Community-based interventions aimed at decreasing blood pressure were the most promising for vulnerable populations across 32 studies, whereas behavior change interventions were the most challenging.
Systematic Review (n=32)
Do community-based cardiovascular disease interventions improve cardiovascular health behaviors and factors in vulnerable populations?
Community-based interventions, particularly those targeting blood pressure, show promise in improving cardiovascular health among vulnerable populations, though behavior change remains challenging.
BACKGROUND: Although cardiovascular health has been improving for many Americans, this is not true of those in "vulnerable populations." To address this growing disparity, communities and researchers have worked for decades, and as a result of their work, a growing body of literature supports the use of community engagement as a component of successful interventions. However, little literature synthesizes community-based interventions that address this disparity among a wide range of vulnerable populations. OBJECTIVE: This article provides a critical review of community-based cardiovascular disease interventions to improve cardiovascular health behaviors and factors among vulnerable populations based on the American Heart Association's 7 metrics of ideal cardiovascular health. METHODS: In February 2011, 4 databases (PubMed, PsychInfo, CINAHL, and Scopus) were searched using the following keywords: vulnerable populations OR healthcare disparities AND cardiovascular disease AND clinical trials OR public health practice AND English. RESULTS: This search strategy resulted in the retrieval of 7120 abstracts. Each abstract was reviewed by at least 2 authors, and eligibility for the systematic review was confirmed after reading the full article. Thirty-two studies met eligibility criteria. Education was the most common intervention (41%), followed by counseling or support (38%) and exercise classes (28%). Half of the interventions were multicomponent. Healthcare providers were the most frequent interventionists. Interventions aimed at decreasing blood pressure were the most promising, whereas behavior change interventions were the most challenging. Almost all of the interventions were at the individual level and were proof-of-concept or efficacy trials. CONCLUSIONS: This analysis provides a step toward understanding the current literature on cardiovascular interventions for vulnerable population. The next step should be integrating the identified successful interventions into larger health systems and/or social policies.
Walton‐Moss et al. (Thu,) conducted a systematic review in Cardiovascular disease in vulnerable populations (n=32). Community-based cardiovascular disease interventions was evaluated on Cardiovascular health behaviors and factors. Community-based interventions aimed at decreasing blood pressure were the most promising for vulnerable populations across 32 studies, whereas behavior change interventions were the most challenging.
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