Cardiovascular Health Awareness Program (CHAP) in Subsidized Social Housing

Not Applicable

Completed

• Conditions: Cardiovascular Diseases; Cardiovascular Risk Factor; Diabetes Mellitus

• Registration Number: NCT03549845
• Lead Sponsor: McMaster University

Brief Summary

This project aims to improve the cardiovascular health of seniors living in subsidized housing by implementing the successful community-based Cardiovascular Health Awareness Program (CHAP). CHAP is a patient-centred, interdisciplinary, multi-pronged, community-led CVD and stroke prevention and management program designed to prevent and reduce the impact of cardiovascular disease in older adults. The program addresses common cardiovascular disease risk factors, such as smoking, physical activity and poor diet by raising awareness of health and community resources available to encourage self-care and appropriate management of cardiovascular disease. A randomized controlled trial will be used to evaluate the impact of CHAP on healthcare utilization by older adults living in subsidized housing.

Detailed Description

This project aims to improve the cardiovascular health of seniors living in subsidized housing by implementing the successful community-based Cardiovascular Health Awareness Program (CHAP). Residents in subsidized housing are considered to be a vulnerable population because of their low income and tend to be in poorer health; with a multitude of chronic illnesses, such as cardiovascular disease (CVD) and diabetes.

This project will build on the success of CHAP in other provinces. The program has been shown to reduce blood pressure and CVD-related hospitalization costs. CHAP is a patient-centred, interdisciplinary, multi-pronged, community-led CVD and stroke prevention and management program designed to prevent and reduce the impact of cardiovascular disease in older adults. The program addresses common cardiovascular disease risk factors, such as smoking, physical activity and poor diet by raising awareness of health and community resources available to encourage self-care and appropriate management of cardiovascular disease.

Taking the form of a randomized controlled trial, the sample will be subsidized housing buildings (low income) for those aged 55 years and over. During CHAP monthly assessment sessions, participants will 1) complete a consent form, 2) complete a cardiovascular risk profile form, 3) undergo blood pressure measurement using an automated blood pressure measuring device, 4) receive targeted healthy lifestyle and preventive care materials, 5) be invited to participate in group health education sessions. Those patients identified at high risk will be assessed by a health professional and referred to a family physician for timely and appropriate follow-up.. The impact this program will have on health care utilization (emergency visits, cardiovascular hospitalization rates) will be measured using administrative databases.

Study Timeline

• Study First Submitted: 2018-05-15
• Study First Submitted QC: 2018-05-25
• Study First Posted: 2018-06-08
• Study Start: 2018-09-17
• Primary Completion: 2021-12-31
• Study Completion: 2022-12-31
• Status Verified: 2023-03
• Last Update Submitted: 2023-03-13
• Last Update Posted: 2023-03-15

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 2742

Inclusion Criteria

• Approximately 50-200 apartment units
• Majority of residents are 55 years of age or older.
• Unique postal code
• Availability of at least one building with similar characteristics for matching/randomization

Individual Inclusion Criteria

• Resides in a study building
• Aged 55 years or older
• Speaks and reads English or French

Note: Younger residents will be allowed to take part in the program but their data will not be included in the analysis.

Exclusion Criteria

• None

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Primary Outcome Measures

Name	Time	Method
Healthcare Utilization Composite - Change in CVD-related emergency department visits and hospitalizations	Monthly from 1 year pre-intervention to 1 year post-intervention	Change in rate of CVD-related emergency department visits and hospitalizations by postal code from administrative databases (Building-level analysis)

Secondary Outcome Measures

Name	Time	Method
Quality-Adjusted Life Years (QALYs)	1 year (post-intervention)	Calculated from EQ-5D-5L at two time points and Canadian value sets
Participant experience of the CHAP intervention	1 year (post-intervention)	Participant experience of the intervention will be evaluated through qualitative individual interviews and focus groups of residents.
Healthcare Utilization - Change in all-cause emergency department visits	Monthly from 1 year pre-intervention to 1 year post-intervention	Change in rate of all-cause emergency department visits by postal code from administrative
Healthcare Utilization - Change in all-cause hospitalizations	Monthly from 1 year pre-intervention to 1 year post-intervention	Change in all-cause hospitalization rates by postal code from administrative data (building-level)
Cost-effectiveness	1 year (post-intervention)	Calculated from program cost data and health outcomes
Change in quality of life	Baseline and 1 year	Measured using EQ-5D-5L

Trial Locations

Locations (1)

Centre de recherche du CHUM; 🇨🇦 Montréal, Quebec, Canada