Health Services Research
Article Comparison Table
|Criteria||Article One||Article Two|
|CitationInclude the APA reference note.||CITATION Rit14 l 1033 (Ritchey, Wall, Gillespie, George, & Jamal, 2014)||CITATION Sho14 l 1033 (Short, Ivoy-Walls, Smith, & Fleetwood, 2014)|
|Content SummaryCraft a 100-150 word summary of the article||The purpose of this research was to investigate the prevalence of leading cardiovascular disease risk factors in the United States of America. The leading cardiovascular risk factors in the United States as identified in the study include hypertension, high cholesterol levels and smoking. The strategy dubbed ‘Million Hearts’ under which the research was conducted is an evidenced based strategy by the Department of Health and Human services and nonprofit and private organizations. The study analyzed data from the National Health and Nutrition Examination Survey (NHANES) on uncontrolled hypertension, uncontrolled high levels of low-density lipoprotein cholesterol (LDL-C) and current smoking. A summary of results analysis revealed that 49.7% of adults aged twenty and above (about 107.3 million) in the U.S have at least one of the three risk factors.||This study was a population-based cross sectional study carried out to determine the prevalence and distribution of cardiovascular disease and risk factors for cardiovascular disease and to assess environmental perceptions and existing health policies that support or deter choices in health. The sampling frame used was address based for enumeration of households and recruitment of participants. An in-home data collection model is used to collect anthropometric measures, survey data and blood samples from participants. Data collected will be merged into a data set for analysis and there will be development of sample weights to ensure that data collected represents the adult population of Mississippi Delta Region. The study aims at ensuring that information collected will be of use in assessment of the burden of cardiovascular disease and in guiding the development and evaluation of the promotion of cardiovascular health and strategies for risk control.|
|Research MethodsDescribe the methods used, including tools, systems, etc.||The research used mainly secondary data coded and archived by NHANES and involved calculation of prevalence estimates for managed LDL-C and estimates for controlled blood pressures among known hypertensive adults. In addition to these, there was estimation of daily mean sodium intake. Data collected, coded and archived by the National Ambulatory Medical Care Survey (NAMCS) was used in the estimation of prevalence of visits to primary care physicians and cardiologists where there was prescription of aspirin or other antiplatelet medication to adults with ischemic vascular disease. This data was used to estimate the prevalence of office visits with prescription of smoking treatment to known adult tobacco users. Another data source for this study was the National Survey on Drug Use and Health (NSDUH) whose data was important in prevalence estimation of current tobacco smoking. This study examined up to four survey cycles using sex, age and race/ethnicity adjusted linear trends (p<0.05). There was use of sex, race and ethnicity adjusted t-tests to examine prevalence changes for two most recent data cycles and differences between sex, age and race-ethnicity within the most recent data cycle.||The model used in the Delta Cardiovascular Health Examination Survey (CHES) was developed through the incorporation of historical accounts of other local and regional data collection surveys. The study design is a population-based cross sectional study with data collection from the non-institutionalized population of the region of Mississippi Delta. The leading risk factors for cardiovascular disease as identified in the study were dyslipidemia, hypertension and diabetes. An estimated sample size of 1000 was expected for this study, drawn from the population of non-Hispanic Blacks and non-Hispanic Whites in Mississippi Delta. An address based sampling method was used to sample households and participants in two stages. A sampling frame was generated and eligible adults were selected for participation. Data collection was with the aid of Examination Management Services, Inc. that provides services in specimen collection, scheduling and completing an interview and examination appointment at the home of each participant. A questionnaire was used to aid data collection. At the end of data collection, data was entered, processed, weighed and results compiled into a data set. Data was merged into one database, matched by the unique identification number of the participant with a final analytic set void of personal identifiers. Each participant will get a cover letter and health report with a summary of anthropometric measurements and clinically relevant laboratory results via mail.|
|Focus of the Research or Study Describe the design of the relevant research or study in the article.||The focus of the research was on the prevalence of the most common risk factors for cardiovascular disease in the United States of America identified as uncontrolled hypertension, uncontrolled LDL-C levels and smoking. The study collected secondary data on these parameters and on primary care and physician office visits to assess the morbidity related to these risk factors. The study was in retrospect with an aim to reduce the mortality associated with cardiovascular disease in individuals predisposed by these risk factors.||The focus of the research was to assess the burden of cardiovascular disease and to examine policy and environmental factors influencing cardiovascular disease. The experimental and cross-sectional nature of the research was aimed at collection of real-time data to produce tangible and practical results from survey data, anthropometric measures and blood samples collected from adults above the age of eighteen years in the sample representative of the study population. The planning phase of the research began in 2011 with implementation between 2012 and 2014.|
|Target Audiences and SubjectsIdentify the target audience (population) and the setting in which the research/study was conducted.||The subjects for the study were adults aged twenty years and above for data collected from NHANES and NAMCS to assess uncontrolled hypertension and uncontrolled LDL-C as risk factors for cardiovascular disease and prevalence of visits to seek health care for morbidity associated with the risk factors respectively. The subjects of the study for data collected from NSDUH was adults aged eighteen years and above. This study did not use live subjects during research. The target audience for this study was adults at the age of eighteen years and above, who are particularly predisposed to the risk factors focused on in the study and are therefore at risk for cardiovascular disease.||The study setting was in Mississippi Delta Region in the Northwest part of Mississippi comprising of 18 counties. The study focused on non-Hispanic Blacks and non-Hispanic Whites in this population with exclusion of individuals below the age of 18, persons legally barred from signing consent forms, pregnant, cancer patients, non-English speakers, persons with psychiatric conditions and hemophilia and those not expected to be in residence within 30 days of selection. The target audience for this study was adults of eighteen years and above. These are individuals susceptible to cardiovascular disease due to their predisposition to risk factors identified in the study as dyslipidemia, hypertension and diabetes.|
|Potential Impact on Future Health Care DeliveryPropose how this information could or will impact future health care delivery or options.||The possible impact of this study on the future of health care delivery is that through the establishment of the prevalence of these risk factors for cardiovascular disease, it is possible to design and implement preventive programs as public health initiative to curb these risk factors. This study will provide evidence based strategies to reduce mortality due to cardiovascular disease. This research is in line with the leading health indicator in the Healthy People 2020 goals dubbed ‘nutrition, physical activity and obesity’. In addition to these, the study will provide guidance on the financial and medical needs to curb cardiovascular disease based on prevalence of risk factors.||The possible impact of this study on future health care delivery is that it enables the assessment of the burden of cardiovascular disease and identifies environmental and health policy factors that influence cardiovascular disease and risk factors that predispose to it. The study will add detailed information on the health outcomes and determinants of chronic disease. Information from this study will aid the development of cardiovascular health promotion programs and their evaluation, and in the development of strategies to evert risk factors for cardiovascular disease. It will further promote policy changes and control of environmental factors that contribute to cardiovascular disease and risk factors.|
Cardiovascular disease has a multifactorial etiology and may be classified as either congenital or acquired. Acquired cardiovascular disease is majorly due to lifestyle and habits such as smoking, alcohol intake and drug and substance abuse and lifestyle diseases including hypertension, diabetes and dyslipidemias. Morbidity and mortality due to cardiovascular disease has been on the rise especially in the 21st Century, it falls under nutrition, physical activity and obesity in the leading health indicators in Healthy People 2020 goals. With sufficient and appropriate health promotion programs and interventions, it is possible to reduce the morbidity and mortality due to cardiovascular disease in the United States of America.
Research by and are both geared towards investigation of cardiovascular disease through assessing the risk factors for cardiovascular disease and establishing disease burden respectively. The significance of these two research studies is that they contribute to the fund of knowledge on cardiovascular diseases and provide a basis for interventions aimed at reducing disease burden, morbidity and mortality due to cardiovascular disease. These two research studies affect health care delivery in the United States by providing evidence to aid policy making and designation of national intervention programs and risk eversion strategies.
Research and data monitoring of healthcare delivery in the United States aids in the discovery and establishment of epidemiological information about diseases including their prevalence, incidence, risk factors, morbidity and mortality due to various diseases depending on the objectives of the study. In addition to these, the impact of various treatments on the outcomes and prognoses of diseases is established through research. Research in health services also examines access to health care, costs and processes and the outcomes of health services among individuals and in populations. Findings obtained from research and data monitoring of healthcare delivery provides information to decision and policy makers and to the public on the efficiency of health systems. In addition to this, research informs and evaluates innovations in health policy. All this is in the benefit of the country’s citizenry.
Potential environments within health care delivery appropriate to research and data monitoring include individual health status of the population, environmental, socioeconomic, biomedical and genetic factors that affect the health of individuals in the population. In addition to these, resource use, outcomes, financing and expenditures in health care delivery are high in the list of potential areas of research and data monitoring in healthcare.
The impact of the studies by and cannot be underestimated in their role in the provision of epidemiological information. These studies provide important information about the risk factors for cardiovascular disease, the disease burden in the population under study and their contribution in the development of interventions, policy innovations and strategies to curb cardiovascular disease. In addition to this, it provides evidence for the need for adjustment of policies and environmental factors that negatively influence individuals in terms of cardiovascular disease.
The studies were intended to influence health care delivery through provision of evidence on the existence of cardiovascular disease as a health concern, the prevalence of its risk factors and the impact of environmental and policy factors on the cardiovascular health of individuals. Provision of evidence from these studies provide a starting point for policy innovations in health and public health intervention to improve the health of citizens and to achieve the Healthy People 2020 goals.
The allied health professional has a role to play in research and data monitoring of healthcare delivery. The allied health professional is well informed in matters of health and may take the role of a principal investigator in healthcare research once they have identified a health issue that needs attention. In addition to this, the health professional may intervene in the designation of programs and policies as interventions in response to research conducted by other individuals in the field of health. The health professional may provide valuable information to other researchers conducting research in the field of health to enable the success of the researchers in health care research.
Hughes, R. G. (2008). Patient Safety and Quality: An Evidence-Based Handbook for Nurses. Agency for Heatlhcare Research and Quality.
Institution of Medicine(US) Roundtable on Value and Science-Driven Healthcare. (2010). Clinical Data as the Basic Staple of Health Learning: Creating and Protecting a Public Good: Workshop Summary. Washington DC: National Academies Press.
Ritchey, M. D., Wall, H. K., Gillespie, C., George, M. G., & Jamal, A. (2014, May). Million Hearts: Prevalence of Leading Cardiovascular Disease Risk Factors-United States. 2005-2012. Morbidity and Mortality Weekly Report, 63(21), 462-467.
Short, V. L., Ivoy-Walls, T., Smith, L., & Fleetwood, L. (2014, February). The Missisipi Delta Cardiovascular Health Examination Survey:Study Design and Methods. Epidemiology Research International.
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