title: Feasibility of community-based screening for cardiovascular disease risk in an ethnic community: the South Asian Cardiovascular Health Assessment and Management Program (SA-CHAMP).
abstract: BACKGROUND
  South Asian Canadians experience disproportionately high rates of cardiovascular disease (CVD). The goal of this qualitative study was to determine the feasibility of implementing a sustainable, culturally adapted, community-based CVD risk factor screening program for this population.
  
  
  METHODS
  South Asians (≥ 45 years) in Calgary, Alberta underwent opportunistic cardiovascular risk factor screening by lay trained volunteers at local religious facilities. Those with elevated blood pressure (BP) or ≥ 1 risk factor underwent point of care cholesterol testing, 10-year CVD risk calculation, counseling, and referral to family physicians and local culturally tailored chronic disease management (CDM) programs. Participants were invited for re-screening and were surveyed about health system follow-up, satisfaction with the program and suggestions for improvement. Changes in risk factors from baseline were estimated using McNemar's test (proportions) and paired t-tests (continuous measures).
  
  
  RESULTS
  Baseline assessment was completed for 238 participants (median age 64 years, 51% female). Mean TC, HDL and TC/HDL were 5.41 mmol/L, 1.12 mmol/L and 4.7, respectively. Mean systolic and diastolic blood pressures (mmHg) were 129 and 75 respectively. Blood pressure and TC/HDL ratios exceeded recommended targets in 36% and 58%, respectively, and 76% were at high risk for CVD. Ninety-nine participants (47% female) attended re-screening. 82% had accessed health care providers, 22% reported medication changes and 3.5% had attended the CDM programs. While BP remained unchanged, TC and TC/HDL decreased and HDL increased significantly (mean differences: -0.52 mmol/L, -1.04 and +0.07 mmol/L, respectively). Participants were very satisfied (80%) or satisfied (20%) with the project. Participants suggested screening sessions and CDM programs be more accessible by: delivering evening or weekends programs at more sites, providing transportation, offering multilingual programs/translation assistance, reducing screening wait times and increasing numbers of project staff.
  
  
  CONCLUSIONS
  SA-CHAMP demonstrated the feasibility and value of implementing a lay volunteer-led, culturally adapted, sustainable community-based CVD risk factor screening program in South Asian places of worship in Calgary, Alberta, Canada. Subsequent screening and CDM programs were refined based on the learnings from this study. Further research is needed to determine physician and patient factors associated with uptake of and adherence to risk reduction strategies.
authors: Department of Medicine, University of Calgary, Libin Cardiovascular Institute, TRW Building GE89, 3280 Hospital Drive NW, Calgary, AB, Canada. charlotte.jones@ubc.ca
authors: Charlotte A
authors: CA
authors: Jones
authors: Alykhan
authors: A
authors: Nanji
authors: Shefina
authors: S
authors: Mawani
authors: Shahnaz
authors: S
authors: Davachi
authors: Leanne
authors: L
authors: Ross
authors: Ardene
authors: A
authors: Vollman
authors: Sandeep
authors: S
authors: Aggarwal
authors: Kathryn
authors: K
authors: King-Shier
authors: Norman
authors: N
authors: Campbell
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People / Q000706:statistics & numerical data*; D002170:Canada; D002318:Cardiovascular Diseases / Q000208:ethnology*; D003153:Community Health Services / Q000458:organization & administration*; D054521:Cultural Competency; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D017060:Patient Satisfaction / Q000208:ethnology / Q000706:statistics & numerical data; D015397:Program Evaluation; D036301:Qualitative Research; D012067:Religion; D012307:Risk Factors