title: Reducing cardiovascular disease risk using patient navigators, Denver, Colorado, 2007-2009.
abstract: BACKGROUND
  Early identification of cardiovascular disease (CVD) risk is important to reach people in need of treatment. At-risk patients benefit from behavioral counseling in addition to medical therapy. The objective of this study was to determine whether enhanced counseling, using patient navigators trained to counsel patients on CVD risk-reduction strategies and facilitate patient access to community-based lifestyle-change services, reduced CVD risk among at-risk patients in a low-income population.
  
  
  METHODS
  We compared clinical characteristics at baseline and 12-month follow-up among 340 intervention and 340 comparison patients from community health centers in Denver, Colorado, between March 2007 and June 2009; all patients had a Framingham risk score (FRS) greater or equal to 10% at baseline. The intervention consisted of patient-centered counseling by bilingual patient navigators. At baseline and at 6-month and 12-month follow-up, we assessed health behaviors of intervention participants. We used an intent-to-treat approach for all analyses and measured significant differences by χ(2) and t tests.
  
  
  RESULTS
  We found significant differences in several clinical outcomes. At follow-up, the mean FRS was lower for the intervention group (mean FRS, 15%) than for the comparison group (mean FRS, 16%); total cholesterol was lower for the intervention group (mean total cholesterol, 183 mg/dL) than for the comparison group (mean total cholesterol, 197 mg/dL). Intervention participants reported significant improvements in some health behaviors at 12-month follow-up, especially nutrition-related behaviors. Behaviors related to tobacco use and cessation attempts did not improve.
  
  
  CONCLUSIONS
  Patient navigators may provide some benefit in reducing risk of CVD in a similar population.
authors: Denver Public Health, 605 Bannock St, Denver, CO 80204, USA. jshlay@dhha.org
authors: Judith C
authors: JC
authors: Shlay
authors: Beverly
authors: B
authors: Barber
authors: Theresa
authors: T
authors: Mickiewicz
authors: Moises
authors: M
authors: Maravi
authors: Jodi
authors: J
authors: Drisko
authors: Raymond
authors: R
authors: Estacio
authors: Gregory
authors: G
authors: Gutierrez
authors: Christopher
authors: C
authors: Urbina
mesh_terms: D000328:Adult; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000517:prevention & control*; D003120:Colorado / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D040362:Geographic Information Systems / Q000706:statistics & numerical data*; D006304:Health Status; D006801:Humans; D015994:Incidence; D008019:Life Style; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment / Q000379:methods*; D013997:Time Factors