‘Doing things differently to make a difference’ Supporting cardiovascular risk management Jill Moffat National Cardiac Education Coordinator 1 May 2012

What do we mean by cardiovascular risk assessment ….? High Cholesterol Diabetes Weight Diet Smoking History High Blood Pressure Heart health check (Heart WOF) to assess individual’s cardiovascular risk factors Calculate risk of having heart attack or stroke over next five years

…and cardiovascular risk management?  Lifestyle change  Combination of lifestyle change and medication  Higher cardiovascular risk → more intensive management

‘Taking control of my heart health’ A programme to support individuals with high cardiovascular risk to:  build health literacy  achieve lifestyle changes through goal setting, action planning and self monitoring

Model of care Developed to be delivered in a structured way within a primary health care setting Face to face risk communication and ‘plan for change’ Week 4-6 Face to face review and ‘plan for change’ End week 1 telephone follow up End week 3 telephone follow up

Programme components For primary health care practice  Training package  Tool kit containing supplementary material For individuals and families  ‘Taking control of my heart health’ booklet

Usability testing with three practices  Provided team training  Intensive testing process (2x 6 week cycle)  Rapid feedback on all components of programme from health professionals, individuals and families

Individual and family feedback Risk communication  “It was a wake up call.”  “Hearing that you have a high risk gives you a kick up the britches.” Goal setting  “It gave you permission to focus on one thing.”  “It encourages you to (gradually) extend your tent pegs - to make your tent bigger and be in a better position to do more.”

Individual and family feedback Support from health professional and family/friends  “Having my wife as ‘coach’ has really helped.”  “My nurse contributed 100% to our experience.” Information (framed positively and practical ‘how to’)  “It’s very positive - the way its presented - not you can’t do it, but you can do it.”

Health professional feedback Appreciated structure and process  “Provided a script to follow.” Risk communication  “You could see the light going on.” Goal setting  “It didn’t make it overwhelming.” BUT TOOK TIME  “..so much information to give.”

Changes post test  Increase focus on goal setting  Reduce detailed information/advice giving during face to face  Direct to sources of information in booklet and other relevant information/community services  Emphasise family involvement and support

‘Doing things differently to make a difference’ Focus on:  Effective risk communication  Support goal setting and self monitoring  Direct to relevant, accessible information and/or services.