Evaluation of Cardiovascular and related Health Interventions in the Uk

Abstract This research proposal focuses on the healthcare initiatives in the UK pertaining to cardiovascular and related diseases. Using journal articles and government reports as secondary sources and comprehensive questionnaire based interviews and direct telephonic surveys as the primary input, the study aims to evaluate the preventive health programs to ascertain their effectiveness. These results would serve to help in adapting polices suitably so that the ideology of preventive care could be translated into a pragmatically feasible approach. Introduction The National Health Service has transformed phenomenally over the last two decades and the UK government has been at the forefront of health policies driven with a preventive focus. Cardiovascular diseases are still the number one killers in the UK. (BHF, 2010) The rapidly aging national population is set to cause a severe burden in terms of allocation of funds and quality of treatment delivery in the coming years. Let alone the burden of caring for an aged population, the general health level of the working age population is also on a decline. Around 2.6 million people are already on the government incapacity benefits while every year almost 600000 people are claiming these benefits. The costs of health related absence from work in the UK is estimated at a staggering ?100 billion which is equal to the entire annual costs of the NHS. [DH, 2008] There is a pressing need and a sense of urgency to plan for the management of this growing burden. This study aims to examine some of these health care initiatives and policies aimed at preventing cardiovascular and related diseases and evaluate their effectiveness. The government has created lot of independent bodies that check the progress of these health initiatives and assess their health impacts. This study will include a literature review of both local and nationwide preventive interventions. Academics and research workers would be consulted to get their perspectives of these programs and their evaluation. The objective of the study is to assess the effectiveness of these interventions and the evaluation procedures in order to provide a strategic focus for the future. Literature ReviewWhy the need for a Preventive Focus on Health programs?There is an overwhelming burden on the NHS to deliver quality healthcare when there are severe financial constrains. There is an urgent need to shift from ideology to pragmatism. New health perspectives are called for. Prevention is better than cure and the financial benefits of a preventive approach are dearly welcome for the cash constrained NHS. One of the significant achievements from a nationwide strategic preventive health program is the National Service Framework initiated program for cardiovascular disease prevention and treatment in 2002. Within 2 years of the implementation of this nationwide initiative a significant decline in cardiovascular mortality rates (40%) among the population aged below 75 years was reported. It is estimated that the Preventive drive from NSF saved around 22,000 lives in 2007. (DH, 2007) Life style disorders and physical inactivity have contributed to a significant rise in Obesity, diabetes and other health risk factors for cardiac diseases. (Allender et.al, 2007) In a recent health survey of England, acceptable physical activity levels were reported at 39% and 29% for men and women respectively. Accelerometry data however, revealed a very low percentage of men and women (6% and 4%) met the recommended activity levels. (BHF, 2010)There is an urgent focus on increasing physical activity (Walk to Work Program) as an effective method to counter the obesity epidemic and its cardiac complications. The anti smoking campaigns and the ‘NHS Diabetes’ programs are aimed at mitigating the risk factors for cardiac diseases. The most recent initiative is the Destination 2020 project, which is aimed at improving the awareness of the public in recognizing the commonalities between cardiovascular diseases and related disorders. This project calls for a cardiovascular c oalition (CVC) to put a practically effective and comprehensive preventive approach against heart diseases. (BHF, 2009)Evaluation of Preventive Health ProgramsAs mentioned before evaluation of the effectiveness of health interventions is vital. The growth so far achieved by the NHS has to be sustained and made more effective by adapting them to local communities in order to improve prevention, diagnosis and treatment delivery. There are quite a few government organizations that are entrusted with overseeing the implementation and auditing of the preventive health intervention programs. This study will focus on some of these evaluations. The National Institute for Health and Clinical excellence (NICE) offers evidence based practical guidelines to the implementation and assessment of such programs. The recently initiated NIHR Public Health Research program is designed to evaluate current programs and offer evidence based approach for future. In particular, the NIHR research program focuses on the practicalities and to address issues such as social inequalities in the implementation of a health initiative. (NHS, 2011) Similarly the NHS Health Scotland evaluates preventive interventions in the country and provides extensive reports pertaining to the programs locally. Furthermore, five independent research bodies namely Fuse, DECIPHer, ‘Northern Ireland Centre of Excellence for Public Health’, CEDAR and UK Centre for Tobacco Control Studies provide research based evidence for implementation and evaluation of public health programs. (NOO, 2011) While some programs have been touted as vastly successful others are found to be lacking in terms of practical results. This study aims to have a closer look into these disparities and arrive at some improvements.Research QuestionHow effective are health organizations in designing and implementing preventive health initiatives to control Heart diseases Is the strategic drive by the UK government health depart ment to control cardiac diseases by preventive programs such as anti smoking campaigns, Physical activity programs, and Obesity and diabetes control programs effective and bearing resultsThere are certainly differences of opinion regarding the answers to these questions. This research seeks to more closely examine the relevant issues and answer these questions. MethodologyResearch StrategyThis research is based on an objective, scientific methodology. This research proposes to use both primary and secondary sources. Articles from databases of published research materials and government publications constitute the secondary sources (Wrenn et. al 2006). These would be obtained by using appropriate keyword based search. The combination of keywords would constitute effective exclusion criteria so that unrelated material could be avoided. For the primary sources of information many government agencies and people responsible for overseeing and evaluating health intervention programs would be contacted over phone and email. The questionnaires for these respondents would be designed based on research findings obtained from the secondary research. In this way it is possible to ascertain if the primary sources of information agree with the conclusions of the previous research findings. Rating scales would be used to assess the effectiveness of he alth interventions and semi structured questionnaires would be employed to gather information directly from the persons who supervised these programs. (Babbie 2010) The advantage of using semi structured questions is that it would help extract more information about the success or failure of these programs.Access/Ethical IssuesTelephonic interviews and email based questionnaires are the main access methods in this study. Since the people currently representing an organization would be contacted and their opinions about current and past health interventions programs will be gathered, it would cause an ethical predicament. The opinions of people in charge of these programs might affect or jeopardize their career with the organization if their views about these programs are unintentionally leaked out. A confidentiality agreement would therefore be necessary to encourage people to talk openly and disclose information related to the health projects.Limitations of the ResearchIt takes a lot of time for large-scale projects to take effect and hence evaluating health projects could have to be undertaken over an extended period. Especially, since some of the new cardio vascular health programs such as ‘Destination 2020’ have just commenced it would not be possible to assess the effects of these and other such new initiatives in this study. Conclusion This proposal outlines the research question concerned with the evaluation of health projects aimed at preventing cardiovascular and other related diseases in the UK. The literature review uses reports from government organizations and clearly highlights the immediate need for intervention and a strategic focus for controlling cardiac health problems across the country. The research methodology is useful to evaluate these programs and to analyze their impact. These results would serve to help us in adapting polices suitably so that the ideology of preventive care could be translated into a pragmatically feasible approach. Time Chart ActivityTime Scale Research Design Planning Review of Literature Research Objectives Preparation of Questionnaires Contact Primary sources Survey Analysis of Data Draft of Dissertation Final Dissertation References Babbie, E R (2010), The Practice of Social Research (12th Edition.), Cengage Learning, Belmont, CA British Heart Foundation (2009), Destination 2020: A Plan for Cardiac and Vascular Health, British Heart Foundation, London. British Heart Foundation, (2010) Coronary Heart Disease Statistics: Behavioral Risk Factors, University of Oxford. Department of Health (2007a), The Coronary Heart Disease National Service Framework: Building for the future – progress report for 2007. DH, (Nov 2008), Improving Health and Work: Changing Lives, Crown Publications. UK National Obesity Observatory (2011) ‘Evaluation Websites’ Viewed Jan 16th 2012, NHS (2011) ‘Research to improve the health of the public and reduce inequalities in health’, Viewed, Jan 16th 2011, http://www.phr.ac.uk/ Steven Allender, Charlie Foster, Peter Scarborough, Mike Rayner (2007), The Burden of Physical Activity related ill Health in the UK, J Epidemiol Community Health ;61:344-348 Wrenn, B, Stevens, R E and Loudon, L (2006) Marketing research: text and cases (2nd Edition), Routledge, UK