Project Description

Strengthening clinical-community linkages in rural NC counties with Community Health Worker (CHW)-delivered, evidence-based, cardiovascular risk reduction interventions

In North Carolina, and nationally, cardiovascular disease (CVD) is the leading cause of death and disease among adults. North Carolina adults have high rates of CVD behavioral risk factors such as physical inactivity, unhealthy eating habits, smoking, and being overweight and obese. To help reduce these risks, researchers from the University of North Carolina at Chapel Hill Prevention Research Center (UNC PRC) will test the effectiveness and implementation of Carolina Heart Alliance Networking for Greater Equity (CHANGE).

CHANGE is a health promotion strategy to link public health and clinical services through community health workers (CHWs). Primary care clinics, public health departments, and CHWs all have strengths in addressing chronic disease risk factors, but there is a widely recognized gap in the coordination among them. The CHANGE strategy includes CHWs as members of primary care and public health teams to distribute a lifestyle behavior change intervention called Heart-to-Health to a total of 380 clinic patients at risk for CVD. Heart-to-Health is an effective lifestyle and medication adherence intervention that includes a computerized decision aid to guide delivery of tailored counseling. The monthly counseling sessions are focused on diet, physical activity, tobacco cessation, and medication adherence and are facilitated by CHWs using tablet computers. The CHWs also will link participants to public health and other community-based resources to support behavior change. The CHANGE strategy will be tested in one underserved, rural community and then refined and replicated in a second community. 

Researchers from the UNC PRC will examine whether CHANGE is effective in increasing the reach of clinical and public health community services to high risk populations and improving composite coronary heart disease risk.

Project Identifier Carolina Heart Alliance Networking for Greater Equity includes CHWs to link primary care and public health teams

Funding Source PRC Program

Project Status Active

Host Institution University of North Carolina at Chapel Hill

Health Topics Cardiovascular health | Medication Adherence | Blood Pressure Control Physical activity | Nutrition

Research setting Medical or clinical site | Community Health Centers | County Health Departments

Race or ethnicity No specific focus

Gender No specific focus

Age group  Adults 18-80 years of age