1. Did you know? By 2030, more than 23 million people in the world will die from CVD each year? CVD is projected to remain the single leading cause of death? A New Zealander dies every 90 minutes from heart disease?

2. Putting people at the heart of reducing CV risk

3. Understand my risk Give me tips Support me making changes Help motivate me

5. …I'm listened to …….you may not have all the answers …….you’ve helped me

6. Risk assessment and understanding risk / condition Gauging thoughts and feelings about risk / condition Understanding management options and preferences Collaborative goal setting and action planning Identify support team Heart attack and stroke awareness Planned monitoring and follow-up Putting people at the heart of reducing CVD risk

7. NEW RESOURCE  Based on shared decision making principles  Infographic and plain language  More information online including an animation  Outlines all the options available to a person  Encourages patient activation  Can be used in a health professional/person conversation, handed out or send in the post with a result

8. Options and choices

9. Making Changes with Taking Control Taking Control is a plan which aims to support individuals with elevated CV risk to develop self-management skills Taking Control helps a person: 1.Understand their risk and what it means for them, right now and in the future 2.Achieve success through setting a manageable goal, having a plan and seeing it through 3.Plan it together with a health professional with support from whanau/family and friends

10. Inspiring behaviour change “To understand what it means to be human is to listen to people describe their ‘lived’ experiences” (Smythe and Norton, 2011) 1) Acknowledge and confirm 2) Identify and work with challenges 3) Goal setting

11. “The problem with communication is the illusion that it has occurred”. George Bernard Shaw

13. Person Engagement Access to healthcare Health literacy Patient activation Culture of medicine Models of care Cultural competence Person engagement challenges

14. Person centred conversations Open ended questions Reflective listening Listening for and strengthening change talk Motivational Interviewing Conveying understandable information Eliciting patient preferences and values Sharing decisions Shared decision making Agenda setting/goal setting/action planning Permission-ask-provide-ask Teach Back Communication skills Resources and tools IT- YHF/ decision aids Paper- Taking Control/CVD generic process Apps

15.  CVD is NZ’s biggest killer  Disengagement may have been an unintended downside of a “number focussed” health target  Relationships are the foundation of healthcare- Be Present!  Health professional self-reflection and action Miriam Lindsay- Nurse Champion, Heart Foundation

16. References and further learning BPAC.(2008).Communicating cardiovascular risk: getting your message across. BPJ, 37(17). Retrieved from: http://bpac.org.nz/BPJ/2008/October/communicating.aspx http://bpac.org.nz/BPJ/2008/October/communicating.aspx Conversation video example ‘ Behind closed doors”: http://personcentredcare.health.org.uk/resources/behind-closed-doorshttp://personcentredcare.health.org.uk/resources/behind-closed-doors Coulter,A., Collins, A. (2011). Making shared decision-making a reality: No decision about me, without me. The King’s Fund. Retrieved from: http://www.kingsfund.org.uk/publications/making-shared-decision-making-realityhttp://www.kingsfund.org.uk/publications/making-shared-decision-making-reality Da Silva, D. (2012). Helping people Share Decision Making: A review of evidence considering whether shared decision making is worthwhile. London: The Health Foundation. Health literacy and Teach back : http://www.teachbacktraining.org/http://www.teachbacktraining.org/ Teach back video example https://www.youtube.com/watch?v=_Vo9Q_EfBX8https://www.youtube.com/watch?v=_Vo9Q_EfBX8 Heart Foundation videos Taking Control, Wanda and William http://www.heartfoundation.org.nz/programmes- resources/health-professionals/primary-prevention/cardiovascular-risk-management/taking-controlhttp://www.heartfoundation.org.nz/programmes- resources/health-professionals/primary-prevention/cardiovascular-risk-management/taking-control Heart Foundation (2014). Shared decision making and cardiovascular risk assessment and management: Positon statement. Retrieved : www.heartfoundation.org.nz/uploads/Heart_Foundation_position_paper_on_SDM.pdfwww.heartfoundation.org.nz/uploads/Heart_Foundation_position_paper_on_SDM.pdf Link to more video examples of shared decision making http://www.advancingqualityalliance.nhs.uk/sdm/resources- 2/sdm-in-action/http://www.advancingqualityalliance.nhs.uk/sdm/resources- 2/sdm-in-action/ Smythe, E., et al. (2012). Insights from a physiotherapist’s lived experience of osteoarthritis. Physiotherapy Theory and Practice, 1–13. Wells, S., et al. (2010). Your heart forecast: a new approach for describing and communicating cardiovascular risk? Heart. 96(708), 713. doi:10.1136/hrt.2009.191320 Online material supporting blood pressure and cholesterol resource: http://www.heartfoundation.org.nz/know-the- facts/conditionshttp://www.heartfoundation.org.nz/know-the- facts/conditions