A strategic approach to advancing health equity for priority populations with or at risk for heart disease - arkansas DP-23-0004 the national cardiovascular health program project abstract summary…

A strategic approach to advancing health equity for priority populations with or at risk for heart disease - arkansas DP-23-0004 the national cardiovascular health program project abstract summary applicant organization: arkansas department of health 4815 west markham street little rock, AR 72205 arkansas has a high burden of cardiovascular diseases (cvds), particularly for hypertension as evidenced by centers for disease control and prevention (CDC) behavioral risk factor surveillance system (brfss, 2021) at a prevalence of 37.1% and rank of 6TH highest among all states. Centers for medicare and medicaid services (CMS) show arkansas's prevalence of hypertension was 59.8% among fee-for-service beneficiaries with a national rank of 19 in 2018. Population-based hypercholesterolemia prevalence is 31.9% (brfss, 2021) and hyperlipidemia prevalence is 36.7% among CMS fee-for-service beneficiaries with national ranks of 15 and 28, respectively. The arkansas department of health (ADH) chronic disease prevention and control branch is a CDC 1815 grantee since 2018 and has been working with outside partners to advance statewide prevention and management efforts for diabetes, heart disease, and stroke, and impact population outcomes for CVD risk factors. While hospitalizations for acute myocardial infarction (AMI) and cerebral infarction decreased by 13.7% and 1.9%, respectively, between 2017 and 2021, hospitalizations for acute hemorrhagic stroke almost always secondary to uncontrolled hypertension increased by 4.4% during the same time frame. Age-adjusted mortality data for 2021 from CDC wide-ranging online data for epidemiological research (wonder) indicate arkansas ranks 1ST among states for the highest AMI mortality and 3RD among states for the highest acute stroke mortality indicating the need for intensified and collaborative primary, secondary, and tertiary preventive efforts in arkansas. Under 1815 funding and despite the unexpected, detrimental impact of the covid-19 pandemic, arkansas through its direct heart disease and stroke interventions: a) served a total of 54,659 patients through team-based care and quality improvement (QI) activities; b) facilitated QI and performance measurement training for 35 clinical providers and staff; c) improved medication adherence by 18% and 20% for patients on antihypertensives and antidiabetic medications, respectively, through medication therapy management in pharmacy settings; d) facilitated american board of telehealth (ABT) training and certification for 58 clinical providers to sustain CVD care during the pandemic; and e) trained 136 community health workers (chws) and certified 13 chws for core competencies as part of building CHW infrastructure in the state. With DP-23-0004 funding, the ADH and key partners will expand its existing learning collaborative (LC) and implement activities specified under this nofo to improve CVD outcomes with an emphasis on targeting disproportionately affected populations. These LC strategies include: strategy 1: track and monitor clinical and social service measures shown to improve health and wellness, healthcare quality, and identify patients at highest risk of CVD with a focus on hypertension and hypercholesterolemia; strategy 2: implement team-based care for CVD risk reduction with a focus on hypertension and hypercholesterolemia, and address social support barriers to improve outcomes; and strategy 3: increase community-clinical linkages for bidirectional referrals, self-management, and lifestyle change to address social vulnerability for populations at increased risk of CVD with a focus on hypertension and hypercholesterolemia. The ADH will use a collaborative public health approach guided by data to implement DP-23-0004 strategy-related activities for heart disease and stroke preventive efforts and improve CVD outcomes among arkansans.