1. This presentation is the intellectual property of the authors. Contact info@chrodis.eu for permission to reprint and/or distributeinfo@chrodis.eu This poster arises from the Joint Action on Chronic Diseases and Promoting Healthy Ageing across the Life Cycle (JA-CHRODIS), which has received funding from the European Union, in the framework of the Health Programme (2008-2013). Sole responsibility lies with the author and the Consumers, Health, Agriculture and Food Executive Agency is not responsible for any use that may be made of the information contained therein. A sustainable, active, primary prevention strategy for CardioVascular Diseases in Italy for adults 50 Barbara De Mei – Daniela Galeone on behalf of the Joint Action on Chronic Diseases and Promoting Healthy Ageing Across the Life Cycle (JA-CHRODIS) National Institute of Health - Ministry of Health- Italy The Project was supported by a grant from the Italian Ministry of Health, Centre of Disease Control (CCM) Joining Forces in Health Promotion to Tackle the Burden of Chronic Diseases in Europe Vilnius, Lithuania 24 – 25 November 2015 ACKNOWLEDGEMENT

2. BACKGROUND  Scientific evidence has reinforced the importance of interventions designed to prevent or delay the onset of CVD through the adoption of healthy lifestyles: a correct diet, regular physical activities and elimination of smoking  In Italy many cardiovascular prevention projects have been developed  On the basis of good results of previous projects, in 2013 the Ministry of Health, with the coordination of Veneto Region, financed the structured model for CVD prevention involving 12 Italian Regions (CARDIO 50)  It is organized in ways that are similar to cancer screening: active recall of healthy subjects combined with offers to intervene in selected subjects  The Model is tested in two previous studies in Veneto Region

3. AIM The main objective is to motivate people to adopt and sustain healthy behaviors in order to reduce CVD mortality and morbidity Specific aims  to evaluate parameters and lifestyle of an asymptomatic population through active call  to estimate the cardiovascular risk of the population and to implement the evaluation of cardiovascular risks in clinical practice  to implement the primary prevention programme (counseling on smoking cessation, healthy diet, physical activity)

4. METHODS TARGET GROUP Asymptomatic men and women aged 50 years resident in the Local Health Authority involved  The Screening Center (SC) of the Prevention Department in collaboration with GPs and Sanitary District are in charge of the organization of the entire programme  The SC prepares the list of residents and the GPs apply a pre- evaluation to sort the lists according to the criteria for exclusion (history of cardiovascular and cerebrovascular events, diabetes, hypertension, severe neoplastic diseases, long-term care, institutionalization)  Selected subjects are called for a visit by the SC with eventual recall in case of non response

5. METHODS Screening visit performed by a Health Assistant/Nurse Professional (or other health staff duly formed) at the Department of Prevention or in other regional offices The participants are evaluated through  an administered lifestyle questionnaire  physical parameters (blood pressure, glycemia, waist circumference and body mass index)  a calculation of physical activity - International physical activity questionnaire (IPAQ) The subjects are classified in 4 risk groups Group A: no behavioral risk factors, regular parameters Group B: behavioral risk factors and regular parameters Group C: new hypertensive and new hyperglycemic subjects independent from behavioral risk factors Group D: not eligible subjects

6. METHODS Proposals of specific interventions for the risk groups  Group A: they are invited to strengthen healthy lifestyles  Group B: they are invited to join for health promotion initiatives individually (individual motivational counseling) or in groups (no smoking groups, walking groups, nutritional groups) organized with GPs, local authorities, cultural and voluntary associations. They are reassessed after 6 months and 1 year  Group C: they sent to the GP to other assessment with the agreement of giving drug treatment after 3/6 months of life style changed  Group D: not eligible subjects (in the lists by mistake)

7. RESULTS Results of pilot phase in Veneto Region Adherence to the project: 60.8% (17.004 subjects) Among these o Group A: 24% o Group B: 56% o Group C: 14% o Group D: 6%  The female population gives greater attention to health and prevention initiatives (51,2% vs 48.8%)  The subjects with unhealthy lifestyles (class B) were invited for health counseling and reassessed after 6 months and1 year. The follow-up adhesion was 50%  A preliminary follow-up evaluation shows that there has been a statistically significant improvement of physical activities and the number of smokers decreased

8. CONCLUSIONS The results confirm that a preventive programme plan based on an active call of citizens by the Department of Prevention could be an effective tool to identify asymptomatic individuals with unknown hypertension and/or hyperglycemia and offering lifestyle interventions to lower the risk of cardiovascular diseases Strengths effective partnerships is in place: the health programmes are organised with the collaboration of GPs, local authorities, cultural and voluntary associations the implementation of healthy lifestyle through community programmes (walking groups, no smoking groups, nutritional groups) Improvment of the awareness of own CVD risk profile (early diagnosis)

9. CONCLUSIONS Weakness about 40% of the population did not adhere to the project and this high percentage requires targeted studies in order to identify the reasons the evaluation of initiatives to change lifestyles needs a long time of work and an appropriate follow-up (especially the changes in diet and physical activity) This CVD prevention programme at the moment is active at regional level (12/20 regions involved) The National Prevention Plan 2014-2018 intend to test the feasibility and to start the programme in all regions by 2018

10. Thank you for attention! Acknowledgment Chiara Donfrancesco (National Institute of Health) Elena Coffano (Regional Health Promotion Documentation Centre Dors) Paola Ragazzoni (Regional Health Promotion Documentation Centre Dors) Maria Teresa Menzano (Ministry of Health) Barbara Pellizzari (Veneto Region) Sandro Cinquetti (Veneto Region) For more information: Barbara Pellizzari barbara.pellizzari@regione.veneto.it; Sandro Cinquetti sandro.cinquetti@ulss7.it.barbara.pellizzari@regione.veneto.itsandro.cinquetti@ulss7.it