Screening for cardiovascular risk in the general population: The SPICES implementation survey

Area of Science:

• Public Health
• Cardiovascular Disease Prevention
• Health Services Research

Background:

• Cardiovascular diseases (CVD) are a leading global cause of death, necessitating effective primary prevention strategies.
• The SPICES survey aimed to implement CVD prevention in five countries, focusing on the Centre Ouest Bretagne (COB) area in France, a rural, underserved region with high CVD mortality.
• A population-based CVD risk screening was required to identify individuals for intervention without straining family practitioner (FP) resources, addressing unknown efficacy and replicability.

Purpose of the Study:

• To characterize individuals undergoing CVD risk assessment using the Non-Laboratory Interheart risk score (NL-IHRS).
• To identify barriers and explore facilitators for general population screening in a primary CVD prevention implementation study.
• To evaluate the efficacy and replicability of a novel CVD screening approach.

Main Methods:

• A cross-sectional descriptive study combined with qualitative interviews.
• The NL-IHRS was administered by trained health students, pharmacists, nurses, and physiotherapists using an e-tool at public events.
• Thematic analysis of 47 interviews with screeners until theoretical saturation.

Main Results:

• 3,384 CVD risk assessments were completed in 5 months across 60 locations, primarily by health students.
• 1,587 (low), 1,309 (moderate), and 488 (high) individuals were identified with varying CVD risks.
• High prevalence of stress (40.1%) and depression (24.5%) was noted; key facilitators included public willingness and trust, while barriers involved screener motivation and e-tool issues.

Conclusions:

• CVD risk screening utilizing health students is effective and preserves FP workforce capacity.
• Replicability is feasible with strong emphasis on establishing and maintaining trust between screeners and researchers.
• Enhancements to e-tool user-friendliness are recommended for improved implementation.