Recent Changes

Tokarski, C. (2004). Smoking cessation treatment cost-effective for health plans. Retrieved July 21, 2010, from Medscape Today Web site: http://www.medscape.com/viewarticle/480313
U.S. Department of Health and Human Services. (1990). The health benefits of smoking cessation: a report of the surgeon general. Center of Disease Control.
Appendix:
After working as a team on the Epidemiology paper together, we were able to make a smooth transition into working on this CHD case study together. First, we both individually researched other case studies throughout the book as well as online to come up with some ideas on what we could focus our study on. After going back and forth on several ideas, we both decided that it would be best to focus on one of the modifiable risk factors of CHD. So, we worked on finding research and both came together with our research and collectively decided that the best focus would be on smoking cessation programs and their overall effects for an HMO.
Caitlin had come up with very good ideas on questions for the case study, so she was assigned to work on the questions and answers part of our study. Christine had found a good amount of information on the background of smoking and coronary heart disease, so we decided that it would be best for her to work on the beginning of the case study focusing on the background of the paper. Christine was also assigned to post on the Wiki and to keep us focused on our deadlines for this project.
We decided to set 4 deadlines to help keep us on track. The first one was set for July 12th, and we were able to come up with several ideas for our case study by this date. The second deadline was set for July 15th, and we narrowed down our choices to one by this date. The 3rd deadline was set for July 24th, which was the date that we were both to have our parts of the study completed. Our last deadline was set for July 25th and we were to have both proofed the paper by this date before the due date of the project on the 26th.
To assist us on keeping each other on track, we utilized several communication methods in order to complete this case study project. We had several phone meetings and also utilized email and text messaging to keep each other informed on our progress.
In conclusion, we both enjoyed working with each other on both the epidemiology paper and this case study on coronary heart disease. We were able to learn so many new things about CHD in general as well the effects of smoking and CHD, and were truly amazed at the shocking figures. We were able to work well together by realizing each other’s strengths and weaknesses in the early stages. This enabled us to organize, research, write, and assist each other effectively in order to complete both of these projects.

Christine Patton-Mitchell
July
July 26, 2010
PHC
PHC 6000 – Epidemiology
Case
Case Study: Smoking Heart Disease
We pledge that we have not plagiarized on any aspect of this assignment.
Executive Summary
p. 1052).
This
This case study cessation program.
Health
Health Effectiveness
Smoking
Smoking programs are effective method.
Cost
Cost Effectiveness
In
In terms of long run.
Overview/Background:
Smoking
Overview/Background:
Smoking plays a to healthcare.
Tobacco,
Tobacco, whether smoked para 1).
Smokers
Smokers are 2 & 7).
Use:
The
Use:
The CDC reports (CDC, 2010).
2002
2002 data reports para 3).
Although
Although tobacco use para 8).
Laws
Laws and Prevention Programs:
Laws
In
Laws
In addition to Kids, 2010).
Prevention
Prevention Programs
Of
Of the 46 (AHA, 2010a).
There
There are a (FDOH, 2010).
The
The Happy HMO Case Study:
The
The University of Happy HMO.
Program
Program Overview Chart:
During
During The First Years of
Cessation
Cessation Program
Size of Happy HMO
450,000
4,892
Cost incurred by Happy HMO
$15,500,000
Healthcare costs saved
$500,000
(Tokarski,
(Tokarski, 2004)
Questions:
·
Questions:
· Are smoking quit smoking?
·
· Does quitting heart disease?
·
· Are smoking for MCOs?
Answers:
Are
Answers:
Are smoking cessation quit smoking?
Among
Among the members (Tokarski, 2004).
Smoking
Smoking cessation programs cessation program.
The
The success rate best option.
There
There are certain p. 3).
Does
Does quitting smoking heart disease?
Smoking
Smoking cessation has para. 2).
Numerous
Numerous studies have Institute, 2007).
Are
Are smoking cessation care organization?
If
If the goal is minimal.
There
There were 54,488 (Tokarski, 2004).
However,
However, if the p. 1052).
References:
American
References:
American Heart Association from http://www.americanheart.org/presenter.jhtml?identifier=4731
American
American Heart Association 21, 2010,
http://americanheart.org/downloadable/heart/1244130433852FACTS%20-%20Tobacco%20Fact%20Sheet%2004-23-09%20_FINAL_.pdf
Barendregt,
http://americanheart.org/downloadable/heart/1244130433852FACTS%20-%20Tobacco%20Fact%20Sheet%2004-23-09%20_FINAL_.pdf
Barendregt, J. J., 1052- 1057.
Centers
Centers for Disease 20010, from
http://www.cdc.gov/tobacco/data_statistics/fact_sheets/index.htm
Florida
http://www.cdc.gov/tobacco/data_statistics/fact_sheets/index.htm
Florida Department of 2010 from
http://www.doh.state.fl.us/Tobacco/quitline.html
35(9), 68.
Goto,
Goto, R., Takahashi, MEDLINE database.
National
National Cancer Institute. from www.cancer.gov
Ockene,
Ockene, I. S. 96, 3243-3247.
Quit Smoking Support. (1995). What are the benefits of quitting smoking? Retrieved July 20, 2010, from www.quitsmokingsupport.com/benefits
Quit guide. RetrievedRetrieved July 20, from http://www.smokefree.gov/quit-guide.aspx
Southard,
Southard, C. (2007). Text database
Tokarski,
Tokarski, C. (2004). site: http://www.medscape.com/viewarticle/480313
U.S.
U.S. Department of Disease Control.

After reviewing the literature on CHD,
Caitlin Donato and learning more aboutChristine Patton-Mitchell
July 26, 2010
PHC 6000 – Epidemiology
Case Study: Smoking and Coronary Heart Disease
We pledge that we have not plagiarized on any aspect of this assignment.
Executive Summary
Smoking plays a predominant role as one of the risk factors associated withof coronary heart disease. As tobacco use is viewed as both a significant contributing factor but also a modifiable factor, removing this disease, Caitlin and I were surprisedrisk factor from the CHD equation is very important to learn howhealthcare. Smokers are 2 to 4 times more likely to develop CHD (AHA, 2010b, paras 5 & 7). From a monetary standpoint, smoking is a costly habit as well. A managed care organization can pay as much of an impact these risk factors hadas 40 percent higher healthcare costs for a smoker than a nonsmoker (Barendregt, Bonneux, & Van Der Maas, 1997, p. 1052).
This case study will take a close look at a smoking cessation program offered by a hypothetical managed care organization called Happy HMO. Outlined below and discussed in detail, this case study will examine the extenthealth effectiveness and cost effectiveness for Happy HMO to which they were modifiableoffer a smoking cessation program.
Health Effectiveness
Smoking programs are successful in reducing CHD incidents. We have decidedgetting about ten percent of participants to formulate our case study using onequit. They are estimated to add 7.1 years of life to every person who quits smoking. For the following main modifiablesmall percentage of smokers who quit from these programs they are tremendously effective. Once a smoker quits they begin to see immediate health benefits. One benefit of smoking cessation is the reduced risk factors forof coronary heart disease:
· Smoking
· High blood cholesterol
· High blood pressure
· Physical inactivity
· Obesity
We will be working on further research ondisease. From the main risk factors during the next couplehealth stand point of daysHappy HMO; smoking cessation programs are an effective method.
Cost Effectiveness
In terms of lowering Happy HMO’s cost and liability, offering a smoking cessation is not the best option. Cessation programs will narrow it downcause members to live longer, but along with older age comes age related illnesses. Age related illnesses have proven to be more expensive than smoking related illnesses and focus on one ofwill therefore, increase healthcare costs for Happy HMO in the above risk factors to base our case study on.long run.
Overview/Background:
Smoking plays a predominant role as one of the risk factors of coronary heart disease. As tobacco use is viewed as both a significant contributing factor but also a modifiable factor, removing this risk factor from the CHD equation is very important to healthcare.
and strokes (AHA article, 2010,(AHA, 2010b, para 1). secondhand smoke (AHA article, 2010,(AHA, 2010b, paras 5 & 7).
Use:
The CDC reports 2008 cigarette use for adults in the state of Florida at 17.5%. This ranked approximately in the middle, Utah being the lowest at 9.2% and West Virginia (tobacco country) being the highest at 26.6% (CDC, 2010).
2002 data reports specifically for Orange County, Florida, reflect a number higher than the state average with 21% of adults smoking. The age group with the largest number of smokers is 18-44 year olds, which comprised 22.1%. This is also higher than the statewide percentage of 18-44 year olds, which comes in at 15.1%. Teen smoking is also a concern in Orange County where a 2007 study shows 17% of high school students smoked. 60.1% of high school students and 77.2% of middle school students reported they were exposed to secondhand smoke (OCHD, 2010, para 3).
Although tobacco use has decreased over the past ten years with 2007 reports showing a national average of 19.8% of adults smoking, the slow rate of decline makes it highly unlikely that the Healthy People goal of 12% will be met for their 2010 target date once data is finalized (AHA, 2010b, para 8).
Laws and Prevention Programs:
Laws
In addition to the large role it plays in regard to CHD, smoking is also considered to be a factor in numerous other health concerns and therefore the subject of a number of federal, state and local laws. In 2009, the Family Smoking Prevention and Tobacco Control Act was signed into law and authorized the Food and Drug Administration to regulate tobacco products in how they are made, marketed, and sold. Highlights of the law include specific restrictions on teen access and marketing. It requires larger warning labels and requires detailed lists of ingredients (Tobacco Free Kids, 2010).
Prevention Programs
Of the 46 million Americans who smoke cigarettes, many are trying to quit. The American Heart Association estimates that more than 49% of adults who have ever smoked have quit. Each year, approximately 1.3 million smokers are able to quit, many with the help of smoking cessation programs (AHA, 2010a).
There are a number of programs on the national and state levels. Smokefree.gov is an online resource guiding people through preparing to quit, quitting, and staying quit (Smokefree, 2010). In 2006, Florida put into law Amendment 4, which formed the Florida Tobacco Education and Use Prevention Advisory Council. It includes elements such as QuitLine, a toll-free telephone based tobacco cessation service (FDOH, 2010).
The Happy HMO Smoking Cessation Case Study:
The University of Michigan’s School of Public Health pooled together data from three separate managed care organizations to study smoking cessation in a hypothetical MCO, which we will call Happy HMO. The data was used to simulate both the financial impact and the cost effectiveness of tobacco cessation (Tokarski, 2004). Following, we will look at the simulated first five years of the cessation program and explore three key questions that discuss whether or not they are successful in getting people to quit smoking, reduction of CHD, and the overall cost effectiveness for Happy HMO.
Program Overview Chart:
During The First 5 Years of
Cessation Program
Size of Happy HMO
450,000
Members who used cessation program
54,488
Members who quit as a result
4,892
Cost incurred by Happy HMO
$15,500,000
Healthcare costs saved
$500,000
(Tokarski, 2004)
Questions:
· Are smoking cessation programs successful in getting people to quit smoking?
· Does quitting smoking reduce the risk of coronary heart disease?
· Are smoking cessation programs a cost effective approach for MCOs?
Answers:
Are smoking cessation programs successful in getting people to quit smoking?
Among the members of Happy HMO who participated in the smoking cessation program there was about a 10 percent quit rate, which could be attributed to the smoking cessation program (Tokarski, 2004).
Smoking cessation programs can be successful in causing a small number of people to quit smoking; however, it can often be a result of other factors. For example, it can depend on the smoker’s readiness to quit smoking (Gallo, 2005, p. 1). According to the 1990 Surgeon General Report, smokers who need assistance should have it available (U.S. Department of Health and Human Services, 1990). The smoker who wants to quit and feel that they are ready will have the highest success rate in quitting through a smoking cessation program.
The success rate in smoking cessation programs may appear discouraging; however, more than 90 percent of smokers who attempt to quit smoking without treatment assistance will fail (Southard, 2007, p. 2). Therefore, if a patient is ready to quit smoking then a smoking cessation program is their best option.
There are certain factors within cessation programs that have been proven to yield a higher success rate. One factor is including nicotine replacement or other medication to facilitate cessation. Programs that do not offer nicotine replacements or other medications increase the cessation rate by about six percent over programs that do offer nicotine replacements (Fleming, 2008, p. 359). Another aspect that can increase the successfulness of a program is to have health professional’s recommend the program (Southard, 2007, p. 3).
Does quitting smoking reduce the risk of coronary heart disease?
Smoking cessation has been proven to allow people to live a longer life than continual smokers (U.S. Department of Health and Human Services, 1999, p.1). A smoker’s body will begin a series of changes within minutes of smoking cessation. It only takes 20 minutes after the last cigarette for the smoker’s blood pressure to drop to normal. After just 24 hours of smoking cessation the chances that person will suffer a heart attack already decreases. The person can decrease their excess risk of coronary heart disease to half that of a smoker after one year of quitting (Quit Smoking Support, 1995, para. 2).
Numerous studies have shown a substantial decrease in CHD deaths for former smokers compared to smokers who never quit. Not only will smoking cessation reduce the risk of developing coronary heart disease, but it will also reduce the risk of reoccurring illnesses by as much as fifty percent (Ockene & Miller, 1997, pp.3243-3247). People who quit smoking are less likely to die from smoking related illnesses, regardless of their age (National Cancer Institute, 2007).
Are smoking cessation programs a cost-effective approach for a managed care organization?
If the goal of Happy HMO is to reduce the amount of enrollee’s that smoke, then offering a cessation program is a cost-effective approach. Covering smoking cessation programs have been found to add 7.1 years to a MCO enrollee’s life expectancy. The cost of cessation programs compared to a health plan’s total expenditures is minimal.
There were 54,488 enrollees of Happy HMO that used the covered smoking cessation program in the first five years. As a result 4,892 members quit than would have without coverage. The smoking cessation program resulted in $0.63 per member per month expenditures to Happy HMO for the first five years and saved Happy HMO .5 million in medical care reduction (Tokarski, 2004).
However, if the goal of a MCO is to reduce their cost and liability it may not be the most cost-effective approach. Smokers incur more health related complications than nonsmokers, however, nonsmokers live longer and can incur more health cost associated with aging (Barendregt, Bonneux, & Van Der Maas, 1997, p. 1052). Taking a closer look at the results from the case study, Happy HMO spends $15.5 million to offer the program for 5 years, and only saves $.5 million in healthcare expenses (Tokarski, 2004). If members of Happy HMO quit smoking, there would be a saving in health care cost in the short-term. Eventually smoking cessation within a population would increase years of life lived and therefore increase healthcare cost to higher rates than current (Barendregt, Bonneux, & Van Der Maas, 1997, p. 1052).
References:
American Heart Association (AHA). (2010a). Smoking Cessation. Retrieved July 22, 2010, from http://www.americanheart.org/presenter.jhtml?identifier=4731
American Heart Association (AHA). (2010b). What are you smoking? Smoking and cardiovascular disease. Retrieved July 21, 2010,
http://americanheart.org/downloadable/heart/1244130433852FACTS%20-%20Tobacco%20Fact%20Sheet%2004-23-09%20_FINAL_.pdf
Barendregt, J. J., & Bonneux, L, & Van Der Maas, P. J. (1997). The health care costs of smoking. The New England Journal of Medicine, 1052- 1057.
Centers for Disease Control. (2010). Smoking and tobacco use. Retrieved July 20, 20010, from
http://www.cdc.gov/tobacco/data_statistics/fact_sheets/index.htm
Florida Department of Health. (2010). QuitLine. Retrieved July 20, 2010 from
http://www.doh.state.fl.us/Tobacco/quitline.html
Gallo, C. (2005). Health matters: promoting health and wellness. Plant the seeds of success for smoking cessation. Nursing CINAHL, 35(9), 68.
Goto, R., Takahashi, Y., Nishimura, S., & Ida, T. (2009). A cohort study to examine whether time and risk preference is related to smoking cessation success. Addiction (Abingdon, England), 104(6), 1018-1024. Retrieved from MEDLINE database.
National Cancer Institute. (2007). Quitting smoking: Why to quit and how to get help. Retrieved July 20, 2010 from www.cancer.gov
Ockene, I. S. & Miller, N. H. (1997). Cigarette smoking, cardiovascular disease, and stroke. American Heart Association, Inc., 96, 3243-3247.
Quit Smoking Support. (1995). What are the benefits of quitting smoking? Retrieved July 20, 2010, from www.quitsmokingsupport.com/benefits
Smokefree.gov (2010). Quit guide. Retrieved July 20, 2010, from http://www.smokefree.gov/quit-guide.aspx
Southard, C. (2007). Smoking cessation initiative: extraordinary success!. Access, 21(5), 8. Retrieved from CINAHL Plus with Full Text database
Tokarski, C. (2004). Smoking cessation treatment cost-effective for health plans. Retrieved July 21, 2010, from Medscape Today Web site: http://www.medscape.com/viewarticle/480313
U.S. Department of Health and Human Services. (1990). The health benefits of smoking cessation: a report of the surgeon general. Center of Disease Control.

heart disease:
·
· Smoking
·
· High blood cholesterol
·
· High blood pressure
·
· Physical inactivity
·
· Obesity
We
We will be study on.
Overview/Background:
Smoking plays a predominant role as one of the risk factors of coronary heart disease. As tobacco use is viewed as both a significant contributing factor but also a modifiable factor, removing this risk factor from the CHD equation is very important to healthcare.
Tobacco, whether smoked or taken in by breathing secondhand, damages arteries and the heart. It lowers the level of good cholesterol, increases heart rate, and replaces oxygen with carbon monoxide in the blood. Blood clots are more likely to form due to smoking, which can cause heart attacks and strokes (AHA article, 2010, para 1).
Smokers are 2 to 4 times more likely to develop CHD. When looking at those who have CHD, smokers are also 2 to 3 times more likely to die from it than non-smokers. In addition to all of the risks for smokers, it is estimated that annually, 46,000 non-smokers die from coronary heart disease related to exposure to secondhand smoke (AHA article, 2010, paras 5 & 7).

Caitlin Donato and Christine Patton-Mitchell
July 19, 2010
PHC 6000 – Epidemiology
Coronary Heart Disease:
We pledge that we have not plagiarized on any aspect of this assignment.
Executive Summary
Christine: 2 pages, Patterns & Trends of its distribution in the world, the US, Florida, Central Florida and Orange County, FL
Patterns and Trends:
Christine: 2 pages, Identify the Risk Factors
Identify the Risk Factors:
The American Heart Association groups risk factors for coronary heart disease into: major risk factors, contributing risk factors, and modifiable risk factors. Major risk factors are those factors that can dramatically increase the risk of CHD. These risk factors cannot be changed, and having multiple risk factors in this category will increase the likelihood of developing CHD. The first major risk factor is increasing age. Instances of CHD increase, as people get older. The AHA reports that 82% of CHD fatalities occur in people who are 65 years or older (AHA, 2010).
The second major risk factor is male gender. Men have a greater likelihood of suffering heart attacks. They are also more prone to attacks earlier in life than women. The third major factor consists of heredity and race. Families with a history of CHD will find a more frequent incidence rate of CHD than those without. CHD also presents a higher risk among Mexican Americans, American Indians, native Hawaiians, and some Asian Americans. African Americans have a greater risk of CHD than Caucasian Americans due to having a greater likelihood of severe high blood pressure (AHA, 2010).
The second category is classified as contributing risk factors. These factors have shown an association with increased instances of CHD, but the exact significance has yet to have been precisely determined. These risk factors include stress, alcohol, and diet (AHA, 2010). The last category includes risk factors that can be reduced, treated, or controlled. This can be done either through medicine or by changing lifestyle habits. These factors include smoking, high blood cholesterol, high blood pressure, physical inactivity, obesity, and diabetes.
Smoking tobacco increases the likelihood of developing CHD between 2-4 times above people who do not smoke. Cigarette smoking can also increase other associated CHD risk factors. Additionally, secondhand smoke can unfortunately also increase the likelihood of CHD. In 2008, a study reported that despite all of the information regarding the ill effects of smoking, 23% of men and 18% of women responded that they were still cigarette smokers. In high school, the study showed 23% of male students and 18% of female students smoked (Lloyd, et al., 2010).
Cholesterol is affected by age, sex, hereditary, and diet. The risk of CHD increases as a person’s blood cholesterol increase. With too much cholesterol, it builds up on artery walls. This contributes to plaque built up which makes arteries narrow and less flexible. High blood pressure is also a modifiable risk factor. It is known as a silent killer except in its most extreme form which is also know as a hypertensive crisis, because there are no symptoms and people with high blood pressure may actually be unaware that damage is occurring to their heart and arteries. High blood pressure causes the heart to thicken and stiffen. This increases the risk of stroke, heart attack, and congestive heart failure. 77% of Americans treated for a first stroke also have high blood pressure. 69% who have a heart attack and 74% of Americans with congestive heart failure also have high blood pressure.
Physical inactivity and obesity are also risk factors. A sedentary lifestyle can often lead to people becoming overweight or obese. Excess weight makes the heart have to work harder and also raises blood pressure and blood cholesterol levels. These factors continue to be an issue in the United States. It is estimated that 144,100,000 or 66.3% of Americans over the age of 20 are overweight or obese. This estimate is made more staggering when you add in the fact that 31.9%, or 23,500,000 children aged 2 to 19 years are also overweight or obese. This in many ways is due to the increasing estimates of inactivity in American children. A 2007 study of high school aged boys and girls reported that when surveyed about their activity during the previous week, 31.8% of females and 18% of males reported that they had not participated in at least one hour of physical activity in the last seven days. A 2008 National Health Survey reported 58% of adults responded that they did not engage in any vigorous physical activity. (Lloyd, et at., 2010).
Additionally, excess body fat can also cause the onset of the last modifiable risk factor, diabetes. 65% of people with diabetes die from some type of heart or blood vessel disease. In 2006, it was estimated that 17,200,000 Americans had diagnosed diabetes. This equates to 7.7% of our adult population. It was further estimated in 2006 that 6,100,000 Americans had undiagnosed diabetes. Diabetes has shown to be more prevalent in African Americans, Mexican Americans, and Hispanic and Latino Americans (Lloyd, et al., 2010).
Beyond the traditional risk factors associated with CHD, scientific research is helping to identify new and emerging risk factors. More than 100 new risk factors have been proposed due to their potential to help identify and improve risk of CHD. Some of these new risk factors are independent predictors of CHD, while others are linked to the existing, more traditional risk factors. Examples of new factors include leukocyte count, fasting, blood glucose level, and instances of periodontal disease (Helfand, 2009). Continued study of both current and emerging risk factors can assist in identifying ways to predict, treat, and prevent coronary heart disease.
Caitlin: 2 pages, Evaluate Preventitive strategies or efforts (CFL and your county if applicable)
3. Evaluate preventive strategies or efforts (also make references to Central Florida and your Country if applicable) 2pages.
When observing the decrease in heart disease morbidity over the past fifty years we can tell that our preventative methods have had a huge effect. If the rate of coronary heart disease death from 1960 continued today more then 1.6 million deaths would occur each year. We can attribute the fact that we only have 500,000 deaths yearly, at least partially, to the success of prevention programs. In 1960 there was no knowledge of the effect that smoking, cholesterol, high blood pressure, and obesity had on the development of coronary heart disease. It was not uncommon for someone in there 50’s or 60’s to die of a heart attack. There have been improvements in rates over the past 50 years; however, we still have 500,000 Americans dying of a disease that is largely preventable (Fact sheet). Before we can discuss suggestions for public health intervention, we should first examine what the state of Florida is currently doing that is yielding these numbers.
The Department of Health and Human Services developed Healthy People 2010 initiatives, which have recognized the need for continued preventive strategies in the US. One goal of Healthy People 2010 is to, “reduce cardiovascular disease and improve quality of life by promoting recommended levels of physical activity; promoting weight management; improving diet and nutrition; eliminating tobacco use; preventing controlling high blood pressure; preventing and reducing elevated cholesterol; and preventing and controlling diabetes” (U.S. department, 2009). The Healthy People 2010 target for death rate per 100,000 (age-adjusted) is 146.93. The center for disease control has tracked progress on heart disease mortality rate, from 2000- 2006, of each Florida County. Orange County reported between 412-428 per 100,000 persons annual deaths which bring the death rate higher than desirable in our County (Florida-heart disease).
The state of Florida has attempted to develop strategies to prevent coronary heart disease within the state. The Florida Heart Disease and Stroke Prevention Program (HDSPP) has teamed up with other local health agencies in an attempt to increase awareness and reduce prevalence (State program, 2010).
Their first prevention strategy includes funding employee wellness programs in four school districts. Polk County School District staffs have already found a positive return on investment of employee wellness program on their healthcare costs (State program, 2010).
The HDSPP have also partnered with Florida’s primary care association to increase the number of community health centers that are using the Health Resources and Services Administration’s Health Disparity Collaborative (HDC) for cardiovascular disease. The HDC is a proactive approach to health designed to identify high-risk patients and promote lifestyle changes (State program, 2010). The HDSPP is also providing assistance to the Florida Medical Quality Assurance, Inc. to train pharmacy students and Nova Southeast University to expand pharmacy interventions to include medication evaluation and patient education. The goal behind this objective is to promote positive health outcomes through medication adherence to those who have suffered coronary heart disease (State program, 2010).
Another Florida prevention strategy for coronary heart disease from the HDSPP was establishing the State Employee Wellness Interagency Council to critique and modify current worksite policies related to employee wellness (State program, 2010). The next partnership of the HDSPP is with the State Department of Health’s Diabetes Prevention and Control Program. Their main aim with this prevention program is to focus on online healthcare professional continuing education programs. These programs address pre-hypertension diagnosis, and recommendations, hypertension, and cholesterol control (state program, 2010).
The final critical partnership is with the Emergency Medical Services Tracking and Reporting System. The HDSPP provides assistance in the training of first responders in an attempt to improve emergency response and upload heart disease data to the National EMS Information System (state program, 2010).
At the national level there are also several prevention programs including the CDC’s WISEWOMAN Program to educate low-income, under or uninsured women on screening, and the effects of dietary, physical activity, and smoking on coronary heart disease (Wisewomen, 2010). Another prevention campaign is the American Heart Association’s nationwide Go Red For Women. This is a campaign geared towards empowering and educating women. The Heart Truth Campaign created introduced the Red Dress as a national symbol for women and heart disease awareness. And finally National Wear Red Day is a day nationwide when Americans wear red to show their support for heart disease awareness (February is, 2010).
4. Discuss implications for public health interventions (also make references to Central Florida and your Country if applicable) 2pages.
As previously stated, heart disease mortality is exceeding Healthy People 2010 target of 146.93 per 100,000 persons. There are plenty of heart disease prevention programs in place at the national, state, and county level; however, proper assessment needs to be taken to ensure those programs are going to yield the highest results.
The first step a public health intervention must take is to properly define the risk of heart disease within a specific population to ensure that their programs are addressing the issues of that area. The Florida Bureau of Chronic Disease Prevention and Health Promotion releases an annual report on the rate of coronary heart disease risk factors within the state population (state program 2010). According to the 2007 Behavioral Risk Factor Surveillance System (BRFSS) survey results:
- 28.2% had high blood pressure
- 19.3% were smokers
- 62.1% were overweight
- 52.7% reported no exercise in the prior 30 days
- 73.8% are fruits and vegetables less than 5 times a day
For a coronary heart disease prevention program to be effective in the state of Florida it should be centered around these areas of high concern. As stated previously, the State of Florida has several programs in place, but, as apparent in these numbers, they are doing little to reduce the risk factors the lead to coronary heart disease.
As indicated by the rates above, Florida health interventions need to be more effective. Awareness has been a driving factor in many interventions, while exercise and nutrition education have seemed to take a back seat in many programs. Incorporating an exercise adherence program into already established prevention programs may be able to address three of these five risk factors: high blood pressure, overweight, and physical activity. Healthy People 2020 have acknowledged this need by adopting a new objective of “increasing overall cardiovascular health in the U.S. population” (Healthy people, 2009). Physical activity and nutrition could be used to measure the progress of this objective.
One focus of improving intervention programs is a more cohesive collaboration. Increasing exercise was an objective for Healthy People 2010, but there was a lack of local collaboration to implement. This would in tale a more direct alignment with county, state, and federal programs (state program 2010). For example, Healthy People 2020 objectives are broad and unobtainable without narrowing the scope down to the county level. Examining the objective previously stated of increasing cardiovascular health, there are several implementations that could be made at the county level to achieve this. Holding nutrition and exercise education courses at establishments frequented by the county’s population promotes attendance. Creating adult sport leagues within the area can promote physical activity. Promoting changes to vending machines within city buildings can create a culture of health around healthy eating.
Another key aspect to effective health intervention programs is constant evaluation. Program evaluation is a systematic method to determine the success of a program (smith 2006). One method that should be used to evaluate prevention programs is a quality-adjusted life years (QALY). At the state level the Florida HDSPP can conduct these ratios for each of their programs in order to find which are effective, which should be modified, and which should be eliminated. QALY adds the number of additional years of life a program is expected to generate, and incorporates the quality of life associated with those years. QALY enable a fair evaluation to be made between two prevention programs that otherwise would not be directly comparable (Fleming, 2008).
Evaluation goes beyond the scope of QALY however. Programs must be monitored more closely throughout the intervention as well. Monitoring a program is essential to observe and measure the progress of a prevention program. If any current prevention program is not already monitoring their program this could be a huge reason for the lack of success in reducing heart disease to targeted levels. Proper monitoring should include data on program implementation, resources allocation, client characteristics, and access to services (Smith, 2006).
There are several programs in place at the national, state, and county level that attempt to raise awareness, and promote health. These programs have not, however, resulted reducing the incidence rate of coronary heart disease to targeted levels. Effectiveness of these programs can be increased through a more thorough collaboration, and stronger evaluation and monitoring system.
2 Pages – Justification of the benefits and synergy of the team
Appendix:
Collaborating with a partner for this paper was extremely beneficial. Through our weekly postings we were both able to find interesting information regarding coronary heart disease. The information we found independently was unique and added to a more broad scope of information. As a partnership we were able to research different areas then come together and choose which areas would be most relevant to include in our paper. We were able to combine our strengths to create a well thought out and executed paper. Caitlin has a great sense of organization and planning. She divided the paper up into portions and assigned deadline to follow. The deadlines ensured that we were able to stay on track and address any issues we may come across early. Caitlin broke the paper into four stages. Our first stage was research. We worked independently to gather data and research on coronary heart disease and current prevention programs. Our first deadline to combine and discuss our findings was June 3rd. After the first deadline we had a much clearer grasp on our topic.
The second stage Caitlin broke the paper into was defining which partner would be responsible for which section. We both reviewed the assignment and based on our research we were able to divide the paper. Christine had found more research on risk factors and trends for the disease so she assigned herself section one and two. Caitlin had stronger information about preventative strategies. We worked together independently to create a rough outline for our sections, and then came together for our second deadline on June 17th to discuss. The third stage was defined as a finished rough draft, which was due July 7th. On that day we came together to discuss our final sections. The fourth and final stage was proof reading, and editing. We edited both our own and our partner’s portions. This final due date for making any changes was July 15th. These breakdowns of the paper and deadlines contributed greatly to the collaborative efforts of this project. It allowed us adequate time to consider all portions of the assignment
Christine is strong in written communication and execution. She was able to coordinate the wiki so that we could share our work and submit any edits to one location.
The execution of creating our wiki was extremely helpful. We were able to utilize the wiki to share information on days that we were not able to meet. Christine made sure to send reminders of what was due and deadlines that were approaching. This made the execution even smoother for our group. When we got down to stage four of our paper Christine did an exceptional job editing all portions. She was able to ensure that the sum of our work was greater then our individual contribution.
Conclusion
References:
Center for Disease Control and Prevention. (2010, January 26). February is American Heart Month. Retrieved June 30, 2010, from http://www.cdc.gov/Features/HeartMonth/
Center for Disease Control and Prevention. (2010, March 25). WISEWOMEN. Retrieved June 30, 2010 from http://www.cdc.gov/print.do?url=http://www.cdc.gov/wisewomen/
U.S. Department of Health and Human Services. (2009, October 30). Heart Disease and Stroke. Retrieved June 30,2010 from
Center for Disease Control and Prevention. (2006). Florida- Heart Disease. Retrieved June 29, 2010 from http://apps.nccd.cdc.gov/giscvh2/Results.aspx
National Institutes of Health. Fact Sheet: Heart Disease. Retrieved June 30, 2010.
Center for Disease Control and Prevention. (2010, February 2). State Program: Florida Basic Implementation. Retrieved June 30, 2010 from http://www.cdc.gov/print.do?url=http://www.cdc.gov/dhdsp/state_program/fl.htm
Fleming, S. (2008). Managerial Epidemiology: Concepts and Cases. (2nd ed.). Chicago: Health Administration Press.
U.S. Department of Health and Human Services. (2009, October 30). Healthy People 2020- View Objectives. Retrieved June 30, 2010 from http://www.healthypeople.gov/hp2020/Objectives/
Thomas, C., Smith, B., & Wright-DeAgüero, L. (2006). The Program Evaluation and Monitoring System: a key source of data for monitoring evidence-based HIV prevention program processes and outcomes. AIDS Education & Prevention, 18(4), 74-80. Retrieved from CINAHL Plus with Full Text database

- 62.1% were overweight
- 52.7% reported no exercise in the prior 30 days
- 73.8%73.8% ate fruits
For a coronary heart disease prevention program to be effective in the state of Florida, it should be centered around these areas of high concern. As stated previously, the State of Florida has several programs in place, but, as apparent in these numbers, they are doing little to reduce the risk factors that lead to CHD.
As indicated by the rates above, Florida health interventions need to be more effective. Awareness has been a driving factor in many interventions, while exercise and nutrition education have seemed to take a back seat in many programs. Incorporating an exercise adherence program into already established prevention programs may be able to address three of these five risk factors: high blood pressure, overweight, and physical activity. Healthy People 2020 have acknowledged this need by adopting a new objective of “increasing overall cardiovascular health in the U.S. population” (Healthy people, 2009). Physical activity and nutrition could be used to measure the progress of this objective.
There are several programs in place at the national, state, and county level that attempt to raise awareness, and promote health. These programs have not, however, resulted in reducing the incidence rate of coronary heart disease to targeted levels. Effectiveness of these programs can be increased through a more thorough collaboration, and stronger evaluation and monitoring systems.
References:
2010, from
http://www.americanheart.org/downloadable/heart/ 1140811583642InternationalCVD.pdf
American Heart Association. (2010b, June 22). Lifestyle Changes.
Retrieved June 09, 2010, from http://www.heart.org/HEARTORG/Conditions/HeartAttack/UnderstandYourRiskofHeartAttack/Understand-Your-Risk-of-Heart-Attack_UCM_002040_Article.jsp
Capewell, S., Ford, E., Croft, J., Critchley, J., Greenlund, K., & Labarthe, D. (2010). Cardiovascular risk factor trends and potential for reducing coronary heart disease mortality in the United States of America. Bulletin of the World Health Organization, 88(2), 120-130. Retrieved from Academic Search Premier database.
2010, from
http://www.cdc.gov//dhdsp/library/fs_heart_disease.htm
2010, from
http://www.cdc.gov/Features/HeartMonth/
Center for Disease Control and Prevention. (2006c). Florida- Heart Disease.
2010, from
http://apps.nccd.cdc.gov/giscvh2/Results.aspx
Center for Disease Control and Prevention. (2010d, February 2). State Program: Florida Basic Implementation. Retrieved June 30, 2010, from http://www.cdc.gov/print.do?url=http://www.cdc.gov/dhdsp/state_program/fl.htm
Florida Department of Health. (2007). Cardiovascular Surveillance Summary, 2007.
Retrieved July 09, 2010, from http://www.doh.state.fl.us/Family/heart/PDF/cvd_surv_summ_2007.pdf
Web site:
http://circ.ahajournals.org/cgi/reprint/CIRCULATIONAHA.109.192667
2010, from
http://www.nih.gov/about/researchresultsforthepublic/heartdisease.pdf
Orange County Health Department. (2010). Heart Disease Statistics.
Retrieved July 3, 2010, from http://www.orchd.com/generalHealth/communityHealth/chronicDisease/heartDisease/statistics/index.asp
Thomas, C., Smith, B., & Wright-DeAgüero, L. (2006). The Program Evaluation and Monitoring System: a key source of data for monitoring evidence-based HIV prevention program processes and outcomes. AIDS Education & Prevention, 18(4), 74-80. Retrieved from CINAHL Plus with Full Text database.
2010, from
http://www.hhs.gov/news/press/2009pres/2009.html
U.S. Department of Health and Human Services. (2009, October 30). Healthy People 2020- View Objectives. Retrieved June 30, 2010, from http://www.healthypeople.gov/hp2020/Objectives/
Not only did we learn more from working together in terms of research, but also on how to work together. Working in teams is a realistic aspect of the work force. While studying for our master’s degree, we should be pushed to work with fellow classmates. It teaches a skill that cannot be taught in a textbook. Yet working together for a project ensures that we can learn both team building skills as well as epidemiology principles. In the workforce, we will have to rely on others and be able to work in teams to get our jobs done. Everyone has strengths and weaknesses that are unique to him or her.
As a partnership, we were able to gather more knowledge on our topic of coronary heart disease. From that we were able to develop a greater scope of knowledge regarding the topic. Once we collaborated on the research, we could ensure that we were using the most relevant information. Lastly, we learned valuable team building skills that will transfer as useful experience in the workforce. This project was an interesting assignment that taught both of us a great deal about the topic of coronary heart disease, as well as working in a partnership.
{Appendix B,C,&D.docx}

After exploring patterns and trends of CHD, we will next look at the risk factors associated with this disease. Risk factors for CHD fall into three main categories: major factors, contributing factors, and modifiable factors. We will discuss all of these categories, with a focus on the modifiable factors as a key element to reduction and prevention. We will conclude this section with a look at some of the emerging risk factors being studied stemming from the healthcare industry’s continued study of this disease.
In the last sections of the paper, we will evaluate CHD prevention efforts and implications for public health intervention. Several of the main programs will be discussed such as the Department of Health and Human Services’ Healthy People 2010, The CDC’s WISEWOMAN initiative, and AHA programs. We will look at state and local programs in Florida such as the Florida Heart Disease and Stroke Prevention Program. In looking at results from both national and local programs, we will conclude with proposed strategies for improving programs to increase program effectiveness in reducing CHD.
and Trends:
Coronary
Coronary Heart Disease 2010a, p.2).
Posing
Posing such a 2010, p.1).
When
When viewing CHD 2010a, p.1).
In
In the United p. 47).
CHD
CHD is also Appendix B).
At
At the state 2007, p.7).
In
In Florida, both & D).
At
At the county p. 1).
Risk
Risk factors are para. 1).
2.
2. Identify the Risk Factors:
The
The American Heart para. 1).
The
The second major para. 2).
The
The second category para. 2).
The
The last category and diabetes.
Smoking
Smoking tobacco increases p. 47).
Cholesterol
Cholesterol is affected para. 4).
Physical
Physical inactivity and 2010, p.48).
Additionally,
Additionally, excess body p. 48).
Beyond
Beyond the traditional heart disease.
3.
3. Preventative Strategies or Efforts:
Since
Since the introduction these numbers.
The
The Department of p. 1).
The
The state of p. 3).
Their
Their first prevention p. 3).
The
The HDSPP have p. 3).
The
The HDSPP is p. 3).
Another
Another Florida prevention p. 3).
The
The next partnership p. 3).
The
The final critical p. 3).
At
At the national p. 1).
4.
4. Implications for Health Interventions:
As
As previously stated, highest results.
The
The first step 2010d, p. 2). According
2).
According to the survey results:
-
- 28.2% had blood pressure
-
- 19.3% were smokers
-
- 62.1% were overweight
-
- 52.7% reported 30 days
- 73.8%
- 73.8% ate fruits a day
For
For a coronary to CHD.
As
As indicated by this objective.
One
One focus of healthy eating.
Another
Another key aspect p. 210).
Evaluation
Evaluation goes beyond p. 2).
There
There are several monitoring systems.
References:
American
References:
American Heart Association. Disease Statistics. RetrievedRetrieved June 07, 2010, from
http://www.americanheart.org/downloadable/heart/ 1140811583642InternationalCVD.pdf
June 22). Lifestyle Lifestyle Changes.
Retrieved June 09, 2010, from http://www.heart.org/HEARTORG/Conditions/HeartAttack/UnderstandYourRiskofHeartAttack/Understand-Your-Risk-of-Heart-Attack_UCM_002040_Article.jsp
of America. Bulletin Bulletin of the Premier database.
Center
Center for Disease May 12). Fact Fact Sheets and 2010, from
http://www.cdc.gov//dhdsp/library/fs_heart_disease.htm
Center
http://www.cdc.gov//dhdsp/library/fs_heart_disease.htm
Center for Disease January 26). February February is American 2010, from
http://www.cdc.gov/Features/HeartMonth/
Center
http://www.cdc.gov/Features/HeartMonth/
Center for Disease Prevention. (2006c). Florida- Florida- Heart Disease.
Retrieved
Retrieved June 29, 2010, from
http://apps.nccd.cdc.gov/giscvh2/Results.aspx
Center
http://apps.nccd.cdc.gov/giscvh2/Results.aspx
Center for Disease February 2). State State Program: Florida from http://www.cdc.gov/print.do?url=http://www.cdc.gov/dhdsp/state_program/fl.htm
Center
Center for Disease March 25). WISEWOMEN.
Retrieved WISEWOMEN.
Retrieved June 30, from http://www.cdc.gov/print.do?url=http://www.cdc.gov/wisewomen/
Fleming,
Fleming, S. (2008). Managerial Managerial Epidemiology: Concepts Administration Press.
Florida
Florida CHARTS Community Set. (2008). Orange Orange County Chronic Disease Profile. RetrievedRetrieved July 05, Health. (2007). Cardiovascular Cardiovascular Surveillance Summary, 2007.
Retrieved July 09, 2010, from http://www.doh.state.fl.us/Family/heart/PDF/cvd_surv_summ_2007.pdf
2010 Update: Journal Journal of the
http://circ.ahajournals.org/cgi/reprint/CIRCULATIONAHA.109.192667
of Health. Fact Fact Sheet: Heart 2010, from
http://www.nih.gov/about/researchresultsforthepublic/heartdisease.pdf
Orange
http://www.nih.gov/about/researchresultsforthepublic/heartdisease.pdf
Orange County Health Disease Statistics.
Retrieved
Retrieved July 3, 2010, from http://www.orchd.com/generalHealth/communityHealth/chronicDisease/heartDisease/statistics/index.asphttp://www.orchd.com/generalHealth/communityHealth/chronicDisease/heartDisease/statistics/index.asp
Thomas, C., Text database.
U.S.
U.S. Department of October 30). Heart Heart Disease and from
http://www.hhs.gov/news/press/2009pres/2009.html
U.S.
U.S. Department of October 30). Healthy Healthy People 2020- from http://www.healthypeople.gov/hp2020/Objectives/
World
World Health Organization. (2010). Background, Background, development and of MONICA. RetrievedRetrieved June 09, http://whqlibdoc.who.int/publications/2003/9241562234_p1-40.pdf
Appendixes:
Appendix
Appendix A:
Collaborating
Collaborating with a extremely helpful.
We were able to combine our strengths to create a well thought out and executed paper. Caitlin has a great sense of organization and planning. She divided the paper up into portions and assigned deadlines to follow. The deadlines ensured that we were able to stay on track and address any issues we may come across early. Caitlin broke the paper into four stages. Our first stage was research. We worked independently to gather data and research on coronary heart disease and current prevention programs. Our first deadline to combine and discuss our findings was June 3rd. After the first deadline, we had a much clearer grasp on our topic.
final sections. The
The fourth and the assignment.
Christine
Christine is strong individual contribution.
Christine
Christine and Caitlin our weaknesses.
Not
Not only did or her.
As
As a partnership, a partnership.

After exploring patterns and trends of CHD, we will next look at the risk factors associated with this disease. Risk factors for CHD fall into three main categories: major factors, contributing factors, and modifiable factors. We will discuss all of these categories, with a focus on the modifiable factors as a key element to reduction and prevention. We will conclude this section with a look at some of the emerging risk factors being studied stemming from the healthcare industry’s continued study of this disease.
In the last sections of the paper, we will evaluate CHD prevention efforts and implications for public health intervention. Several of the main programs will be discussed such as the Department of Health and Human Services’ Healthy People 2010, The CDC’s WISEWOMAN initiative, and AHA programs. We will look at state and local programs in Florida such as the Florida Heart Disease and Stroke Prevention Program. In looking at results from both national and local programs, we will conclude with proposed strategies for improving programs to increase program effectiveness in reducing CHD.
and Trends:
Coronary
Coronary Heart Disease CHD in 20022005 numbered 7.227.6 million (AHA, 2010a).2010a, p2). Although since et al., 2010).2010, p.120). Current projections CHD (AHA, 2010a).
Posing2010a, p.2).
Posing such a care (WHO, 2010).
When2010, p.1).
When viewing CHD China (AHA, 2010a).
In2010a, p.1).
In the United et al., 2010).
CHD2010, p. 47).
CHD is also et al., 2010).2010, p. 120). In 2010, billion (CDC, 2010a).2010a, para.1). In addition Appendix B).
At
At the state of Health and statistical and trend death (FDOH, 2007).
In2007, p.7).
In Florida, both declines in age adjustedage-adjusted death rates females (FDOH, 2007).2007, p.9). Florida’s Department (See Appendix C,D,….).
AtC & D).
At the county deaths from Coronary Heart DiseaseCHD have declined 170.9 per 100,000 (See Appendix ).100,000. However, the Florida (OCHD, 2010).2010, para. 1). Full 2006-2008 (Florida CHARTS, 2010).
Risk2010, p. 1).
Risk factors are smoke (OCHD, 2010).
Identify2010, para. 1).
2. Identify the Risk Factors:
The
The American Heart older (AHA, 2010).
The2010b, para. 1).
The second major pressure (AHA, 2010).
The2010b, para. 2).
The second category diet (AHA, 2010). The2010b, para. 2).
The last category and diabetes.
Smoking
Smoking tobacco increases not smoke. Cigarette smoking can also increase other associated CHD risk factors. Additionally, secondhand cigarette smokers. In high school, theThe study showed that in high school students, 23% of students smoked (Lloyd,(Lloyd et al., 2010).
Cholesterol2010, p. 47).
Cholesterol is affected blood cholesterol increase.increases. With too to plaque builtbuild up which high blood pressure.
Physicalpressure (AHA, 2010b, para. 4).
Physical inactivity and inactivity in American children. A the last seven7 days. A vigorous physical activity. (Lloyd,activity (Lloyd et at., 2010).
Additionally,al., 2010, p.48).
Additionally, excess body Latino Americans (Lloyd,(Lloyd et al., 2010).
Beyond2010, p. 48).
Beyond the traditional leukocyte count, fasting,fasting blood glucose disease (Helfand, 2009).2009, p. 502). Continued study heart disease.
3. Evaluate preventive strategies
3. Preventative Strategies or efforts (also make references to Central Florida and your Country if applicable) 2pages.
When observingEfforts:
Since the decrease in heart disease morbidityintroduction of prevention programs over the past fifty years we can tell that our preventative methods have hadyears, there has been a huge effect.decrease in heart disease morbidity. If the heart disease deathdeaths from 1960 continued todaytoday, more then programs. In 19601960, there was development of coronary heart disease.CHD. It was improvements in ratestrends over the years; however, weit is still have 500,000 Americans dying of a disease that is largely preventable (Fact sheet).disease that remains the leading cause of death in the US (CDC, 2010a, p.1). Before we these numbers.
The
The Department of use; preventing and controlling high (U.S. department, 2009).2009, p. 3). The Healthy People 2010 nationwide target for (age-adjusted) is 146.93.146.93 for both men and women. The centerCenter for disease controlDisease Control has tracked rate, from 2000- 2006,2000-2006, of each in our County (Florida-heart disease).
Thecounty (CDC, 2006c, p. 1).
The state of reduce prevalence (State program, 2010).
Their(CDC, 2010d, p. 3).
Their first prevention school districts. The Polk County School District staffs have already found a positive return on investment ofreduction in healthcare costs due to this employee wellness program on their healthcare costs (State program, 2010).
The(CDC, 2010d, p. 3).
The HDSPP have with Florida’s primary care associationPrimary Care Association to increase lifestyle changes (State program, 2010). The(CDC, 2010d, p. 3).
The HDSPP is heart disease (State program, 2010).
Another(CDC, 2010d, p. 3).
Another Florida prevention strategy for coronary heart diseaseCHD from the employee wellness (State program, 2010). The(CDC, 2010d, p. 3).
The next partnership programs address pre-hypertension diagnosis, and recommendations,pre-hypertension, hypertension, and cholesterol control (state program, 2010).
The(CDC, 2010d, p. 3).
The final critical Information System (state program, 2010).
At(CDC, 2010d, p. 3).
At the national levellevel, there are heart disease (Wisewomen, 2010).(CDC, 2010e, p. 2). Another prevention Truth Campaign created introduced the awareness. And finallyfinally, National Wear disease awareness (February is, 2010).
4. Discuss implications(CDC, 2010b, p. 1).
4. Implications for public health interventions (also make references to Central Florida and your Country if applicable) 2pages.
AsPublic Health Interventions:
As previously stated, is exceeding the Healthy People to ensure thosethese programs are highest results.
The
The first step state population (state program 2010).(CDC, 2010d, p. 2). According to survey results:
-
- 28.2% had blood pressure
-
- 19.3% were smokers
-
- 62.1% were overweight
-
- 52.7% reported 30 days
-
- 73.8% areate fruits and a day
For
For a coronary state of FloridaFlorida, it should risk factors thethat lead to coronary heart disease.
AsCHD.
As indicated by this objective.
One
One focus of This would in taleentail a more federal programs (state program 2010).(CDC, 2010d, p. 2). For example, healthy eating.
Another
Another key aspect a program (smith 2006).(Smith, 2006, p. 4). One method the state levellevel, the Florida comparable (Fleming, 2008).
Evaluation2008, p. 210).
Evaluation goes beyond monitoring their programprogram, this could services (Smith, 2006).
There2006, p. 2).
There are several however, resulted in reducing the and monitoring system.
2 Pages – Justificationsystems.
References:
American Heart Association. (2010a). International Cardiovascular Disease Statistics. Retrieved June 07, 2010, from
http://www.americanheart.org/downloadable/heart/ 1140811583642InternationalCVD.pdf
American Heart Association. (2010b, June 22). Lifestyle Changes.
Retrieved June 09, 2010, from http://www.heart.org/HEARTORG/Conditions/HeartAttack/UnderstandYourRiskofHeartAttack/Understand-Your-Risk-of-Heart-Attack_UCM_002040_Article.jsp
Capewell, S., Ford, E., Croft, J., Critchley, J., Greenlund, K., & Labarthe, D. (2010). Cardiovascular risk factor trends and potential for reducing coronary heart disease mortality in the United States of America. Bulletin of the benefitsWorld Health Organization, 88(2), 120-130. Retrieved from Academic Search Premier database.
Center for Disease Control and synergyPrevention. (2010a, May 12). Fact Sheets and At-a-Glance Reports. Retrieved July 8, 2010, from
http://www.cdc.gov//dhdsp/library/fs_heart_disease.htm
Center for Disease Control and Prevention. (2010b, January 26). February is American Heart Month. Retrieved June 30, 2010, from
http://www.cdc.gov/Features/HeartMonth/
Center for Disease Control and Prevention. (2006c). Florida- Heart Disease.
Retrieved June 29, 2010, from
http://apps.nccd.cdc.gov/giscvh2/Results.aspx
Center for Disease Control and Prevention. (2010d, February 2). State Program: Florida Basic Implementation. Retrieved June 30, 2010, from http://www.cdc.gov/print.do?url=http://www.cdc.gov/dhdsp/state_program/fl.htm
Center for Disease Control and Prevention. (2010e, March 25). WISEWOMEN.
Retrieved June 30, 2010, from http://www.cdc.gov/print.do?url=http://www.cdc.gov/wisewomen/
Fleming, S. (2008). Managerial Epidemiology: Concepts and Cases. (2nd ed.). Chicago: Health Administration Press.
Florida CHARTS Community Health Assessment Resource Tool Set. (2008). Orange County Chronic Disease Profile. Retrieved July 05, 2010, from http://www.floridacharts.com/charts/DisplayHTML.aspx?ReportType=7244 &County=48&year=2008
Florida Department of Health. (2007). Cardiovascular Surveillance Summary, 2007.
Retrieved July 09, 2010, from http://www.doh.state.fl.us/Family/heart/PDF/cvd_surv_summ_2007.pdf
Lloyd, J., Adams, R., Brown, T., Carnethon, M., Dai, S., De Simone, G., et al. (2010). Heart Disease and Stroke Statistics 2010 Update: Journal of the team
Appendix:
CollaboratingAmerican Heart Association, 121 (7), e46-e216. Retrieved July 6, 2010, from AHA Journals Web site:
http://circ.ahajournals.org/cgi/reprint/CIRCULATIONAHA.109.192667
National Institutes of Health. Fact Sheet: Heart Disease. Retrieved June 30, 2010, from
http://www.nih.gov/about/researchresultsforthepublic/heartdisease.pdf
Orange County Health Department. (2010). Heart Disease Statistics.
Retrieved July 3, 2010, from http://www.orchd.com/generalHealth/communityHealth/chronicDisease/heartDisease/statistics/index.asp
Thomas, C., Smith, B., & Wright-DeAgüero, L. (2006). The Program Evaluation and Monitoring System: a key source of data for monitoring evidence-based HIV prevention program processes and outcomes. AIDS Education & Prevention, 18(4), 74-80. Retrieved from CINAHL Plus with Full Text database.
U.S. Department of Health and Human Services. (2009, October 30). Heart Disease and Stroke. Retrieved June 30, 2010, from
http://www.hhs.gov/news/press/2009pres/2009.html
U.S. Department of Health and Human Services. (2009, October 30). Healthy People 2020- View Objectives. Retrieved June 30, 2010, from http://www.healthypeople.gov/hp2020/Objectives/
World Health Organization. (2010). Background, development and organization of MONICA. Retrieved June 09, 2010, from http://whqlibdoc.who.int/publications/2003/9241562234_p1-40.pdf
Appendixes:
Appendix A:
Collaborating with a research different areasareas, and then come our paper. WeThis helped out our research efforts greatly. If we had been working independently on this paper our scope of information would have been much narrower. Therefore, in the research and brainstorming session having a partner was extremely helpful.
We were able and assigned deadlinedeadlines to follow. the first deadlinedeadline, we had our topic.
The
For the second stagestage, Caitlin broke paper into was defining which divide the paper.paper accordingly. Christine had for the diseasedisease, so she assigned herselfwe thought it would be best for her to do section one about preventative strategies.strategies, so she was assigned section three and four. We worked together independently to for our individual sections, and stage was proof reading,proofreading, and editing. of the assignment
Christineassignment.
Christine is strong coordinate the wikiWiki so that one location.
The The execution of creating our wikiWiki was extremely helpful. WeChristine was in charge of uploading and changes and we were able utilize the wikiWiki to share to meet. She was also able to provide help to her partner whenever there were technical questions regarding the Wiki. Christine also made sure were approaching. Christine also sent out reminders to continue posting our updates weekly in the class discussion folder. This made of our paperpaper, Christine did individual contribution.
References:
Center for Disease Control
Christine and Prevention. (2010, January 26). February is American Heart Month. Retrieved June 30, 2010, from http://www.cdc.gov/Features/HeartMonth/
Center for Disease ControlCaitlin were not only able to identify our individual strengths and Prevention. (2010, March 25). WISEWOMEN. Retrieved June 30, 2010 fromhttp://www.cdc.gov/print.do?url=http://www.cdc.gov/wisewomen/
U.S. Departmentweaknesses, but also determine ways in which we could maximize our strengths that would eliminate our weaknesses. One example of Health and Human Services. (2009, October 30). Heart Disease and Stroke. Retrieved June 30,2010 from
Centerthis was apparent in the proofing portion. Caitlin has a stronger ability to proof for Disease Control and Prevention. (2006). Florida- Heart Disease. Retrieved June 29, 2010 fromhttp://apps.nccd.cdc.gov/giscvh2/Results.aspx
National Institutesgrammatical errors. Christine has a stronger ability to proof the paper for content inconsistencies. For that reason, we decided to both proof the entire paper rather than just proofing our personal sections. Caitlin proofed with more of Health. Fact Sheet: Heart Disease. Retrieved June 30, 2010.
Centera focus on grammar, while Christine checked for Disease Control and Prevention. (2010, February 2). State Program: Florida Basic Implementation. Retrieved June 30, 2010 from http://www.cdc.gov/print.do?url=http://www.cdc.gov/dhdsp/state_program/fl.htm
Fleming, S. (2008). Managerial Epidemiology: Concepts and Cases. (2nd ed.). Chicago: Health Administration Press.
U.S. Departmentmore content issues. This is one example of Health and Human Services. (2009, October 30). Healthy People 2020- View Objectives. Retrieved June 30, 2010how we were able to accentuate our strengths for this paper in a way that overshadowed our weaknesses.
Not only did we learn more from http://www.healthypeople.gov/hp2020/Objectives/
Thomas, C., Smith, B., & Wright-DeAgüero, L. (2006). The Program Evaluation and Monitoring System:working together in terms of research, but also on how to work together. Working in teams is a key sourcerealistic aspect of datathe work force. While studying for monitoring evidence-based HIV prevention program processes and outcomes. AIDS Education & Prevention, 18(4), 74-80. Retrieved from CINAHL Plusour master’s degree, we should be pushed to work with Full Text databasefellow classmates. It teaches a skill that cannot be taught in a textbook. Yet working together for a project ensures that we can learn both team building skills as well as epidemiology principles. In the workforce, we will have to rely on others and be able to work in teams to get our jobs done. Everyone has strengths and weaknesses that are unique to him or her.
As a partnership, we were able to gather more knowledge on our topic of coronary heart disease. From that we were able to develop a greater scope of knowledge regarding the topic. Once we collaborated on the research, we could ensure that we were using the most relevant information. Lastly, we learned valuable team building skills that will transfer as useful experience in the workforce. This project was an interesting assignment that taught both of us a great deal about the topic of coronary heart disease, as well as working in a partnership.