Abstract P302: Longitudinal Evaluation of Impact and Results of the Mississippi Kidney Foundation’s Renal Evaluation and Assessment Program (REAP)

Abstract

Introduction: Health fair-type screenings are one of the most recognizable forms of community-based health promotion. Though these screenings offer benefits in theory, little evidence supports their value. Through REAP, Mississippi Kidney Foundation routinely provides screenings for cardiovascular and renal disease risk factors. At each screening, participants obtain blood pressure, height, weight, laboratory assessments (metabolic/renal blood chemistries, complete blood count, total cholesterol, urinalysis) and complete a questionnaire regarding risk factors and disease history. Participants also receive written information about values/goals and consultation with a healthcare provider. Without a systematic evaluation, the overall value of this program is unknown. The purpose of this study was to review the impact and results of REAP and identify any changes that could improve outreach and patient care. Methods: We reviewed demographics and prevalence of cardiovascular and renal disease risk factors among participants over the previous 4 years (2010-2013). Screening sites were classified as urban or rural, according to census data. Risk factors were defined as elevated blood pressure (SBP ≥ 140 mmHg and/or DBP ≥ 90 mmHg), cholesterol (total > 200 mg/dL), or blood glucose (fasting ≥ 100 mg/dL); reduced kidney function (elevated BUN/Cr and/or eGFR < 60 ml/min); and proteinuria (≥ 30 mg/dL). Results: Over the review period, 57 screenings were performed at 34 sites, 15 classified as rural. Of the 5,545 participants, 4,299 were at urban and 1,246 at rural sites. Overall, 1,760 (32%) had elevated blood pressure (36% vs 31%, rural vs urban, respectively), 2,013 (36%, 40% vs 35%) elevated cholesterol and 1,046 (19%, 23% vs 18%) elevated glucose. Reduced kidney function was identified in 762 (14%, 15% vs 13%) participants, while 1,423 (26%, 29% vs 25%) had proteinuria. Among those reporting ethnicity (n=1,948) and gender (n=3,164), 614 (32%) were Caucasian, 1,290 (66%) African-American, and 2,270 (72%) female. Conclusions: Through this review, we determined that though REAP appears to target at risk populations, further efforts are needed to improve participation of males and those in rural areas. Elevated risk factors were more prevalent in rural areas; however, this may reflect differences in treatment rates, not absolute values. To better assess the impact of REAP, define risk factors, and influence patient care, we identified that more rigorous tracking, review of disease and treatment history, and further assessments are needed (i.e. full lipid panel). A graded system targeting patient follow-up is necessary, particularly among those at greatest risk. Based on these findings, these changes will be implemented, along with a post-screening evaluation of participants’ perceived benefits and result utilization.