U18HS027944

Achieving Outstanding Cardiovascular Health Outcomes for All Ohioans: A Statewide Cardiovascular Health Collaborative (CARDIO-OH) - Project Summary

Modifiable cardiovascular disease (CVD) risk factors such as hypertension, cholesterol, and smoking contribute strongly to CVD morbidity, mortality, and healthcare costs. Ohio is in the highest quartile for CVD morbidity and mortality and has significant disparities in CVD risk factors by geographic region, race/ethnicity, and insurance type, demonstrating substantial opportunity for improvement.

We propose using a unique facilitated co-design approach to develop a heart-healthy quality improvement (QI) intervention based on patient-centered outcomes research (PCOR) in the context of an expanded statewide Ohio Cardiovascular Health Collaborative (CARDI-OH) to accelerate statewide CVD improvement and reductions in disparities.

This proposal builds on pockets of regional QI strengths to develop a larger, more extensive, and sustainable external QI support infrastructure by linking the three regional health improvement collaboratives and seven medical schools with greater reach and extension within primary care, linked to our statewide collaborative, the Ohio Cardiovascular Health Collaborative.

This three-year project has three aims. For Aim 1, we propose to expand a nascent statewide cardiovascular health collaborative and establish a sustainable external QI support infrastructure. For Aim 2, we will co-design, implement, and evaluate the effectiveness, adoption, implementation, and maintenance of the heart-healthy QI intervention overall and by subgroup (e.g., geography, insurance, race/ethnicity) using a group randomized stepped wedge design. And for Aim 3, we will determine patient, provider, clinic, and other contextual factors associated with greater improvements in cardiovascular care and outcomes at the heart-healthy QI clinics.

We will conduct a robust mixed methods evaluation of: 1) CARDI-OH's evolution, network development, dissemination, and sustainability; 2) the co-design, adoption, implementation, maintenance, and effectiveness of the heart-healthy QI intervention overall and by subgroup; and 3) the factors associated with better clinical performance on CVD risk factor process improvement.

Project findings will be useful to policymakers, health insurers, practice managers, healthcare providers, and patients. This project could provide a transformative and sustainable statewide model for cardiovascular health improvement and disparity reduction which, through our mixed methods evaluation, can be shared broadly for replication.

Case Western Reserve University

NOT APPLICABLE

93.226 - Research on Healthcare Costs, Quality and Outcomes

Division of Grants Management [HHS - AHRQ]

Center for Evidence and Practice Improvement (CEPI) [HHS - AHRQ]

Ohio United States

State-Wide

Supporting Primary Care to Advance Cardiovascular Health in States with High Prevalence of Preventable CVD Events (U18) (RFA-HS-20-002)

Amendment Since initial award the End Date has been extended from 12/31/23 to 12/31/24 and the total obligations have increased 161% from $1,584,382 to $4,139,236.