CDC National Heart Disease and Stroke Prevention Program

Maine
Basic Implementation

The Maine Bureau of Health in the Maine Department of Health Services began receiving funds from CDC in 2000 to support a state heart disease and stroke prevention program.

Burden of Heart Disease and Stroke

• Nearly 1 out of 4 deaths in Maine are due to heart disease. (National Vital Statistics Report, 2009.)
• 2,815 Mainers died from heart disease in 2006 (22.9% of total deaths in Maine). (National Vital Statistics Report, 2009.)
• 670 Mainers died from stroke in 2006 (5.4% of total deaths in Maine). (National Vital Statistics Report, 2009.)

See the Maine Cardiovascular Health Program Web site for statistics.

• According to 2007 Behavioral Risk Factor Surveillance System (BRFSS) survey results,  adults in Maine reported having the following risk factors for heart disease and stroke:
  
  • 28.7% had high blood pressure
  • 40.2% of those screened reported having high blood cholesterol
  • 7.8% had diabetes
  • 20.2% were current smokers
  • 62.9% were overweight or obese (Body Mass Index greater than or equal to 25.0)
  • 44.0% reported no exercise in the prior 30 days
  • 71.4% ate fruit and vegetables less than 5 times a day

Key Responsibilities

• Facilitate collaboration among public and private sector partners, such as managed care organizations, health insurers, federally funded health centers, businesses, priority population organizations, and emergency response agencies.
• Define the burden of heart disease and stroke and assess existing population-based strategies for primary and secondary prevention of heart disease and stroke within the state.
• Develop and update a comprehensive state plan for heart disease and stroke prevention with emphasis on heart-healthy policies development, physical and social environments change, and disparities elimination (e.g., based on geography, gender, race or ethnicity, or socioeconomic status).
• Identify culturally appropriate approaches to promote heart disease and stroke prevention among racial, ethnic, and other priority populations.
• Use population-based public health strategies to increase public awareness of the heart disease and stroke urgency, the signs and symptoms of heart disease and stroke, and the need to call 9–1–1.
• Support health care organizations system changes to assure quality of care and implementation of primary and secondary prevention for heart disease and stroke.
• Monitor, implement, and evaluate prevention strategies and programs in health care settings, work sites, and communities.
• Provide training and technical assistance for health care professionals, and partners to support primary and secondary prevention of heart disease and stroke.
• Monitor quality of care for primary and secondary prevention.

State Highlights

• The Maine Cardiovascular Health Program (MCVHP) works collaboratively with the 28 established Healthy Maine Partnership (HMP) coalitions to address chronic disease prevention through policy and systems changes. Through the Fund for a Healthy Maine, the MCVHP assists the HMP coalitions to address high blood pressure, high cholesterol, and timely treatment for heart attack and stroke. For example, 22 of the 28 HMP coalitions are working to increase access to community resources and support for prevention and control of high blood pressure and high cholesterol.
• Healthy Maine Works is a collaborative project of the Maine Center for Disease Control, Maine Office of Substance Abuse, and Maine Department of Education, delivered in collaboration with local HMPs. Healthy Maine Works’ purpose is to support Maine employers in the development of work site wellness programs. Healthy Maine Works offers training, web-based assessment, program planning tools, and continuing technical assistance to employers in developing and maintaining work site wellness programs. Web-based tools for Maine employers integrate work site health promotion and chronic disease management  of multiple partner programs (e.g. MCVHP, Diabetes Prevention and Control, Tobacco, Physical Activity and Nutrition).
• Nineteen HMP coalitions have assisted employers in creating user accounts through Healthy Maine Works, and 12 of the 19 HMP coalitions assisted three or more work sites in account establishment. The user account allows an employer to access assessment tools to identify health-related priorities, receive recommendations for program development, and create a work site wellness action plan reflective of employee needs.  As of June 2010, 97 work sites have Healthy Maine Works’ user accounts, and 59 work sites have completed a baseline inventory and accessed strategies for establishing work site wellness programs. These employers have the potential to reach 12,272 employees with programs to improve blood pressure and cholesterol control. A web-based survey conducted in spring 2010, documented that 57% of HMP coalitions have used Healthy Maine Works.
• Through the MCVHP Healthcare Systems Intervention to Improve Detection and Control of High Blood Pressure, over 40 blood pressure master trainers (BPMTs) trained 919 clinical staff in 110 primary care settings, which is approximately 26% of Maine’s primary care practices.  Training improved knowledge and skills of clinical professionals—improvements that were sustained four and six months post-training. BPMTs also implemented environmental and quality improvements, such as calibration and maintenance standards for equipment in primary care and other health care settings. This intervention has the potential to reach 75,168 patients.
• MCVHP participates in the Maine Practice Improvement Network to increase participation in public reporting initiatives, such as National Committee for Quality Assurance (NCQA) and Bridges to Excellence. These efforts help to improve cardiovascular outcomes, share learning experiences, and facilitate mentoring among clinical practices on the use of electronic medical records (EMR) to improve management of blood pressure control. In May 2010, the number of practices receiving NCQA certification for office systems (which includes use of EMR) increased from just 9 in 2008 to 268. Approximately 186,528 adult patients with high blood pressure will be affected by this educational effort.
• The MCVHP and the Diabetes Prevention and Control program have a statewide strategic planning process underway that involves a variety of diverse partners. This 10-year plan will require stakeholders to address issues such as statewide health care systems quality improvement initiatives. Partners include Quality Counts, Maine Patient-Centered Medical Home (PCMH) Pilot, and Aligning Forces for Quality. The Maine PCMH Pilot consists of 26 primary care practices and received Medicare funding through Dirigo Health Agency. The activities of these practices will provide input into the development of the chronic disease strategic plan.
• HealthInfoNet is an independent, nonprofit organization created to develop a statewide system for sharing clinical information in Maine. This system will permit the sharing of patient health care information across health care providers and organizations. The Maine regional extension centers will manage a process of group purchasing, service contracting, and support services that will implement and optimize the use of EMRs in Maine. The system’s objectives will be to drive down the cost of investment in EMR technology, help providers successfully implement EMRs, and optimize the use of EMR technology by providers in conjunction with “meaningful use” criteria.

For more information visit Maine's heart disease and stroke prevention program..

To view county-level data, visit our interactive map site.