A Contemporary Phone-Based Cardiac Coaching Program: Evolution and Cross Cultural Utility

Area of Science:

• Cardiovascular disease management
• Health services research
• Culturally competent healthcare

Background:

• The Hospital Admission Risk Program (HARP) Cardiac Coach Program was adapted for Greek and Italian populations due to local community diversity.
• Culturally and Linguistically Diverse (CALD) groups have unique perceptions of health and responses to healthcare services.
• Previous evidence suggests CALD groups may benefit from tailored health interventions.

Purpose of the Study:

• To evaluate the adaptability and effectiveness of a phone-based cardiac coaching program for Greek and Italian populations.
• To compare outcomes of adapted programs with an existing English-speaking cohort.

Main Methods:

• Retrospective analysis of cardiovascular risk profiles (waist circumference, weight, height, lipids, HbA1c, smoking, physical activity) at program entry and discharge.
• 383 patients recruited post-acute coronary event/intervention (June 2011-June 2013) into English (n=301), Greek (n=40), or Italian (n=42) cohorts.
• Multivariate logistic regression used to adjust for baseline differences between cohorts.

Main Results:

• Baseline differences observed in age, smoking history, lipid profiles, blood pressure, weight, and physical activity across the cohorts.
• Despite baseline variations, the proportion of patients meeting defined health targets at discharge was similar across English, Greek, and Italian groups.
• The adapted phone-based program demonstrated comparable effectiveness regardless of language group.

Conclusions:

• Integrated disease management via phone-based coaching can be successfully adapted for Culturally and Linguistically Diverse (CALD) patients.
• Culturally adapted programs achieve comparable health outcomes to standard programs for English-speaking populations.
• Health services should be flexible and responsive to local community needs to maximize patient benefit.