Cardiovascular health in indigenous communities: successful programs.
BACKGROUND
Indigenous people across the globe have generally had suboptimal access to quality medical care and effective prevention programs. The available programs that existed have generally been poorly funded and have primarily focussed on infectious diseases. More recent trends denoting significant rising morbidity and mortality of chronic diseases have brought some limited medical focus on cardiovascular diseases, their risk factors and their prevention. However, there is a growing body of evidence-published and unpublished-of developed and developing successful programs to provide culturally appropriate and sensitive treatment for cardiovascular diseases and prevention. Within this report, we aim to describe some of these programs in order to understand common approaches and links that make them successful. Once this survey is completed, a template for successful CVD programs can be created for the development of future programs.


METHODS
We used several methods to gather information about successful Indigenous CVD programs: Pub Med search (keywords: Indigenous, native, First Nation, Aboriginal, cardiovascular, cardiac, etc.), online searches of government-based health programs (World Health Organization, Centers for Disease Control, etc.) and non-government health programs (World Heart Federation, Bill & Melinda Gates Foundation, etc.), and, importantly, personal communication with multiple thought leaders and program directors in the field of international CVD treatment and prevention.


RESULTS
Programs can be divided into: (1) epidemiologic programs, which focus on data collection, (2) focussed prevention programs and population approach to CVD prevention, and (3) clinical prevention and intervention programs.


CONCLUSIONS
Common themes that define successful Indigenous CVD programs include: dedicated focus on the Indigenous population, widespread community involvement within the Indigenous population, often through the use of Indigenous community health workers, a focus on high-risk individuals within the population and regularly scheduled contact between the program and participants. We recommend that these themes are incorporated during development of future CVD programs for Indigenous people.
Huffman
Mark D
MD
Division of Cardiology, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States.
Galloway
James M
JM
D001315:Australia; D002170:Canada; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000517:prevention & control*; D005260:Female; D006266:Health Education / Q000458:organization & administration*; D006303:Health Services, Indigenous / Q000458:organization & administration*; D006304:Health Status; D006801:Humans; D008297:Male; D009656:North America; D044382:Population Groups / Q000706:statistics & numerical data; D011315:Preventive Medicine / Q000458:organization & administration*; D016730:Program Development; D015397:Program Evaluation; D011634:Public Health / Q000592:standards / Q000639:trends; D011787:Quality of Health Care