Assessment of Comprehensive Cardiovascular Program:
Basis for Building Community Coalition and Impact Evaluation

Eduardo J. Simoes, MD, MSc, MPH [1, 3, 4]
Nisreen Kabeer, MPH [2]
Suzanne D’Isabel, MPH [2]
Anjali Desphande, PhD [1, 2]

1. Office of Epidemiology, Missouri Department of Health, Columbia, MO.
2. Division of Chronic Disease Prevention and Health Promotion, Missouri Department of Health, Columbia, MO.
3. Prevention Research Center and Department of Community Health, School of Public Health, Saint Louis University, St. Louis, MO.
4. School of Medicine, University of Missouri, Columbia, MO.

Needs assessment helps cardiovascular health comprehensive programs (CVH) to identify outcomes of interest to target communities and provides the basis for impact evaluation. Assessments that combine traditional surveillance (i.e., mortality, hospitalization, risk behaviors), with telephone survey on community’s perception of environmental and policy determinants of heart healthy life-style, are a powerful tools for strengthening CVH coalitions and generating baseline data for impact evaluation. In Missouri, an assessment integrated into a quasi-experimental impact evaluation identified a finite list of environmental and policy factors in which intervention communities were interested: walk/bike trail, public sports outdoor/indoor facilities, food information network, fresh produce cost and healthy choices at cafes/restaurant. It also found that leisure-time physical activity (LPTA) decreased with lack of public outdoor sports facilities (Odds Ratio(OR)=0.7); and that eating five or more fruits and vegetables per day increased with the presence of nutrition information networks (OR=1.4) as well as healthy choices at cafes/restaurant (OR=1.3) and low cost of fruits and vegetables (OR=3.3). Aging, less than high school education and black race were also related to both eating less than five fruits and vegetables per day and decreased LPTA. Prioritizing these determinants will enable and strength community participation in coalition building while potentially affecting heart-healthy life-style in these communities. If effective, such initial collaboration should strength coalition’s self-efficacy.