CARE is an acronym for Cardiovascular Assessment, Risk Reduction, and Education. The CARE Collaborative was initiated by the Kentucky Heart Disease and Stroke Prevention (KHDSP) Task Force. The CARE Collaborative is a blood pressure awareness program for men and women in Kentucky age 18 and above. This program uses a blood pressure record tool, which focuses on an educational encounter using green (normal), yellow (caution), and red (high) blood pressure color zones.
Individuals often do not understand what number ranges are considered normal or high. Many also do not understand the severity of the consequences of having high blood pressure.
There are two versions of the CARE Collaborative: Standard and Optimal. The Standard version follows the JNC 7 guidelines. The Optimal version follows the American Heart Association and American College of Cardiology recommendations. CARE Collaborative training and materials are available for both versions.
An educational encounter is the interaction between the participant and a trained CARE Collaborative Coach. All participants are provided with appropriate feedback regarding their blood pressure including steps to reduce high blood pressure. This interaction includes the mandatory program requirement that CARE Collaborative Coaches refer participants with elevated blood pressures, who do not have a healthcare provider, to a source of proper medical care.
CARE Collaborative Coaches provide the educational encounter by having participants identify where their blood pressure lies. They also provide blood pressure education and lifestyle modification suggestions. Data collected from the encounter is analyzed and can offer robust reports for your agency that can show improvements in blood pressure, lifestyle changes and patient health literacy.
The CARE Collaborative can be used in various ways within your organization. Returning participants often make lifestyle changes that can help lower blood pressure and lead to better blood pressure control. The patients that implement these lifestyle changes help improve quality measures that must be reported at the provider level. Health departments that are seeking accreditation will be able to utilize the analyzed data reports to meet various measures that are required for accreditation.
Merritt Bates-Thomas and Leah Jacobs at the Green River District Health Department had been providing CARE Collaborative educational encounters in the community for some time. Seeing a growing need to improve health outcomes of those with an elevated blood pressure in their community, they began developing a program that would provide more direct, ongoing education.
Using the CARE Collaborative as their basis, they developed CARE Direct; a program designed to help give participants the appropriate resources to lower and monitor their blood pressure. Patients receive a free automatic blood pressure monitor and 12 monthly patient encounters that can be completed in person or telephonically.
Participant JC57 was the first participant to complete the entire 6 month program of CARE Direct then moved on to completing the 6 month Enhanced Maintenance Program. Below you will find in her words, the impact the CARE Direct program at Green River District Health Department had on her life.
“A little over a year ago, my blood pressure was running in the 140-150 systolic and in the upper 70’s on diastolic.
I had a nurse at the health department taking my blood pressure every day or two, knowing it was high and I am on blood pressure medicine.
After having a biometric screening done, I was referred to the CARE Direct program. I met with Leah Jacobs who explained the importance of monitoring blood pressure and signed a six-month contract to meet with her monthly. I was loaned a digital cuff to use to monitor my blood pressure daily and a log for documentation, and taught how to use the cuff properly. Every month we discussed different topics such as ‘My Plate’ for food portions, exercise, losing weight, how to read nutrition labels, triglycerides, cholesterol, stress and many others, with handouts to keep that I can refer back to from time to time.
After my six months, the blood pressure cuff was mine to keep and I was given the option of moving forward on my own, or signing up for an enhanced maintenance program. I saw result in my numbers, going from 148/76 to an average of 114/67 so I signed on for another six months. While being in the program, I have lost 20 pounds, and feeling better not only physically, but mentally as well, than I have in years.
Even though I have graduated from the CARE Direct program, Leah has given me the key to a better life. I am still on my path to a healthier me, feeling confident that I can reach my goal.”
Participant JC57 submitted lipid profile numbers from her last PCP visit. Participant stated she has attributed these numbers to the CARE Direct Program and all that she had accomplished over the past year. Cholesterol 171; Triglycerides 140; HDL 41; LDL 101; LDL/HDL Ratio 4.11
Enrolled in CARE Direct: January 17, 2019
Graduated CARE Direct: December 19, 2019
Starting Blood Pressure: 147/89
Ending Blood Pressure: 116/75