JMIR Publications

ABSTRACT

Background:

The Ohio Cardiovascular and Diabetes Health Collaborative (Cardi-OH) unites general and subspecialty medical staff at the seven medical schools in Ohio with community and public health partnerships to improve cardiovascular and diabetes health outcomes and eliminate disparities in Ohio’s Medicaid population. Although statewide collaboratives exist to address health improvements, few deploy needs assessments to inform their work.

Objective:

Cardi-OH conducts an annual needs assessment to identify high priority clinical topics, screening practices, policy changes for home monitoring devices and referrals, and preferences for the dissemination and implementation of evidence-based best practices. The results of the statewide needs assessment could also be used by others interested in dissemination of best practices to primary care teams.

Methods:

The cross-sectional survey was distributed electronically via REDCap to both Cardi-OH grant members and Cardi-OH non-grant members (i.e., people who have engaged with Cardi-OH but are not funded by the grant).

Results:

A total of 88% (n=103) of 117 Cardi-OH grant members and 8% (n=98) of 1,204 non-grant members completed the needs assessment survey. Of those, 51% (n=53) of Cardi-OH grant members and 47% (n=46) of non-grant members provided direct clinical care. The top three cardiovascular and diabetes clinical topics (ties included) for Cardi-OH grant members (clinical and non-clinical) were: 1) lifestyle prescriptions (n=50, 49%), 2) atypical diabetes (n=38, 37%), 2) COVID-19 and cardiovascular disease (CVD) (n=38, 37%), and 3) mental health and CVD (n=38, 37%). For non-grant members, the top three topics were: 1) lifestyle prescriptions (n=53, 54.1%), 2) mental health and CVD (n=39, 39.8%), 3) alcohol and CVD (n=27, 27.6%), and 3) cardiovascular complications (n=27, 27.6%). Regarding social determinants of health (SDoH), Cardi-OH grant members prioritized three topics: 1) weight bias and stigma (n=44, 43%), 2) family-focused interventions (n=40, 39%), and 3) adverse childhood events (n=37, 36%). Non-grant members’ choices were: 1) family-focused interventions (n=51, 52%), 2) implicit bias (n=43, 43.9%), and 3) adverse childhood events (n=39, 39.8%). Assessment of other risk factors for CVD and diabetes across grant and non-grant members revealed SDoH screening in approximately 50% of patients in each practice, whereas some frequency of depression and substance abuse screening occurred in 80-90%. Access to best practice home-monitoring devices was challenging with 25-60% of members reporting challenges in home blood pressure monitoring devices, diabetes self-management education, and continuous glucose monitors for diabetes management.

Conclusions:

Cardi-OH grant and non-grant members shared the following high priority topics: lifestyle prescriptions, CVD and mental health, family-focused interventions, alcohol and CVD, and adverse childhood experiences. Assessing educational needs of providers in providing best practices to reduce CVD risk factors is essential for ensuring dissemination resources are practical and useful to providers as we work to improve cardiovascular and diabetes health in Ohio's Medicaid population. Clinical Trial: Not applicable