Changing Behaviour Can Address Cardiovascular Risk
NOTE: The following is a feature story on the collaborative heart health project ANCHOR.
Like many people, Halifax-resident Penny MacKenzie didn't think much about heart health. With five children and a full-time job, she didn't have time to focus much on exercise or eating habits.
But one day her perspective changed.
"I never had to worry about my weight and I was never one to do exercise for exercise's sake. I guess I put on weight over time," Ms. MacKenzie says. "Then, one day, I stumbled and had to catch myself. I was surprised at how heavy I had become. No wonder I was having some trouble moving around."
Ms. MacKenzie's doctor suggested she take part in the ANCHOR program (A Novel Approach to Cardiovascular Health Risk by Optimizing Risk Management). The innovative program tackles behaviour change through counselling. It is a partnership between the Department of Health and Wellness, Capital District Health Authority, Cape Breton District Health Authority, the Heart and Stroke Foundation of Nova Scotia, Pfizer Canada and the QEII Foundation.
Claudine Szpilfogel, ANCHOR project manager, says cardiovascular disease kills an estimated 2,800 Nova Scotians every year and accounts for nearly 36 per cent of deaths in the province. She says these numbers could be reduced through preventative measure such as lifestyle changes.
The ANCHOR project helps participants make behaviour changes, through screening, motivational counselling and follow up, group education sessions, referrals to community programs and other tools. It operates out of two primary care practices, the Duffus Health Centre in Halifax and Sydney Family Practice Centre.
"The ANCHOR project takes a positive and realistic approach to motivate participants to improve their eating and exercise habits," says Ms. Szpilfogel. "It's a collaborative effort that offers a breadth of expertise and resources to deliver evidence-based and best-practice interventions to optimize cardiac health.
"Our goal is to minimize cardiac risk and reduce health-care costs through a preventative and disease management team approach, and we are seeing positive results."
The ANCHOR project has helped more than 1,500 patients improve their health and reduce the risk for heart disease. Thirty-four per cent of patients in the program reduced the risk of heart attack or stroke over the next 10 years by 10 to 25 per cent.
According to Halifax ANCHOR site co-ordinator and cardiac nurse, Krista Courtney-Cox, the approach works because it is customized to the goals of each person.
"We work with participants to help them set realistic goals on their own, and then we follow up to see if they stick to their lifestyle goals and, as a result, lower their risk for heart problems," says Ms. Courtney-Cox.
Penny MacKenzie joined the study in 2007 at age 58. She was at moderate risk for a heart attack with a body mass index of 32.4, 108 centimetre waist and a high blood cholesterol of 6.8.
"Penny was typical of the people we work with in the ANCHOR study," Ms. Courtney-Cox says. "She was able to set some realistic goals, including more walking and better eating habits. We saw her every three months to discuss her progress and track her measurements. There was no pressure, but we wanted to help her manage her own eating and exercise habits."
After this first phase, the program aims to identify how much support is required to maintain positive health behaviours by participant who successfully reduced their risk of heart disease.
"The second phase is more hands-off, but we track vital statistics and measurements, and provide encouragement at regular intervals," Ms. Courtney-Cox says. "We have been pleased with the results as many participants have maintained their healthier habits.
Ms. MacKenzie says she appreciated the regular check-ins to keep her on track. Today, she has a BMI of 28, a 90-centimetre waist and a cholesterol level of 4.32. She has gone from moderate to a low risk for heart disease and has maintained her health status. At 62, Penny has more energy to play with her grandkids and has maintained her walking schedule.
"I feel better than I have in 10 years. The ANCHOR project has been very motivating, both mentally and emotionally. They focused on what was positive. Even during the ups and downs, they never made me feel guilty," said Ms. MacKenzie. "I'm no longer afraid of losing my physical abilities. Now I can stick around for my grandkids!"
Ms. Szpilfogel says a third phase of the ANCHOR project is underway to better understand how to help participants who were unable to reduce their heart disease risk.
"When we combine knowledge and resources, we can achieve a great deal," said Ms. Szpilfogel. "We hope to continue work with the ANCHOR program to help address cardiovascular health in Nova Scotia for generations to come."
More information about the ANCHOR program is available at www.anchorproject.ca or by calling 902-453-2204.