¹Christine Ku, MPH, ²Shivaughn Hem-Lee-Forsyth, PhD, MPH, ³Leselle Pierre, MSc

¹naviHealth, Brentwood, Tennessee

²,³ Department of Public Health and Preventive Medicine, School of Medicine, St. George’s University, Grenada.

This policy analysis of the Million Hearts Initiative (MHI) intended to examine the extent to which the initiative met the policy process guidelines set forth by the Centers for Disease Control and Prevention (CDC). The three objectives were to identify which CDC policy process domains were met; to identify any gaps in implementing the CDC Policy domains; and finally, to determine if the MHI was successful in preventing 1 million heart attacks and strokes within 5 years. The CDC policy process includes five domains: problem identification, policy analysis, policy and strategy development, policy enactment, and policy implementation (1). Data was collected through the use of key words that subject matter experts utilize when describing cardiovascular disease (CVD) risks and peer-reviewed journal articles. Results showed that not all CDC domains were met and there were also gaps when implementing the MHI.

Million Hearts Initiative, Centers for Disease Control and Prevention, heart attacks, strokes, policy analysis, public policy

Dr. Shivaughn Hem-Lee-Forsyth, Department of Public Health and Preventive Medicine, St. George’s University, True Blue

Books:
1) Centers for Disease Control and Prevention. The CDC Policy Process [Internet]. [cited 2018 March 21]. Available from: https://www.cdc.gov/policy/polaris/training/policy-cdc-policy-process.html

2) National Heart, Lung, and Blood Institute. Know the Differences: Cardiovascular Disease, Heart Disease, Coronary Heart Disease [Internet]. [cited 2019 Jan]. Available from: https://www.nhlbi.nih.gov/sites/default/files/publications/Fact_Sheet_Know_Diff_Design.508_pdf.pdf

3) Boutayeb A, Boutayeb S. The burden of non communicable diseases in developing countries. International Journal for Equity in Health 2005;4(2):1-8.

4) Frieden TR, Wright JS, Conway PH. Is rapid health improvement possible? Lessons from the Million Hearts Initiative. Circulation 2017;135(18):1677- 1680.

5) Million Hearts. Costs & Consequences [Internet]. [cite 2018 Aug 20]. Available from: https://millionhearts.hhs.gov/learn-prevent/cost-consequences.html

6) Sacco RL, Frieden TR, Blakeman D., Jauch EC, Mohl S. What the Million Hearts Initiative Means for stroke: a presidential advisory from the American Heart Association/American Stroke Association. Stroke 2012;43(3),924-928.7

7) Pearson TA. Public policy approaches to the prevention of heart disease and stroke. Circulation 2011;124(23),2560-2571.

8) Centers for Disease Control and Prevention. CDC grand rounds: The Million Hearts Initiative [Internet]. [cited 2018 Aug 21]. Available from: https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6150a1.htm

9) Cardiology Magazine. Million hearts celebrates success, sets new goals for 2022 [Internet]. [cited 2017 Aug 16]. Available from: https://www.acc.org/latest-in-cardiology/articles/2017/08/16/10/42/million-hearts-celebrates-success-sets-new-goals-for-2022

10) Centers for Disease Control and Prevention. Heart disease risk factors [Internet]. [cited 2015 Aug 10]. Available from: https://www.cdc.gov/heartdisease/risk_factors.htm

11) Centers for Disease Control and Prevention. Conditions that increase risk for stroke [Internet]. [cited 2018 March 27]. Available from: https://www.cdc.gov/stroke/conditions.htm

12) Arksey H, O’Malley L. Scoping studies: towards a methodological framework. International Journal of Social Research Methodology 2005;8(1):19-32.

13) Centers for Disease Control and Prevention. Family history and other characteristics that increase risk for heart disease [Internet]. [cited 2015 Aug 10]. Available from: https://www.cdc.gov/heartdisease/family_history.htm

14) Cadet JV. HHS launches massive campaign to curtail heart attacks, strokes. Health Imaging 2011 [Internet]. [cited 2018 Aug 24]. Available from: https://www.healthimaging.com/topics/oncology-imaging/hhs-launches-massive-campaign-curtail-heart-attacks-strokes

15) Tomaselli GF, Harty MB, Horton K, Schoeberl M. The American Heart Association and the Million Hearts Initiative: A presidential advisory from the American Heart Association. Circulation 2011;124,1795-1799.

16) Title IV. Prevention of Chronic Disease and Improving Public Health [Internet]. [cited 2018 Aug 20]. Available from: https://obamawhitehouse.archives.gov/health-care-meeting/proposal/titleiv

17) Giberson SF. Million HeartsTM: pharmacist-delivered care to improve cardiovascular health. Public Health Reports 2013;128(1),2-6.

18. Melynk BM, Orsolini L, Gawlik K, Braun L, Chyun D, Conn V, et al. The Million Hearts Initiative: guidelines and best practices. The Nurse Practitioner 2016;41(2),46-53.

19) Glusenkamp NT, Oetgen WJ, Mullen B. The Million Hearts Initiative – targeting key drivers of cardiovascular mortality from a medical specialty society perspective. US Cardiology Review 2012;9(1),66-70.

20) Staff N. AAFP Voices Support for HHS’ Million Hearts Initiative [Internet]. [cited 2011 Oct 12]. Available from: https://www.aafp.org/news/health-of the-public/20111012millionhearts.html

21) O’Brien JM. Million Hearts: the role of pharmacy, pharmacy benefit design, and improving medication adherence [PowerPoints Slides]. Accessed 2018 Aug 30.

22) Premier, Inc. awarded key subcontract from Deloitte consulting LLP to support the implementation of the Million Hearts cardiovascular disease risk reduction model [Internet]. [cited 2018 Feb 1]. Available from: http://investors.premierinc.com/news/press-release-details/2016/Premier-Inc-Awarded Key-Subcontract-from-Deloitte-Consulting-LLP-to-Support-the-Implementation-of-the-Million-Hearts-Cardiovascular-Disease-Risk-Reduction Model/default.aspx

23) Be one in a MILLION HEARTS: preventing 1 million heart attacks and stroke over 5 years [Internet]. [cited 2018 Aug 30Available from: https://www.heart.org/idc/groups/heart-public/@wcm/@mwa/documents/downloadable/ucm_459306.pdf

24) Million Hearts: strategies to reduce the prevalence of leading cardiovascular disease risk factors --- United States, 2011. Centers for Disease Control and Prevention 2011;60(36),1248-1251.

25) D’Arrigo T. Changes coming to Million Hearts. American Public Health Association 2017 [Internet]. [cited 2018 Aug 30]. Available from: https://www.pharmacist.com/article/changes-coming-million-hearts

26) Million Hearts. Million Hearts: meaningful progress 2012-2016 [Internet]. [cited 2018 Aug 25]. Available from: https://millionhearts.hhs.gov/files/MH meaningful-progress.pdf

27) Pirruccello JP, Traynor K, Aragam KG. “Road map” to improving enrollment in cardiac rehabilitation: identifying barriers and evaluating alternatives. Journal of the American Heart Association 2017;6,e007468.8

28) Schopfer DW, Forman DE. Benefits of cardiac rehabilitation in older adults. American College of Cardiology 2016 [Internet]. [cited 2018 Sept 5]. Available from: https://www.acc.org/latest-in-cardiology/articles/2016/10/19/09/22/benefits-of-cardiac-rehabilitation-in-older-adults

29) CDC Million Hearts Initiative & Men’s Health Network State of Men’s Heart Health Webinar Transcript [Internet]. [cited 2013 June 3]. Available from: https://millionhearts.hhs.gov/files/MensHealth_transcript.pdf

30) Richey MD, Hannan J, Wall HK, George MG, Sperling LS. Notes from the Field: Characteristics of Million Hearts Hypertension Control Champions, 2012-2019. MMWR. 2020;69(7):196-197.

31) Ritchey MD, Wall HK, Hannan, J, Sperling LS. Million Hearts: 2012-2016 Final Report Addendum, June 2020 [Internet]. [cited 2021 April 23]. Available from: https://millionhearts.hhs.gov/files/MH_final_report_addendum_2020.pdf

VOLUME 04 ISSUE 06 JUNE 2021