Creation of a Community-Based SMBP Monitoring Program Including Physical Activity and Lifestyle Modification in South Dakota

Submission Date: April 2023

State/Territory Submitted on the Behalf of: South Dakota

States/Territories Involved: South Dakota

Funding Source: CDC

CDC Funding:

Yes

CDC Funding (Specified):

Other CDC Funding

Grant Number:

DP18-1815: Strategies for Improving the Health of Americans Through Prevention and Management of Diabetes, Heart Disease, and Stroke

Other Funding:

Other

Domain Addressed:

Community-Clinical Linkages, Health Promotion, Health Systems Strategies

Public Health Issue:

Heart disease is the leading cause of death in South Dakota, with 18.5% of deaths attributed to heart disease and 4.3% of deaths attributed to stroke. According to national statistics, approximately 30% of adults in South Dakota are aware they have high blood pressure, a leading risk factor for cardiovascular disease; however, only 54% have their blood pressure under control.

Evidence-based strategies to improve blood pressure control include Self-Measured Blood Pressure (SMBP) monitoring, the regular measurement of blood pressure by the patient outside the clinical setting, either at home or elsewhere, plus additional clinical support. Clinical support can include one-on-one counseling, web-based or telephonic support tools, and educational classes.

Project Objectives:

The South Dakota (SD) Department of Health (DOH) provided funding for an innovative program to increase the reach and effectiveness of evidence-based programming through a clinical-community collaboration to implement and support SMBP monitoring.
The goals of the community-based SMBP monitoring program were to:
• teach people the proper technique to take their own blood pressure,
• collect frequent blood pressure readings, and
• achieve better blood pressure control.

Program Action:

The South Dakota Department of Health, Sanford Health of Mitchell, and the City of Mitchell Recreation Center were key partners in this collaboration. Mitchell Rec Center designed an innovative program, Cardio Index, combining physical activity, lifestyle modification, and SMBP monitoring. The Rec Center recruited clients by offering the Cardio Index program to all interested adults and, once enrolled, contacted participants’ healthcare providers.

Cardio Index program participants were instructed on the correct way to measure blood pressure and received a blood pressure cuff on loan for two weeks. Participants measured and recorded 10 blood pressure readings at the beginning of the program and then participated in six weeks of personal training at no charge. After the conclusion of the six-week program, participants measured and recorded 10 more blood pressure readings.

Data/Other Information Collected:

As of June 2021, 70 participants have entered the Cardio Index program, and 26 have completed the entire program. Of the 26 participants completing the program, 21 have decreased their 7-day averages in systolic and diastolic BP for both morning and evening readings.

Impact/Accomplishments:

Implementing SMBP monitoring with clinical support among adults with hypertension, along with at least 150 minutes of light to moderate physical activity each week, has created healthier habits in Cardio Index participants. Dietary tracking and consistent BP monitoring, both in the morning and evening, have resulted in increased accountability.

Additionally, a systematic change has occurred due to the development of the Cardio Index program at the Rec Center. The Rec Center’s identity and marketing approach has taken on a new look, focusing more on helping community members with chronic conditions than the traditional fitness center model. The Rec Center has shifted staff to provide more time for each participant to engage them in every aspect of their wellness journey.

Challenges/Lessons Learned:

The Mitchell Rec Center faced many challenges as the first non-clinical, community-based program to offer SMBP monitoring in South Dakota. One challenge of the program was sharing data about participants’ BP readings between the Rec Center and healthcare providers. To ensure patient confidentiality, the Rec Center ultimately decided to hand-deliver the data to the healthcare facilities. Another challenge arose when COVID-19 prevented participants from coming into the facility and participating in one-on-one training sessions. The Rec Center adapted to this challenge by providing continued support to participants virtually, as did so many others.

Next Steps:

The Mitchell Recreation Center will continue the program through June 2023 and extend it if possible. The goal is to expand this program to other fitness facilities by having the Cardio Index program replace the facility’s enrollment benefit package. Typically, when a member signs up at any gym, they can meet with a fitness professional a certain number of times for free. The Rec Center plans to expand what they have created in private settings by giving them the model for Cardio Index and allowing them to implement it in place of free services they currently offer. This will extend the scope and influence of the program’s true purpose, which is to encourage engagement between participants and their relevant healthcare providers.

Program Areas:

Heart Disease and Stroke

State Contact Information:

South Dakota
Rachel Sehr, BSN, RN
South Dakota Department of Health
605.367.5356
Rachel.Sehr@state.SD.us

Board President's Challenge:

No

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