Support your Heart: Feasibility trial of a cardiovascular health intervention for young adults - Cardiovascular disease (CVD) is a major health problem in the US, affecting nearly 50% of adults. While CVD prevalence has remained stable over the last two decades, acute cardiac events have increased in young adults. The prevalence of CVD increases with age making early intervention and prevention essential. Seven of every 10 cases of CVD could be prevented by managing lifestyle factors. The American Heart Association (AHA) introduced cardiovascular health metrics (i.e., Life’s Essential 8 [LE8]: sleep, physical activity, blood glucose, blood lipids, blood pressure, smoking, body mass index, and diet), reflecting a shift towards health promotion and preservation throughout the life course versus disease treatment. Only 27% of young adults meet the threshold for ideal cardiovascular health. What remains missing from the AHA’s metrics is a focus on psychosocial factors that are associated with adverse cardiovascular outcomes, such as social isolation, loneliness and stress. Further, the US Surgeon General identified an urgent public health need to address the “epidemic of loneliness and isolation” particularly among young people. Currently, there are no intervention studies that seek to address the impact of social isolation and/or loneliness on cardiovascular health among young adults. Our research team has experience developing and delivering telephone coping skills interventions for patients with advanced lung disease, and tailored interventions for health risk behaviors. In the current proposal, we will apply these precision prevention approaches to a health coach delivered intervention for young adults targeting the AHA’s LE8 indicators, and collect data regarding the intervention feasibility and acceptability. This R34 will consist of a development phase which will include co-development of the Support Your Heart telephone intervention and a pre-pilot single arm 12-week study (n=20). To minimize costs and maximize acceptability, Support Your Heart will include access to the current standard of practice from the American Heart Association to address LE8 (the MyLifeCheck© App). Feasibility metrics will include acceptability, satisfaction, adherence and retention. Following the development and pre-pilot testing, we will conduct a pilot randomized feasibility trial (n=50) comparing Support Your Heart to MyLifeCheck© in a 6-month randomized controlled pilot trial. Results from this pilot feasibility trial will provide preliminary evidence to support a fully powered randomized controlled trial examining whether Support Your Heart improves LE8 over a 1-year period compared to standard American Heart Association materials. Support Your Heart using health coach delivery is significant because it addresses cardiovascular health among young adults using a precision public health approach and covers stress, social isolation, and loneliness. With this integration we take a strengths-based approach, which is consistent with the American Heart Association’s shifting emphasis on primordial prevention. This research has the potential for substantial public health impact by addressing both cardiovascular health, social isolation, loneliness and stress which comprise significant health burden.
