Testing a Community Intervention to Increase Aspirin Use
Condition: Myocardial Infarction; Stroke
MeSH terms: Myocardial Infarction; Infarction
Study type: Interventional

Summary: 
      This research will test the effect of mass media or mass media plus a clinic based education
      program will improve appropriate aspirin use for cardiovascular disease prevention. It is a
      group randomized design of 24 geographic areas in Minnesota with adjacent states serving as
      controls.
    

Detailed description: 
      Proposed is a demonstration and implementation project to increase the appropriate use of
      aspirin for primary prevention of acute myocardial infarction and stroke in the population of
      Minnesota. Although significant progress in the reduction of acute myocardial infarction and
      stroke is apparent, these cardiovascular disorders continue as the leading causes of
      morbidity and mortality. In recent years, and in the context of the positive results from
      large randomized clinical trials, there is growing consensus that aspirin, when appropriately
      used, reduces cardiovascular morbidity in men aged 45-79 and women aged 55-79 years. The use
      of aspirin for primary prevention was recommended in the U.S. Preventive Services Task Force
      Report in 2009 and more recently in the CDC/CMS 'Million Hearts' ABCs (aspirin, blood
      pressure, cholesterol, smoking) campaign. Aspirin use is also recommended in the Healthy
      People 2020 goals. However, many adults who would benefit, are not taking aspirin.

      The investigators have been fortunate to receive a large philanthropic donation to launch a
      campaign to increase appropriate aspirin use in the State of Minnesota. The proposed grant
      requests funding to evaluate that campaign and the innovative approaches it proposes. In the
      context of a innovative mass media effort, the investigators intend to test new methods for
      health system change to increase appropriate aspirin use. Using a two-arm design, the
      investigators have defined 24 geographic areas in the state that will form the basis for a
      group-randomized trial. This design will allow us to distinguish the effects of the
      intervention methods. The interventions will be evaluated by sequential surveys of the
      target-age general population at baseline and follow-up. Appropriate aspirin use in that
      population will be the primary goal and endpoint. Simultaneous surveys of adjacent Upper
      Midwestern states (Iowa, North and South Dakota, Wisconsin) will assess secular trends.
      Morbidity and mortality data will monitor disease trends and complications associated with
      aspirin use.

      A substantial pilot study in a middle sized community in Northern Minnesota allows us to
      refine and validate our intervention and measurement methods at the community level. This
      pilot also demonstrated behavior change of a magnitude supportive of our design assumptions.

      This program, if successful, should result in a generalizable program tested in a real world
      population setting.
    

Intervention name(s): Mass Media plus clinic intervention.; Media
Intervention type(s): Other; Other
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Prevention
Keywords: Cardiovascular Disease