The Heart of New Ulm Project: Using Community-Based Cardiometabolic Risk Factor Screenings in a Rural Population Health Improvement Initiative

Abstract

Awareness of cardiovascular disease and diabetes risk factors can improve the health of individuals and populations. Community-based risk factor screening programs may be particularly useful for quantifying the burden of cardiometabolic risk in a given population, particularly in underserved areas. This study provided a description of a screening platform and how it has been used to monitor the cardiometabolic risk profile within the broader Heart of New Ulm Project, which is based in a rural Minnesota community. A cross-sectional, descriptive examination of baseline screening data indicated that 45% of the target population participated in the program over 8 months. Overall, 13% of the sample reported a personal history of diabetes or cardiovascular disease. Among the subset without active cardiometabolic disease, 35% were found to be at high risk for developing cardiovascular disease or type 2 diabetes over the next 8-10 years. A high prevalence of metabolic syndrome, high low-density lipoprotein cholesterol, obesity, and low fruit/vegetable consumption were of particular concern in this community. This article describes the use of screening results to inform the design of intervention programs that target these risk factors at both the community and individual levels. In addition, design considerations for future community-based cardiometabolic risk factor screening programs are discussed, with a focus on balancing program objectives related to health surveillance, research, and the delivery of preventive health care services.

Lifestyle changes and prevention of metabolic syndrome in the Heart of New Ulm Project

“…As described elsewhere (Boucher et al, 2008, VanWormer et al, 2012), HONU is a 10-year community health initiative designed to reduce the attack rate of myocardial infarctions and burden of CVD risk factors in the New Ulm, MN area. There are multiple individual and environmental interventions as part of HONU.…”

Two-year impact of lifestyle changes on workplace productivity loss in the Heart of New Ulm Project: Table 1

“…The sample included adults who participated in a heart health screening programme in 2009 and in 2011. Details of this programme are described elsewhere,7 but briefly, screenings were free to adults who resided or worked in the target community (working age population ≈10 000). Events were held at community and worksite locations throughout New Ulm.…”

The State of Population Health Surveillance Using Electronic Health Records: A Narrative Review

“…44 The Marshfield Epidemiologic Study Area study in Ladysmith, Wisconsin, used EHR data to obtain the local incidence of dental disease 45,46 and, similarly, the Heart of New Ulm project in rural Minnesota applied advanced analytics to the large Allina Health System EHR database to monitor cardiovascular risk factors. 47 Beginning in 2011, the New York City Department of Health and Mental Hygiene (NYC DOHMH) Primary Care Information Project (PCIP) developed the Hub Population Health System (''the Hub'') to retrieve aggregate data from participating outpatient systems across the city. 48 As of 2013, the Hub includes more than 650 practices serving more than 1.6 million patients in the past year and 4 million 212 PAUL ET AL.…”