WISEWOMAN: Well-Integrated Screening and Evaluation of WOMen Across the Nation - Cardiovascular disease (CVD) is the leading cause of death among American adults at 217 deaths per 100,000 population, and Nevada, with almost 252 per 100,000 and ranked 44th nationwide in CVD-related mortality. Approximately 7.2 percent of adults in Nevada have been diagnosed with heart disease, compared to 6.3 percent nationally.2 The leading cause of death in Nevada, among other chronic diseases, is heart disease.3 In addition, hypertension affects almost half of all Americans, with nearly 80 percent of those cases still classified as uncontrolled. Despite the high prevalence and low levels of control, research suggests evidence-based strategies for preventing and managing CVD can be effective if those interventions can improve adherence to diet, lifestyle, and medication recommendations, improve quality of life, and reduce hospitalizations and healthcare costs. Nevada’s Chronic Disease Prevention and Health Promotion (CDPHP) Section intends to extend preventive health services to low-income women aged 35-64 years who are uninsured or underinsured and who participate in the Women’s Health Connection (WHC) Program. These extended health services will include assessing CVD risk factors and providing services to reduce those risks through improved diet, physical activity, tobacco cessation, and medication adherence support. Systems are already in place to provide these services using Community Health Workers (CHWs), electronic health record alignment, team-based care, electronic referrals, community-clinical linkages, and health systems change. This will be achieved by implementing key evidence-based strategies, using surveillance data, and collaborating with national, statewide, and local partners. Hypertension and elevated serum cholesterol are major risk factors for heart disease and stroke, and about a third of Nevada residents have known hypertension (32.6 percent) or high cholesterol (36.0 percent) rates.4 Heart disease affects certain groups in Nevada more than others. Non-Hispanic Black residents have higher rates of hypertension (40.4 percent), significant cardiovascular disease (12.5 percent versus the Nevada mean of 9.2 percent), and stroke mortality (65 deaths per 100,000) than the general population.4,3 For heart disease, people in urban counties (188.6 urban deaths per 100,000 versus 156.9 deaths in rural counties) and adults older than 65 years (14.6 percent vs. 5.3 percent in populations under 65) also have disproportionate prevalence rates.3,5 The purpose of the Nevada Chronic Disease Prevention and Health Promotion (CDPHP) section intends to extend preventive health services to women who are participants of the Center for Disease Control (CDC)-funded National Breast and Cervical Cancer Early Detection and Prevention (NBCCEDP) program, known in Nevada as Women’s Health Connection (WHC). These extended health services include an assessment of CVD risk factors and provision of services to reduce those risks through improved diet, physical activity, tobacco cessation, and medication adherence support. The Well-Integrated Screening and Evaluation of WOMen Across the Nation (WISEWOMAN) program is in place to provide services, including working with Community Healthcare Workers (CHWs), electronic health record alignment, team-based care, electronic referrals, community-clinical linkages, and health systems. The program uses key evidence-based strategies; utilizes surveillance data; collaborates with national, statewide, and local partners; and coordinates with existing current relevant program work. The outcome of this application will address the Core Component of the Notice of Funding Opportunity (NOFO) and is designed to reduce CVD risk factors, including high blood pressure, elevated cholesterol, obesity, poor nutrition, inactivity, diabetes, and smoking.
