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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
Key Responsibilities
- Facilitate collaboration among public and private sector
partners, such as managed care organizations, health
insurers, federally funded health centers, businesses,
priority population organizations, and emergency response
agencies.
- Define the burden of heart disease and stroke and assess
existing population-based strategies for primary and
secondary prevention of heart disease and stroke within the
state.
- Develop and update a comprehensive state plan for heart
disease and stroke prevention with emphasis on heart-healthy
policies development, physical and social environments
change, and disparities elimination (e.g., based on
geography, gender, race or ethnicity, or socioeconomic
status).
- Identify culturally appropriate approaches to promote
heart disease and stroke prevention among racial, ethnic,
and other priority populations.
- Use population-based public health strategies to
increase public awareness of the heart disease and stroke
urgency, the signs and symptoms of heart disease and stroke,
and the need to call 9–1–1.
- Support health care organizations system changes to
assure quality of care and implementation of primary and
secondary prevention for heart disease and stroke.
- Monitor, implement, and evaluate prevention strategies
and programs in health care settings, work sites, and
communities.
- Provide training and technical assistance for health
care professionals, and partners to support primary and
secondary prevention of heart disease and stroke.
- Monitor quality of care for primary and secondary
prevention.
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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
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