外展帮助农村患者在家治疗高血压
WILLIAMSON, 西维吉尼亚州 — Craig Warren's life revolved around sports when he was growing up. Football, basketball, baseball — "if they had it at school, I played it," he said.
But over the years, healthy activities like sports took a back seat to other demands. 现年57岁的沃伦患有心脏病、肾病和糖尿病. 十年前,他中风了. 三年前,他接受了肾脏移植手术.
这些天, 沃伦每天检查四次血压, 记录这些数字并报告给梅丽莎·贾斯蒂斯, his community health worker and a nurse at the Williamson Health and Wellness Center. She showed Warren how to take his blood pressure and regularly checks in with him.
“梅丽莎打电话来确认我的血压是否正常. 如果不是的话, 她会和移植诊所联系,他们会决定我需要做什么,沃伦说。, who also sees Justice each week in his home in this once-thriving Appalachian coal town.
“对我们来说,现在监测他的血压并保持低水平非常重要, 因为如果我们不, 我们可能会失去移植的肾脏,法官说.
沃伦监测血压的关键是他使用的监测器, 从威廉姆森健康中心借来的. 这是150多个家庭中的一个, validated blood pressure devices the center has provided to community members who can't afford them — people whose health depends on their ability to routinely check their blood pressure to keep it under control.
因为保险通常不会支付这些费用, 中心提供这些设备, thanks to a partnership with the 美国心脏协会 and funding from the Pallottine Foundation of Huntington, 西维吉尼亚州. Through similar partnerships at clinics and Federally Qualified Health Centers across the nation, the AHA helps put blood pressure cuffs on the arms of thousands of people who need them. 像沃伦一样,许多人生活在农村地区,获得医疗服务的机会有限.
高血压的危险
近一半的美国人.S. 成年人有高血压,也叫高血压. 未经处理的, 高血压会导致严重的健康状况,包括心脏病发作, 心脏衰竭, 中风, 糖尿病和肾衰竭. 总的来说,只有大约四分之一的美国人.S. 成人高血压患者应适当控制血压.
西弗吉尼亚州是美国高血压发病率最高的州之一. 沃伦居住的明戈县也不例外.
西弗吉尼亚州的贫困率几乎是全国的三倍. Many residents lack access to healthy foods and other resources that would make it easier to fight the multitude of chronic illnesses decimating the population.
高血压只是其中之一,但它是一个需要控制的关键因素. Research suggests that lowering blood pressure levels by just 10 mm Hg can reduce the risk for major cardiovascular events as much as 20%, 27%的人中风,13%的人死于任何原因.
Studies show at-home blood pressure monitoring programs can successfully reduce hypertension rates. 这正在威廉姆森发生, where the Wellness Center has been recognized by the AHA for achieving a greater than 70% hypertension control rate among the residents it serves. To date, 77% of its patients are maintaining blood pressure within the normal range.
The program lending out blood pressure devices came at a crucial time, Justice said. During 2020, the COVID-19 pandemic shut down many self-monitoring kiosks in local pharmacies. “没有人能轻易拿到手铐,这就是美国心脏协会挺身而出的时候. 特别是在那个时候,这是非常值得赞赏的."
更重要的是, 美国心脏协会帮助提供的设备是最先进的, 她说, 他指出,医疗保险公司通常不包括这类设备.
参与社区活动
冬青米切尔, 美国心脏协会在西弗吉尼亚州的社区影响主任, 谁来监督合伙企业, 他说,每天看到血压数字会激励人们降低血压.
米切尔说:“当你给他们戴上手铐时,你就把权力交给了他们。. “这几乎就像一场游戏,如何把这些数字降下来. 他们开始做一些事情,比如减轻体重,多锻炼."
威廉姆森并不是唯一从该项目中受益的地方.
使用帕洛廷基金会的资助, Mitchell said she's forged relationships with clinics that provide the blood pressure devices to dentists and libraries in several 西维吉尼亚州 counties, 希望能接触到那些可能被忽视的人. 她总共向全州的项目发放了大约1000台设备.
她说:“我们正努力满足人们的需求。. "They might not see a doctor that often, but they might go twice a year to get their teeth cleaned."
如果牙医发现病人有高血压, 那位病人被转介到当地一家诊所就诊, 她说. "This 'warm handoff' provides the critical clinical follow-up for folks who need hypertension care."
Libraries are another good place to reach people who don't always see a doctor, Mitchell said.
离威廉姆森大约90英里, the Cabell County library system lends out blood pressure monitors as if they were books. 该项目通过与Valley Health的合作来运作, which runs 40 health centers and public health programs across southwestern 西维吉尼亚州 and southern Ohio.
卡西麦克雷, Valley health的医疗助理和社区健康专家, sets up a table at the Salt Rock public library in Cabell County during monthly events, 向人们展示如何使用这些设备. 她给他们量血压, explains what a healthy blood pressure level should be and talks to people about what foods to eat or avoid to keep blood pressure properly managed.
"Most of the people who stop to get their blood pressure taken are already on medication for it,麦克雷说. “但他们中的很多人没有办法在家里检查血压. 他们可以把这些显示器带回家,这很有帮助."
麦克雷建议人们在数字高的时候去看医生. 如果他们没有医生, 或者如果他们没有保险, she refers them to a Valley Health clinic where they can pay based on what they can afford. 有些人对自己患有高血压感到惊讶.
Mitchell would like to expand the program and is always looking for new ways to reach people who could benefit.
“我们会一直尝试,”她说. "Hypertension really haunts us in 西维吉尼亚州, and this has been really helpful."