Abstract
This paper proposes a paradigm shift in health care from a focus on death and disability to one on health empowerment resulting in improved cardiovascular lifestyles for all Canadians. It describes a national interprofessional initiative to achieve this new vision in the area of cardiovascular health promotion. Achieving Cardiovascular Health in Canada (ACHIC) is a partnership of health professional associations and other health advocate groups whose vision is to promote optimal cardiovascular health (including cerebrovascular health) for all Canadians through interprofessional partnership initiatives and support systems. ACHIC’s objectives are to: 1) identify system barriers and supports to cardiovascular health; 2) develop strategies that will have a positive impact on the practices of health professionals/educators in the promotion of cardiovascular health; 3) develop an interprofessional national approach to support strategies to achieve cardiovascular health in Canada; and 4) support the development and delivery of consistent, evidence-based messages by health professionals/educators for promotion of cardiovascular health.
Résumé
Cet article propose un virement dans l’approche empruntée par les intervenants de la santé, centrée non pas sur la morbidité et la mortalité mais plutôt sur une nouvelle prise de pouvoir sur la santé qui permettrait d’améliorer le mode de vie cardiovasculaire de tous les Canadiens. L’article décrit une initiative interprofessionnelle sur le plan national visant à implanter cette nouvelle vision dans le domaine de la santé cardiovasculaire. Réaliser la santé car-diovasculaire au Canada (RSCC) réunit des associations de professionnels de la santé et d’autres organismes voués à la promotion de la santé publique. Cette initiative a comme mission de promouvoir une santé cardiovasculaire optimale (incluant cérébrovasculaire) pour tous les Canadiens, au moyen de collaborations et associations interprofessionnelles et de systèmes de soutien. Les objectifs spécifiques du RSCC sont: 1) d’identifier les facteurs dans le système de santé actuel qui empêchent ou qui encouragent la santé cardiovasculaire; 2) de développer des stratégies qui auront un impact positif sur la pratique des professionnels et éducateurs de la santé lorsqu’ils promouvoient la santé cardiovas-culaire; 3) de développer une approche interprofessionnelle sur le plan national permettant de réaliser la santé cardiovasculaire au Canada; et 4) d’appuyer le développement et la communication, par les professionnels et éducateurs de la santé, de messages constants, crédibles et fondés sur les preuves scientifiques qui promouvoient la santé cardiovasculaire.
Footnotes
Name of department & institution to which the work should be attributed: ACHIC (See Appendix A for full list of partners), CMA Secretariat, Attn: Millicent Toombs, Canadian Medical Association, 1867 Alta Vista Drive, Ottawa, ON K1G 3Y6
This work was in part funded by a Health Canada grant to the Achieving Cardiovascular Health in Canada (ACHIC) partnership administered by the Canadian Medical Association ACHIC secretariat. ACHIC is a national intersectoral partnership for improving cardiovascular lifestyles of Canadians through improved practice.
References
- 1.Lear S, Stachenko S. Prevention of Cardiovascular Diseases: The Role of the Cardiovascular Specialist. Draft Report of the 1998 Canadian Cardiovascular Society Consensus Conference. 1998. [Google Scholar]
- 2.Goldman L, Garber AM, Grover SA, Hlatky MA. Task Force 6. Cost effectiveness of Assessment and Management of Risk Factors. Bethesda Conference #27. J Am Coll Cardiol. 1996;27:1020–30. doi: 10.1016/0735-1097(96)87734-5. [DOI] [PubMed] [Google Scholar]
- 3.Smith HE, Herbert CP. Preventive practice among primary care physicians in British Columbia: Relation to recommendations of the Canadian Task Force on the Periodic Health Examination. CMAJ. 1993;149(12):1795–800. [PMC free article] [PubMed] [Google Scholar]
- 4.Hutchison B, Abelson J, Woodward C, Norman G. Preventive care and barriers to effective prevention: How do family physicians see it. Can Fam Phys. 1996;42:1693–700. [PMC free article] [PubMed] [Google Scholar]
- 5.Meyers DG, Steinle BT. Do physicians’ beliefs about coronary risk factors account for poor screening and treatment rates. Angiology. 1996;8:783–87. doi: 10.1177/000331979604700805. [DOI] [PubMed] [Google Scholar]
- 6.Schucker B, Wittes JD, Santanello NC, et al. Change in cholesterol awareness and action: Results from national physician and public surveys. Arch Intern Med. 1991;151:666–73. doi: 10.1001/archinte.1991.00400040020006. [DOI] [PubMed] [Google Scholar]
- 7.Giles WH, Anda RF, Jones DH, et al. Recent trends in the identification and treatment of high blood cholesterol by physicians: Progress and missed opportunities. JAMA. 1993;269:1133–38. doi: 10.1001/jama.1993.03500090069035. [DOI] [PubMed] [Google Scholar]
- 8.O’Keefe CE, Hahn DF, Betts NM. Physicians’ perspectives on cholesterol and heart disease. J Am Diet Assoc. 1991;91:189–92. [PubMed] [Google Scholar]
- 9.Advisory Board of the International Heart Health Conference. The Victoria Declaration on Heart Health. International Heart Health Conference. 1992. [Google Scholar]
- 10.Advisory Board of the Second International Heart Health Conference. The Catalonia Declaration: Investing in Heart Health. Barcelona. 1995. [Google Scholar]
- 11.Achieving Cardiovascular Health Care in Canada ACHIC. Physician behaviour with respect to cardiovascular disease prevention. Summary of literature. 1997. [Google Scholar]
- 12.Achieving Cardiovascular Health Care in Canada ACHIC. Practitioner behaviour and cardiovascular risk factors update 1996–98. 1999. [Google Scholar]
- 13.Achieving Cardiovascular Health Care in Canada ACHIC. Report on the Meeting of the Achieving Cardiovascular Health in Canada Partnership. Ottawa, Ontario: CMA House; 1998. [Google Scholar]
- 14.Davis DA, Taylor-Vaisey A. Translating guidelines into practice. A systematic review of theoretic concepts, practical experience and research evidence in the adoption of clinical practice guidelines. CMAJ. 1997;157(4):408–16. [PMC free article] [PubMed] [Google Scholar]
- 15.Achieving Cardiovascular Health Care in Canada ACHIC. Reimbursement of services for health promotion and prevention of cardiovascular disease. 1999. [Google Scholar]
- 16.Achieving Cardiovascular Health Care in Canada ACHIC. Tools/programs for health care professionals for CV health promotion and prevention. 1999. [Google Scholar]
- 17.Canadian Task Force on Development of The Healthy Heart Kit. The Healthy Heart Kit: Helping your patients reduce their risk. 1999. [Google Scholar]
- 18.Smith ER. The Healthy Heart Kit. Can J Cardiol. 1999;15(3):349,351–52. [PubMed] [Google Scholar]
- 19.Grundy SM, Balady GJ, Criqui MH, et al. Primary prevention of coronary heart disease: Guidance from Framingham. Circulation. 1998;97:1876–87. doi: 10.1161/01.CIR.97.18.1876. [DOI] [PubMed] [Google Scholar]
- 20.Wilson PWF, D’Agostino RB, Levy D, et al. Prediction of coronary heart disease using risk factor categories. Circulation. 1998;97:1837–47. doi: 10.1161/01.CIR.97.18.1837. [DOI] [PubMed] [Google Scholar]
- 21.Greenland P, Grundy S, Pasternak RC, Lenfant C. Problems on the pathway from risk assessment to risk reduction. Circulation. 1998;98:1761–62. doi: 10.1161/01.CIR.97.18.1761. [DOI] [PubMed] [Google Scholar]
- 22.D’Agostino RB, Wolf PA, Belanger AJ, Kannel WB. Stroke risk profile: Adjustment for antihy-pertensive medication. The Framingham Study. Stroke. 1994;25:40–43. doi: 10.1161/01.STR.25.1.40. [DOI] [PubMed] [Google Scholar]
- 23.Taylor M, Thorpe D. The Heart and Healthy Lifestyles. An information program for Grade IV students. Manitoba: The Canadian Council of Cardiovascular Nurses; 1990. [Google Scholar]
- 24.Davis DA, Thomson MA, Oxman AD, Haynes RB. Changing physician performance: A systematic review of the effect of continuing medical education strategies. JAMA. 1995;274(9):700–5. doi: 10.1001/jama.1995.03530090032018. [DOI] [PubMed] [Google Scholar]
- 25.Oxman AD, Thomson MA, Davis DA, et al. No magic bullets: A systematic review of 102 trials of interventions to improve professional practice. CMAJ. 1995;153(10):1423–31. [PMC free article] [PubMed] [Google Scholar]
- 26.Borduas F, Carrier R, Drouin D, et al. An interactive workshop: An effective means of integrating the Canadian Cardiovascular Society clinical practice guidelines on congestive heart failure into Canadian family physicians’ practice. Can J Cardiol. 1998;14(7):911–16. [PubMed] [Google Scholar]
- 27.Horowitz CR, Goldberg HI, Martin DP, et al. Conducting a randomized controlled trial of CQI and academic detailing to implement clinical guidelines. Joint Commission J Qual Improv. 1996;22(11):734–50. doi: 10.1016/S1070-3241(16)30279-6. [DOI] [PubMed] [Google Scholar]
- 28.CNA/CMA. Working Together: A Joint Canadian Nurses’ Association /Canadian Medical Association Collaborative Practice Project (HIV/AIDS Example) 1996. [Google Scholar]
- 29.Howkins E, Allison A. Shared learning for primary health care teams: A success story. Nurse Educ Today. 1997;17(3):225–31. doi: 10.1016/S0260-6917(97)80138-4. [DOI] [PubMed] [Google Scholar]
- 30.Headrick LA, Wilcock PM, Batalden PB. Interprofessional working and continuing medical education. BMJ. 1998;316(7133):771–74. doi: 10.1136/bmj.316.7133.771. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 31.McClaran J, Lam Z, Snell L, Franco E. The importance of the case management approach: Perceptions of multidisciplinary team members. J Case Manage. 1998;73:117–26. [PubMed] [Google Scholar]
- 32.McClaran J, Lam Z, Franco E, Snell L. Can case management be taught in a multidisciplinary forum. J Cont Educ in the Health Prof. 1999;19:181–91. doi: 10.1002/chp.1340190307. [DOI] [Google Scholar]
- 33.Tamblyn R, Battista R. Changing clinical practice: Which interventions work. J Cont Educ in the Health Prof. 1993;13:273–88. doi: 10.1002/chp.4750130403. [DOI] [Google Scholar]