Abstract
BackgroundCardiovascular disorders (CVD) are the single greatest cause of mortality worldwide. In the UK, the National Health Service (NHS) has launched an initiative of health checks over and above current care to tackle CVD. However, the uptake of Health Checks is poor in disadvantaged communities. This protocol paper sets out a UK-based study (Sussex and Nottingham) aiming to co-produce a community delivered CVD risk assessment and coaching intervention to support community members to reduce their risk of CVD.The overall aim of the project is to implement a tailored-to-context community engagement (CE) intervention on awareness of CVD risks in vulnerable populations in high, middle and low-income countries. The specific objectives of the study are to enhance stakeholder’ engagement; to implement lifestyle interventions for cardiovascular primary prevention, in disadvantaged populations and motivate uptake of NHS health checks.MethodsThis study uses both qualitative and quantitative methods in three phases of evaluation, including pre-, per- and post-implementation. To ensure contextual appropriateness the ‘Scaling-up Packages of Interventions for Cardiovascular disease prevention in selected sites in Europe and Sub-Saharan Africa: An implementation research’ (SPICES) project will organize a multi-component community-engagement intervention. For the qualitative component, the pre-implementation phase will involve a contextual assessment and stakeholder mapping, exploring potentials for CVD risk profiling strategies and led by trained Community Health Volunteers (CHV) to identify accessibility and acceptability. The per-implementation phase will involve healthy lifestyle counselling provided by CHVs and evaluation of the outcome to identify fidelity and scalability. The post-implementation phase will involve developing sustainable community-based strategies for CVD risk reduction. All three components will include a process evaluation. A stepped wedge cluster randomised trial of the roll out will focus on implementation outcomes including uptake and engagement and changes in risk profiles. The quantitative component includes pre and post-intervention surveys. The theory of the socio-ecological framework will be applied to analyse the community engagement approach.DiscussionBased on the results ultimately a sustainable community engagement-based strategy for the primary prevention of CVD risk will be developed to enhance the performance of NHS health care in the UK. The Trial Registration number is ISRCTN68334579.
Highlights
Cardiovascular disorders (CVD) are the single greatest cause of mortality worldwide each year, estimated to contribute to 31% of all deaths globally [1]
Given that the rolling out of the National Health Service (NHS) Health Checks programme over and above current care across the UK has not been implemented as efficiently as it could have been, especially in some of the most disadvantaged groups prone to developing CVD, the project aims to scale-up packages of interventions for cardiovascular prevention to these vulnerable populations
The main focus of this project is the de-institutionalization of health care by operating outside of formal healthcare settings
Summary
Cardiovascular disorders (CVD) are the single greatest cause of mortality worldwide each year, estimated to contribute to 31% of all deaths globally [1]. Some other risk factors for CVD are modifiable, such as smoking, a lack of physical activity, being overweight, lower consumption of fruit and vegetables, high blood pressure, diabetes and high cholesterol [2]. These risk factors can be changed through lifestyle or behavioural modifications. The specific objectives of the study are to enhance stakeholder’ engagement; to implement lifestyle interventions for cardiovascular primary prevention, in disadvantaged populations and motivate uptake of NHS health checks
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