State Program: Virginia
Basic Implementation

The Virginia Department of Health began receiving funds from CDC in 1999 to support a state heart disease and stroke prevention program. The program received increased funding for basic implementation beginning in 2001.

Burden of Heart Disease and Stroke

• Heart disease is the leading cause of death in Virginia, accounting for 14,952 deaths or approximately 26% of the state's deaths in 2002. (National Vital Statistics Report 2004;53(5)).

• Stroke is the third leading cause of death, accounting for 3,960 deaths or approximately 7% of the state's deaths in 2002. (National Vital Statistics Report 2004;53(5)).

• According to Behavioral Risk Factor Surveillance System (BRFSS) survey results, adults in Virginia reported having the following risk factors for heart disease and stroke:
  
  In 2005,
   
  • 26.8% had high blood pressure
  • 37.1% of those screened reported having high blood cholesterol

  In 2006,
   

  • 7.4% had diabetes
  • 19.3% were current smokers
  • 61.8% were overweight or obese (Body Mass Index greater than or equal to 25.0)
  • 21.7% reported no exercise in the prior 30 days

State Highlights

• Since 2004, the Heart Disease and Stroke Prevention (HDSP) program has partnered with the Virginia Community Healthcare Association (VCHA) and the Virginia Diabetes Prevention and Control Project to support implementation of the health disparities collaboratives in Virginia’s federally qualified community health centers (health centers). The collaboratives include implementation of a quality improvement model, a system to track and report system changes, and reports of clinical performance measures in each participating health center. In 2005, Virginia began providing the collaboratives learning sessions in-state, decreasing the burden on health centers wishing to apply. As of June 2007, 41% (33/80) of Virginia’s health center sites were participating in a collaborative. This is a 200% increase from 2004, when there were 11 health centers participating. There are currently almost 8,000 patients entered in the cardiovascular collaborative registries statewide.
   
• The HDSP also partners with Community Care Network of Virginia (CCNV), a statewide primary care provider network and healthcare management company representing health care professionals who provide primary care access to medically underserved and underinsured populations through at least 23 community health center organizations providing care at 66 sites across the Commonwealth. CCNV is developing a system to identify and track common performance measures in all member community health centers, and a quality improvement system to address gaps. This system will supplement the data collected as a part of the health disparities collaboratives, and will extend beyond these measures to capture data not a part of the collaboratives’ registry data requirements.
   
• In 2007, the HDSP initiated a new partnership with the Virginia Association of Free Clinics to develop an infrastructure for assessing current clinical systems, tracking clinical data, and improving quality based on evidence. This will include identifying appropriate clinical performance measures, collecting and analyzing clinical data, and utilizing data to identify opportunities for improvement. This will be a systems change for the clinics, as there has never before been a coordinated approach to performance measurement and quality improvement at the association level.
   
• The HDSP began partnering with the Virginia Business Coalition on Health (VBCH) in 2006. The VBCH, with more than 80 employer members, is a non-profit, employer driven organization committed to improving the quality of health care in communities throughout Virginia through the cooperative efforts of employer purchasers and healthcare providers. The first phase of the partnership included distribution of materials to promote appropriate response to medical emergencies, including heart attack and stroke, to all members and other affiliated business organizations. Beginning in 2007, the partners will be developing a tool for worksites that will promote the development of work site wellness programs, with a focus on blood pressure and cholesterol control, to be piloted in member organizations.
   
• The HDSP project partners with Prospect Community Empowering Center (PCEC), a statewide network of African American churches, to promote secondary prevention of heart disease and stroke among congregants. The PCEC network currently includes approximately 40 churches across Virginia, with more than 10,000 total congregants. This model includes infrastructure at the state and regional level to support health ministries in each member church. This includes increasing awareness of the signs and symptoms of heart attack and stroke, providing Cardiopulmonary Resuscitation (CPR) and Automated External Defibrillator (AED) training for congregants, training church representatives to provide blood pressure screenings, and increasing awareness of risk factors through health messaging.
   
• The HDSP has partnered with the American Stroke Association to support stroke systems of care in Virginia, from primary prevention through rehabilitation. The HDSP was a key member of the state stroke leadership group that developed Virginia’s work plan, which comprehensively addresses all of the components in a stroke system of care. In early 2007, the HDSP was a member of a legislatively appointed work group that was charged to make policy recommendations for improving stroke systems. The HDSP has also partnered with the Virginia Telehealth Network to seek resources to improve the telehealth infrastructure in Virginia, with delivery of acute stroke care via telehealth solutions in underserved areas the primary goal.
   
• The HDSP project provides support for, and collaborates on an ongoing basis, with the Virginia Healthy Pathways Coalition. Organized almost ten years ago, the coalition has grown into a vital partner for addressing heart disease and stroke prevention issues. Approximately 65 members represent more than 40 organizations and agencies vested in reducing the burden of cardiovascular disease in Virginia.
   
• The HDSP project administers a certification training program to update health care professionals' knowledge and skills in the measurement of blood pressure. The training incorporates techniques of the American Heart Association’s recommended method of measuring blood pressure and current guidelines from the National Heart Lung and Blood Institute’s Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7). The program offers certification for blood pressure measurement specialists and blood pressure measurement specialist trainers. In 2007, the State Nursing Council of the Virginia Department of Health enacted a nursing directive mandating that all public health nurses (and all other employees to whom measuring blood pressure is delegated) be trained using this curriculum and required to use the methods taught in the course in their daily public health practice.
   
• A video self-study version of the course, produced in partnership with the Virginia Healthy Pathways Coalition, has been distributed to more than 4,000 locations in more than 30 states. The video toolkit has been reviewed and approved by the American Heart Association’s Science Review panel, and won an award of merit from the National Health Information Resource Center.

For more information on heart disease and stroke prevention, visit the Virginia Cardiovascular Health Project Web site at http://www.vahealth.org/cvd/index.htm.*

To view county–level data, visit our interactive map site at http://www.cdc.gov/dhdsp/library/maps/statemaps.htm.

 
*Links to non–Federal organizations are provided solely as a service to our users. Links do not constitute an endorsement of any organization by CDC or the Federal Government, and none should be inferred. The CDC is not responsible for the content of the individual organization Web pages found at this link.
 

Page last reviewed: September 6, 2007
Page last modified: September 6, 2007
Content source: Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion