Multicomponent intervention for primary prevention of cardiovascular diseases in general practitioner practices and community settings: lessons from the SPICES project in Belgium

Hamid Hassen, Naomi Aerts, Kathleen Van Royen, Sibyl Anthierens, Caroline Masquillier, Steven Abrams, Hilde Bastiaens

Keywords: Cardiovascualr diseases; GP practices; Community; Prevention; Implementation

Cardiovascular diseases are preventable through population and individual level interventions. Due to frequent contact with patients and opportunity for appropriate risk assessment, GP practices have a vital role in prevention of CVDs. On the other hand, community settings are complementary and often more able to reach vulnerable populations. However, the role of GP practices and community settings in lifestyle preventive interventions is not well documented.

Research questions:
We aimed to describe and explore the potential of GP practices and community settings in CVD preventive interventions in selected vulnerable districts of Antwerp, Belgium.

The SPICES project in Antwerp used the participatory action research approach to improve CVD risk identification and communication in the community and GP practice settings. Three GP practices and 4 various types of community settings were involved. Adults aged 40 or above were the target population. The intervention is tailored to the context and individual’s CVD risk level. We used an effectiveness-implementation Hybrid type III design, which emphasizes on testing implementation strategies and implementation outcomes, while also monitoring effectiveness. The intervention consists of CVD profiling and risk communication, brief behavior change counseling, and tailored lifestyle coaching. The primary outcomes are CVD risk level measured using non-laboratory INTERHEART risk score, CVD knowledge and risk perception, and physical activity level. We will describe the evaluation of GP practice and community settings in terms of RE-AIM - reach, effectiveness, adoption, implementation and maintenance.

A total of 353 participants (67 in the GP practice, 279 in community settings, and 7 online) participated. The final results will be available at the conference.

This study will show the potential of GP practices and community settings in implementation of multicomponent CVD preventive interventions in vulnerable communities. Furthermore, it will provide an insight on possible directions to integrate provision of CVD preventive interventions in GP practices and community.

Points for discussion:
How to integrate community and primary care settings?

Lifestyle interventions in primary care settings and the burden on healthcare professionals