Reducing CVD Risk among Women Accessing Reproductive Health Services

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The InShape program is funded by the CDC, and envisioned to develop and evaluate a program to improve screening for chronic disease risk factors for women who use Title X clinics, to facilitate and monitor referrals to insure risk factors are treated to goals, and to provide risk reduction counseling, as appropriate.

PROJECT DESCRIPTION

Because low-income status is associated with multiple risk factors for chronic disease, women accessing reproductive health services in Title X funded clinics are at high risk for such diseases. However, often they are not screened for risk factors, and when they are, identified risk factors often go untreated or receive inadequate treatment. Because many women of reproductive age have most of their contact with medical care through Title X clinics, such clinics provide an opportunity for these women to receive screening for risk factors with referrals and education as appropriate. Thus the purpose of this study is to develop and evaluate a program to improve screening for chronic disease risk factors at Title X clinics, to facilitate and monitor referrals to insure risk factors are treated to goals, and to provide risk reduction counseling, as appropriate.

Phases I and II of this III phase study will be conducted at the Pitt County Health Department in Greenville, NC, where approximately 3000 patients are seen each year for reproductive health services. During Phase I (Year 1), we will conduct formative research to assess health department and community resources relevant to screening, referral, and risk reduction counseling and we will assess patient barriers and facilitators of lifestyle change. In Phase II (Years 2, 3), we will screen and re-screen (at one year follow-up) 1000 participants who use reproductive health services for high blood pressure, abnormal blood lipids, high blood glucose, obesity, and smoking. Those with screening values requiring medical management will enter into a program of case management to insure appropriate referral, follow-up on referral, and adherence to recommended treatment. In addition, we will enroll 200 participants at increased CVD risk (high blood pressure, abnormal blood lipids, high blood glucose and/or obesity) into a year-long lifestyle intervention program that will focus on improving diet quality and increasing physical activity. In Phase III (Year 4), we will prepare both English and Spanish versions of a 6 month lifestyle intervention in a format that is ready for dissemination and will test the feasibility of this program at the Durham County Health Department in Durham, NC, whose Title X patients are approximately 50% Hispanic.

FUNDING

  • Funding Source: Centers for Disease Control
  • Dates of funding: September 30, 2009 to September 29, 2013
  • Current Status: Disseminated

KEY CONTACTS

Principal Investigator: Thomas Keyserling, MD MPH
Phone: (919) 966-2276
Fax: (919) 966-2274
Email: thomas_keyserling@med.unc.edu