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Health Outcomes | Blood Pressure Evaluation Measures

Health outcomes measures for blood pressure screening and control1-6

The effectiveness of blood pressure screening and control programs depends on the intensity of program effort and the use of multiple interventions. A rule of thumb is that the more programs implemented together as a package or campaign, the more successful the interventions will be.

Baseline

  • Determine levels of employee blood pressure screening rates and self-reported high blood pressure from employee health survey, health risk appraisal, or biometric screening. Examples include: 
    • What percentage of employees have been screened by a clinician or in a worksite blood pressure screening program at least once in the previous 12 months
    • Note that generally worksite screening programs should not be used as a substitute for regular follow-up and treatment of employees with high blood pressure. These employees should be encouraged to obtain regular clinical follow-up care with their physician. Some worksites do provide case management for employees with high blood pressure by nurses or other qualified staff through an occupational health clinic
  • Determine baseline percentage of employees with health behaviors or conditions where individuals have a higher risk associated with high blood pressure such as overweight, nutrition (a high sodium intake increases blood pressure in some people), heavy and regular use of alcohol, type 2 diabetes, or being physically inactive
  • Determine levels of diagnostic and treatment procedures from health care and pharmaceutical claims data ◦Of those employee who were screened, what percentage of employees were referred for clinical diagnosis and treatment
    • How many cases of high blood pressure (i.e., hypertension) were identified
    • Frequency of complications of high blood pressure such as heart attacks, stroke, and kidney disease
  • Determine employee knowledge, attitudes, and beliefs about blood pressure screening and control 
    • Evaluate employees’ current knowledge of the health benefits of blood pressure screening and control
    • Measure employee’s knowledge of their risks for high blood pressure
    • Assess employee awareness of existing workplace blood pressure screening and control programs, policies and benefits
    • Assess employee awareness of behaviors that may reduce high blood pressure risk, such as reducing obesity or overweight, type 2 diabetes, nutrition (a high sodium intake increases blood pressure in some people), heavy and regular use of alcohol, or being physically inactive

Process

  • Periodic repeats of baseline measures

Outcome

  • Assess changes in the numbers of employees receiving blood pressure screening
  • Assess changes in the percentage of employees who report high blood pressure levels
  • Assess aggregated changes in the percentage of employees with health behaviors or conditions where individuals have a higher risk associated with high blood pressure such as overweight, type 2 diabetes, nutrition (a high sodium intake increases blood pressure in some people), heavy and regular use of alcohol, or being physically inactive 
    • The percent of employees identified through medical claims data as having high blood pressure will remain the same or increase, since a person who has been diagnosed with high blood pressure keeps that diagnosis permanently. However, over time medical claims data should show a decrease in the complications of high blood pressure (e.g., heart disease, stroke, kidney disease, and blindness)
  • Determine change in levels of diagnostic and treatment procedures from health care and pharmaceutical data
  • Assess changes in employee knowledge, attitudes, and beliefs about blood pressure screening and control 
    • Evaluate changes in employee knowledge of the health benefits of screening and control for high blood pressure
    • Measure changes in employee’s knowledge of their risks for high blood pressure
    • Assess changes in employee awareness of existing workplace blood pressure screening and control programs, policies and benefits
    • Assess changes in employee awareness of behaviors that may reduce high blood pressure risk
       

References

1.  Campbell KP, Lanza A, Dixon R, Chattopadhyay S, Molinari N, Finch RA, editors. A Purchaser’s Guide to Clinical Preventive Services: Moving Science into Coverage. Washington, DC: National Business Group on Health; 2006. 

2.  Centers for Disease Control and Prevention. Framework for program evaluation in public health. Morbidity and Mortality Weekly Report 1999;48(No. RR-11): 1-40.

3.  Matson Koffman DM, Goetzel RZ, Anwuri VV, Shore K, Orenstein D, LaPier T. Heart-healthy and stroke-free: successful business strategies to prevent cardiovascular disease. Am J Prev Med. 2005; 29(5), suppl. 1:113-121.

4.  Pelletier KR. Clinical and cost outcomes of multifactorial, cardiovascular risk management interventions in worksites: a comprehensive review. J Occup Environ Med. 1997; 29(12): 1154-1169.

5.  Matson Koffman DM, Lanza A, Campbell KP. A Purchaser’s Guide to Clinical Preventive Services: A tool to improve health care coverage for prevention. Preventing Chronic Disease, April 2008; 5(2).

6.  Goetzel RZ, Ozminkowski RJ. Program evaluation. In: O’Donnell MP, editor. Health promotion in the workplace, 3rd edition. Albany, NY: Delmar Thomson Learning; 2002. p 116-165.

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