This document discusses cardiovascular disease risks among people of color and efforts to address high blood pressure. It notes that every 24 hours, 131 men and 148 women of color die from cardiovascular disease. About 75 million US adults have high blood pressure, affecting 40% of African Americans in particular. Lifestyle changes like diet, exercise, weight loss and stress management can help control blood pressure, but many patients are not achieving control. The document describes the GetHealthyHarlem website created to provide culturally-relevant health information to Harlem residents online and activities like Project SHARE to screen for high blood pressure in the community.
2. Every 24 hours…
131 men of color, and 148 women of
color will die from cardiovascular
disease (heart attacks, strokes, etc.)
American Heart Association, 2008
3. High Blood Pressure
Plays a significant role in contributing to:
Heart attacks
Strokes
CDC. Health, United States, 2008. Hyattsville, MD: National Center for Health Statistics; 2008.
4. High Blood Pressure
One in three adults…
Or, about 75 million people, above the age of 20, in the United States have high blood
pressure
5. High Blood Pressure and
People of Color
31% of all Americans affected
29% of Hispanics
40% of African-Americans
Among African Americans,
hypertension (HTN) develops earlier
in life and tends to be more severe,
therefore increasing the risk for HTN-
related complications
7. Status of the ABCS
Aspirin People at increased risk of cardiovascular 47%
disease who are taking aspirin
Blood People with hypertension who have adequately 46%
controlled blood pressure
pressure
Cholesterol People with high cholesterol who have 33%
adequately controlled hyperlipidemia
Smoking People trying to quit smoking who get help 23%
Source: MMWR: Million Hearts: Strategies to Reduce the Prevalence of Leading
Cardiovascular Disease Risk Factors --- United States, 2011, Early Release, Vol. 60
8. Case in Point…
Vickie
Harlem resident
Worships at Abyssinian
Baptist Church
Told by physician that
she had high blood
pressure…
9. What we eat
What we drink
What, how much we smoke
How we exercise
How we deal with stress
Play significant roles in the development of disease.
11. An “activated” Vickie…
Changed her diet
Began exercising
regularly
Embraced yoga and
meditation
Lost 20 lbs
Normalized her blood
pressure…without
medication
12. Unfortunately…
Vickie is unique
Vickie’s Doctor is
unique
13. Why?
About 80% of those with high blood pressure,
were aware, were in treatment
48% had their high blood pressure controlled
But…
52% were not controlled
AHA.org
14. Lifestyle Modification
The average visit length was 15 minutes.
Providers have minimal time to provide
counseling and education with clients
May not feel comfortable in providing
information and support*
Lack of resources for other types of clinic-
based supports
Need for adjunctive measures
15. How can we reach more
people with Vickie’s story?
17. Background
• “More than any other
communication medium
or health-related
technology, the Internet
has the greatest
potential to promote
health and prevent
disease for individuals
and communities
throughout the world”
• (Bernhardt Health Education
Res 2000)
18. Background
“About 6 million
Americans go online for
medical advice on a
typical day. That means
more people seek medical
advice online than
actually visit health
professionals...”
Source: Fox S, Rainie L. Vital decisions: how Internet
users decide what information to trust when they or their
loved ones are sick. Pew Internet & American Life
Project; 2002
19. Advantages?
Anonymous
Private
Convenient
Spend as much or as little time as you want or
need
Multi-media – appeals to different learning
styles
Can turn it off whenever you want – Control!
20. Pew Internet & American Life Project Reports
People Want Information About…
93% - a particular illness or condition.
65% - nutrition, exercise or weight control
64% - prescription drugs
48% - alternative or experimental treatments or medicines
39% - mental health issue such as depression or anxiety
33% - sensitive health topic that is difficult to talk about
32% - particular doctor or hospital (report cards)
Source: Fox S, Rainie L. Vital decisions: how Internet users decide what
information to trust when they or their loved ones are sick. Pew Internet & American
Life Project; 2002
21. Evidence for efficacy?
50% say information influenced eating and exercise habits
48% of Internet users say that retrieved information helped improve
the way they took care of themselves
47% say that retrieved information affected their health care
decisions about treatment and care
Seeking health care
Asking doctor new questions
Getting a second opinion
22. Health, Internet, &
Harlem(n=646) of Harlem residents
Phone survey
Majority have computers (77%) and use the Internet (65%)
Many seek information on medical problems and treatment, diet,
nutrition, fitness or exercise
Majority of Internet users trust the Internet for health-related
information
But, there is a lack of high quality, culturally-relevant, low-literacy
information on health.
…many expressed difficulty understanding information found online and
stated a need for assistance in interpreting the health information…
23. Barriers
Process issues:
Consumers often use large
search engines to obtain
information
Searches- Confusing,
overwhelming, frustrating
Cline et al, 2001
24. Formative research: Focus groups
What would improve What kind of content
your experiences on the would you like to see?
web?
“Easy navigation…not Specific information on
being bombarded by health topics, medications
advertisement…a good (Provide) Prevention
catchy website name information…like what I
that’s easy to recall” can do to avoid a stroke
“Seeing people who Locating health providers
look like me…”
“Break down complex
Exercise regimens,
stretching techniques
health issues into
understandable Finding health food
information…” stores, restaurants that
serve raw food
Stress reduction
25. Web Portal Development
Together with
community and
academic partners, we
developed a Harlem-
based health
information website
45. Consumer reactions
Focus group responses to
GetHealthyHarlem.org:
“Geared toward residents of Harlem, so more
personal and interesting”
“It has more information than (just) medical
health issues, such as preventive medicine”
“It keeps you updated (on health issues)”
“It has real people as subjects of the articles”
“It has the pulse of the Harlem community”
47. Project SHARE
Support for
Hypertension
Awareness, Reduction
and Education
CDC funded initiative to
screen consumers for
elevated blood pressure,
link them to health care
resources and provide
supportive education
GHH is a key component
48. For More Information
Alwyn Cohall, MD
atc1@columbia.edu
www.GetHealthyHarlem.org
Support for the Harlem Health Promotion
Center and Project SHARE is generously
provided by the Centers for Disease Control
and Prevention under the Prevention
Research Centers Program