants, increasing awareness and dialogue with providers about access and standards of care, and finding creative solutions.

CHHS uses interactive health technology tools developed by CPC to ensure accurate, efficient messaging, participant tracking and data management.  These tools include:

Heart Healthy Solutions cardiovascular disease risk assessment

• An interactive, computerized cardiovascular disease risk assessment delivered via touchscreen kiosk or the Internet (www.health-e-solutions.org)
• Calculates a person's chance of developing heart disease in the next 10 years based on age, gender, diabetes status, smoking status, blood pressure and cholesterol levels
• Produces a printout that contains a risk score and customized heart health recommendations that people can take to their healthcare provider
• Illustrates how someone can lower their score by lowering blood pressure and cholesterol, and quitting smoking

Outreach Screening And Referral System (OSCAR)

This interactive laptop application allows community health workers to provide onsite heart disease risk assessment and recommendations, anywhere in the state.  OSCAR advances the field of public health by equipping the community health worker with resources, guidelines and behavior change cues in a portable format.  Additionally, OSCAR allows for reports to be generated regarding population trends, screening and follow up, and evaluation.

OSCAR provides efficiency in data collection, Framingham risk assessments, ongoing evaluation of progress, and interactive guidance to the CHW in their navigation of at-risk individuals. OSCAR cues the CHW when to refer individuals into medical care and supports the CHW in assessing readiness for change and in creating appropriate action plans. It reminds CHWs when to schedule follow-up calls and visits for at-risk participants. OSCAR can generate a doctor's referral letter and/or guideline-based recommendations for the at-risk participant. Local resources such as exercise and/or nutrition education classes, cardiac rehab classes on managing hypertension, and Colorado Quitline are examples of lifestyle modification programs utilized in CHHS, and these resources are linked per county in OSCAR.

Colorado Heart Healthy Solutions website:  www.hearthealthysolutions.org This website provides local information about CHHS events, educational resources, news and links to other resources.

However, tools alone will not help people change behavior.  Through partnerships in communities, CHHS is building the momentum to make significant changes in our health.  CHHS provides opportunities for local citizens to receive training and employment as a community health worker, and to become a health promoter in their community. Local health profession students and others in the communities volunteer at events to strengthen to message for improving cardiovascular health.   Participants in CHHS are referred into medical clinics near where they live, and lifestyle programs such as exercise and nutrition classes. CHHS partners give feedback and create innovative approaches to help people make changes in the way that feels right to them.  Partners include Community Health Networks, local health departments, medical practices and hospitals, 9Health Fair, Visiting Nurse Associations and San Luis Valley Area Health Education Center.

Funding:

This multimillion dollar project is funded by the Cancer, Cardiovascular Disease and Pulmonary Disease Grants Program at the Colorado Department of Public Health and Environment from January 2006 - June 2010.