Addressing the Disparity Gap in Cardiac Care Receives Community Engagement Scholarship Award

Linda S. Vail, representing the Ingham County Health Department, and Dr. Adesuwa B. Olomu, College of Human Medicine, are the co-recipients of the 2015-16 Community Engagement Scholarship Award

Cardiovascular disease is a serious diagnosis for an individual, and that often means changing and rearranging one's lifestyle and daily habits.

That can be not only difficult, but nearly impossible, to manage for patients in the lower socioeconomic rungs of society.

Dr. Ade Olomu and the Ingham County Health Department (ICHD) are the 2016 co-recipients of the Community Engagement Scholarship Award bestowed during the annual MSU Awards Convocation on February 9^th. The collaboration was recognized for translating research into practice in cardiovascular care for vulnerable populations, with the goal of decreasing the effects of cardiovascular disease and death.

The innovative Office Guidelines Applied to Practice (Office-GAP) Program was designed to activate and engage patients and improve prevention of cardiovascular disease for vulnerable populations in outpatient settings through the use of appropriate evidence-based medications and lifestyle changes.

Funding from the Blue Cross Blue Shield of Michigan Foundation and the Agency for Healthcare Research and Quality enabled more than 800 patients to enroll in the Office-GAP program from 2010 to 2015. In addition, more than 595 patients have attended the educational group visits and follow-up appointments with their health care providers.

The Office-GAP program was developed and tested in three cohorts through a pretest-posttest quasi-experimental design over six months, followed by a 12-month follow-up. It integrates health literacy, communication skills education for patients and physicians, decision support tools, and shared decision making into routine care.

The Office-GAP Program led to improved evidence-based medication usage, improved blood pressure control, increased patient-provider shared decision making, patient satisfaction with their provider, and confidence in the health care decisions made. The program has provided an opportunity for student, resident physician, and faculty engagement in health disparity studies.

Collaboration with Ingham County Health Department

The Ingham County Health Department (ICHD) operates the Ingham Community Health Centers and has a longstanding history of providing primary care services to vulnerable populations by serving as a healthcare home to more than 19,000 patients. Services include primary care, dental, chronic disease management, on-site lab, infectious disease, immunizations, prenatal care, refugee health assessments, health education, and risk reduction.

"As the clinical safety net for vulnerable patients in our community, it is vital that our providers are equipped with the tools required to address the challenges that exist in treating the unique healthcare needs of this population," said Linda Vail, ICHD health officer and representing member of the partnership.

"The cardiac care partnership provides reciprocal benefits to both parties. ICHD has an established patient population and existing relationships between providers and patients. We gain the ability to implement evidence-based decision support interventions into our care practices for some of the county's most vulnerable residents. Our core values of health equity and social justice are put into practice by addressing the disproportionate burden of cardiovascular disease among African-Americans and low-income populations," said Vail.

An agreement form, known as a GAP Contract, lists all the recommended medications and life style changes for each patient. After the doctor and the patient have reviewed the document together, each signs the form. One of the challenges is to engage the vulnerable patients in their own health care.

"Self-management of chronic conditions like cardiovascular disease is so important. We have to connect with these patients. They don't ask many questions, they don't want to make waves. So we want them to know what they have to do to help prevent a heart attack," said Olomu.

Next Steps

Olomu and her team are currently working together to apply for National Institutes of Health funding for a randomized controlled trial of the Office-GAP Program in 12 clinics across Michigan. The new research could test how to use technology in patient care, including text messages to engage those in their care.

According to Olomu, if this funding becomes available, it could lead to sustaining the program within communities across the entire state and beyond.

Community Engagement Scholarship Award

MSU's Community Engagement Scholarship Award is conferred annually and provides University-wide recognition of highly engaged community-based research collaborations that positively impact both the community and the scholarship of MSU faculty.

Olomu and the partnership will also represent Michigan State University in the 2016 competition for the regional W.K. Kellogg Foundation Community Engagement Scholarship Awards and the national C. Peter Magrath Community Engagement Scholarship Award, both sponsored by the Association of Public and Land-Grant Universities and the Engagement Scholarship Consortium.