The national cardiovascular health program project - organization: wisconsin department of health services, 1 west wilson street, madison WI 53703-3445 serving: state of wisconsin application for: the…

The national cardiovascular health program project - organization: wisconsin department of health services, 1 west wilson street, madison WI 53703-3445 serving: state of wisconsin application for: the national cardiovascular health program (CDC-RFA-DP-23-0004) the wisconsin department of health services' chronic disease prevention program (cdpp) and partners will work to address the persistent disparities in cardiovascular disease and its related health factors, with a focus on the social determinants of health (sdoh) that drive health disparities and inequities. Our approach will implement and evaluate evidence-based and informed strategies to prevent and manage CVD in identified populations and communities. This will be achieved through statewide and regional learning collaboratives (LC) informed by members of priority communities. The approach will facilitate communication and exchange of ideas to inform data-driven healthcare practice improvements, link community and clinical resources, and address sdoh to reduce hypertension and high cholesterol. The wisconsin heart health alliance will serve as the statewide learning collaborative with three action-oriented LCS to specifically address the strategies of the national cardiovascular health program. This will include two regional LCS in brown and dane counties, as well as an LC for rural health systems. All three represent priority populations, having high prevalence of cardiovascular disease, hypertension, and high cholesterol, as well as poor sdoh. Brown and dane have a significant percentage of the population identifying as persons of color. This regional LC approach ensures that a majority (=51%) of LC collaborators and partners are from, and have members of, the priority populations and include geographic distribution. Strategies and activities will be implemented to improve outcomes for people at increased risk for cardiovascular disease including 1) track and monitor clinical and social services needs using electronic health records and health information technology, 2) increase the use of multidisciplinary teams to address social services and support needs and referrals to resources, and, 3) link community resources and clinical services to support bidirectional referrals, self-management and engagement of community health workers. Through this approach, cdpp will achieve these outcomes within partner healthcare and community settings: - increased blood pressure control among populations. - decreased disparities in hypertension control among populations. - increased utilization of social services and support among populations at highest risk of CVD, with a focus on hypertension and high cholesterol.