Keywords: cardiovascular disease prevention, general population, implementation
In 2015, cardiovascular diseases (CVD) caused 31% of worldwide deaths. SPICES involves five countries in an international primary prevention implementation study. In France, the study was implemented in a rural, deprived territory with a cardiovascular increased mortality. An assessment of CVD risk of individuals in general population was conducted in public events and places of the territory in 2018. Screeners, stakeholders, and researchers experimented barriers and facilitators to this assessment. The efficacy and the replicability of such a study were unknown.
Following the Non-Laboratory Interheart risk score (NL-IHRS), what are the characteristics of the individuals undergoing CVD risk assessment for SPICES? Which barriers and facilitators were experimented by the whole screening team?
Implementation study combining a cross-sectional descriptive study to qualitative interviews. The NL-IHRS was completed on a voluntary basis, recording age, gender, familial history of heart attack, diabetes, hypertension, smoking status, physical activities, dietary habits, psychosocial factors, and abdominal obesity. After the screening, groups of students, GP trainees, pharmacists, nurses, physiotherapists, members of the research team were interviewed until theoretical saturation of the data for each group. Thematic analysis was performed with double blind coding.
From April 15th to September 14th, 2019, 3374 assessments were undertaken in 64 different places. 1582 individuals were at low CVD risk, 1304 at moderate risk, 488 at high risk. Stressed or depressed individuals were 39,8% and 24,4% of the population. 50 qualitative interviews were conducted. Main facilitators were readiness of the population, trust between screeners and research team, media attention and word spread. Main barriers were lack of motivation, difficulties to handle the research software.
This recruitment was successful. Levels of diabetics and smokers were comparable to the French population, hypertensive and physical inactive were lower. Stress and depression were unexpectedly high. Training of screeners and ambulatory research software should be improved.
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