A community-oriented primary care project in a rural population: reducing cardiovascular risk

Area of Science:

• Public Health
• Cardiovascular Disease Prevention
• Rural Health Interventions

Background:

• High cardiovascular mortality rates in poor, rural areas necessitate targeted interventions.
• Community-Oriented Primary Care (COPC) models offer a framework for addressing local health needs.
• Previous research indicates a gap in effective cardiovascular risk reduction strategies for rural populations.

Purpose of the Study:

• To evaluate the effectiveness of a COPC program in reducing cardiovascular risk in two rural New York towns.
• To assess the impact of house-to-house screening and education on blood pressure and risk factor knowledge.
• To determine the feasibility and challenges of implementing a COPC model in a resource-limited rural setting.

Main Methods:

• A controlled community-oriented primary care (COPC) program was implemented in two rural towns.
• House-to-house visits included blood pressure screening, risk factor assessment, and educational interventions.
• The study town received additional interventions: provider follow-up and sliding-fee medical services.

Main Results:

• Residents in the study population showed a 3.1 mm Hg lower adjusted systolic blood pressure compared to the control group after 2 years.
• Individuals screened at both time points had a 2.7 mm Hg lower adjusted systolic blood pressure.
• While knowledge of cardiovascular risk factors improved, significant changes in risk behaviors were not observed.

Conclusions:

• Implementing a COPC model in a rural setting is feasible for reducing systolic blood pressure.
• Engaging local and medical community support is crucial for program success.
• Further strategies are needed to effectively modify cardiovascular risk behaviors in rural populations.