1998: 3 counties 2013: 55 counties

Once upon a time…

W.A.Neal, MD …there was a famous pediatric cardiologist. He saved and improved the quality of the lives of hundreds of sick children.

He was very happy about this.

But he knew there was more. In 1995, the WV age adjusted death rate from heart disease was 21% higher than the national average.

Something had to be done. But the grown-ups just didnt seem to be getting it.

Now, this was not just your average run of the mill famous pediatric cardiologist. He was a deep thinker! Hold that thought.

The postman delivered letters that invited lots of people (including the famous pediatric cardiologist and a cranky nurse) to a meeting.

And lots of people went to the meeting to do good work.

And everyone listened carefully to all the speeches. Lfdoas lfoei ad ald da ll ldjpe fj j erd lfoe d 0p aod ap apo A[a aeipf apoiap d ka adl k

Then everyone at the meeting got a special assignment to a special focus group. And the famous pediatric cardiologist with the bright idea was assigned to the same focus group as the cranky nurse.

…blah blah…if the school nurses had the money…blah blah…reports The cranky nurse didnt like focus groups with all talk and no action and said so as she introduced herself to the group.

My name is Valerie Minor and I am from Alderson-Broaddus College, Department of Nursing and also Field Faculty for the WV Rural Health Education Partnerships…

In 1991, Governor Gaston Caperton called a special session of the Legislature Passed the Rural Health Initiative (RHI) Act Main purpose: Increase retention of state trained health professionals In 1991 WV received a W. K. Kellogg grant Main purpose: Provide rural community-based academic training sites for health professionals In 1995 Kellogg and RHI are joined and form the West Virginia Rural Health Education Partnerships.

The land of dead-end reports The famous pediatric cardiologist agreed. He decided to introduce himself to the cranky nurse.

W.Neal, MD So over lunch at the meeting, the famous pediatric cardiologist talked to the cranky nurse. He told her about his bright idea and about 2 dyn-o-mite resources...

The Bright Idea Prevention! Identify kids at risk for cardiovascular disease. Go to the schools and offer free screenings. –Blood pressure –Finger-stick for cholesterol (evolved to FLP) –BMI –Eventually neck check for acanthoisis nigricans Get those at risk into appropriate treatment. Reverse Universal Screening

West Virginia Rural Health Education Partnerships An infrastructure found only in West Virginia! And you will do community service projects…

WVU SOM Department of Pediatric Cardiology

Many Moving Parts WVU Institutional Review Board RHEP School Superintendents School Nurses Funding

CDC Benedum Foundation Department of Pediatrics Foundation Compton Nutrition Chair American Heart Association Private contributions PROBLEM: SUSTAINBILITY

WE CARDIAC Chair, Senate Committee on Health and Human Resources Fall 2000

And the famous pediatric cardiologist said, This is good. W. Neal, MD

Major Change: Demise of RHEP School Year

No worries. Well just will reconfigure. W. Neal, MD

Based at WVU SOM Many of the same people –Site Coordinators became Area Coordinators Able to focus on CARDIAC alone –More involvement in intervention Remains community-based

PRESTON MONONGALIA ROANE CALHOUN GILMER WEBSTER BRAXTON NICHOLAS CLAY Kathryn Greenlief DODDRIDGE WETZEL MARSHALL OHIO BROOKE HANCOCK TYLER PLEASANTS RITCHIE WIRT Dalena Riggs TUCKER GRANT MINERAL HAMPSHIRE MORGAN BERKELEY JEFFERSON HARDY PENDLETON Robin VanFleet FAYETTE RALEIGH KANAWHA Tammy Pyle-Vicars WOOD JACKSON PUTNAM MASON CABELL WAYNE LINCOLN Tina Whitt GREENBRIER Nahied Haidar MARION TAYLOR BARBOUR Valerie Minor CARDIAC 2012 LEWIS UPSHUR RANDOLPH POCAHONTAS Rhonda Carpenter HARRISO N CARDIAC WEST – Tammy CARDIAC EAST – Kathryn SUMMERS MONROE MCDOWELL WYOMING MINGO LOGAN BOONE Janetta Massie MERCE R decline d

So far, so good! 15 years of Surveillance, Research and Intervention And certainly not the end…