Introduction
Coronary heart disease is a significant public health issue in England. The public health challenge related to coronary heart disease is depicted by the fact that it is one of the leading causes of mortality in Europe. According to the World Health Organization (2017), cardiovascular disease is responsible for over half of deaths in Europe. The problem of coronary heart disease is also important in public health practice because 80% of premature heart disease is preventable (Nichols, Townsend, Scarborough, and Rayner, 2013). NHS England (2017) reveals that cardiovascular disease morbidity in England is increasing. It affects 34 of every 100,000 women and 154 of every 100,000 men in England. Coronary heart disease is correlated to the socioeconomic variables. It is more prevalent among low socioeconomic groups (Cannon et al., 2010). Notably,t the etiology or risk factors for coronary heart disease are multi-factorial. Heran et al. (2011) indicate that coronary heart disease is associated with the interaction of environmental, lifestyle, and genetic factors. Specific lifestyle factors, such as poor diet, are reported to contribute most to mortality due to cardiovascular disease (Bajekal et al., 2012).
The risk of developing specific heart conditions, such as coronary heart disease increases with age. Socioeconomic deprivation in Coventry is closely linked to coronary heart disease (Bertuccio et al., 2011). Cannon et al. (2010) explain that factors that contribute to heart disease, such as alcohol, diet, exercise, use, and smoking are closely related to the socioeconomic status or conditions of affected individuals. For instance, the World Health Organization (2017) reveals that more than 20% of cardiovascular conditions are a result of smoking. Cardiovascular disease is also an issue of concern due to associated health costs. For example, in 2009, the healthcare system in the United Kingdom spent over £8.7 billion on managing cardiovascular disease (NHS England, 2017).
Coronary heart disease is associated with the narrowing of arteries, which leads to a lack of oxygen or ischemia. Nichols et al. (2013) reveal that the heart of an individual with coronary heart disease normally responds with angina. Additionally, coronary heart disease is likely to cause myocardial infarction or heart attack (Purdy, Griffin, Salisbury, and Sharp, 2011). Permanent damage to the heart and resultant death are other possible outcomes of coronary heart disease. The high cost of treatment for coronary heart disease represents its negative social and economic impact on affected families and communities (Bajekal et al., 2012). In addition, people with coronary heart disease are often rendered less productive. Coronary heart disease also affects the psychological well-being of affected individuals and families. The negative social and economic effects of coronary heart disease on communities in Coventry justify an investigation into associated public health issues (Williams, Stamatakis, Chandol, and Hamer, 2011). Investigation into coronary heart disease in Coventry is necessary for indicating evidence-based The present report aims to provide a comprehensive discussion on the application of the epidemiology approach to determine interventions for tackling coronary heart disease among adults in Coventry. The objectives of the report are to discuss epidemiological methods of determining the prevalence of coronary heart disease in Coventry and to determine interventions for tackling the identified public health problem. The report also focuses on discussing how to implement evidence-based intervention to address the high prevalence of heart disease in Coventry. The epidemiology approach is preferred for the investigation as it provides opportunities for assessing the nature and severity of public health issues (Nichols et al., 2013).
Epidemiological Methods to Measure the Prevalence of Coronary Heart Disease in Adults in Coventry
Before determining interventions for tackling coronary heart disease among adults in Coventry, it is necessary to establish the prevalence of the public health problem (Ahrens and Pigeot, 2014). It is important to specifically determine factors that increase the predisposition of adults in Coventry to coronary heart disease, including socioeconomic variables and lifestyle factors (Abramson and Abramson, 2011). In addition, the consequences or effects of coronary heart disease on communities in Coventry should be determined. There are specific methods that can be used to determine the prevalence of coronary heart disease among adults in Coventry and associated etiological factors and consequences. A cross-sectional study design is most appropriate for determining the prevalence of coronary heart disease among adults in Coventry (Mukherjee and Patil, 2011). All factors related to the prevalence of coronary heart disease among adults in Coventry, including exposure, confounders, and outcome will be measured concurrently through the use of a cross-sectional study (Ahrens and Pigeot, 2014). An ecological study design is also used to determine the prevalence of a condition. However, an ecological study is not appropriate for this project as it focuses on the implementation of interventions at the population level rather than the individual level (Sattelmair et al., 2011).
A cross-sectional study will be carried out by first recruiting a representative sample that will include adults in Coventry at high risk of developing coronary heart disease. The study sample will provide a snapshot of specific factors that predispose participants to coronary heart disease, such as smoking, poor dietary choices, and socioeconomic deprivation (Abramson and Abramson, 2011). Cross-sectional study is also preferred for the study project as it is comparatively cheaper. It also provides a quick option for gathering adequate data for measuring the prevalence of a health condition (Mukherjee and Patil, 2011). Therefore, through a cross-sectional study, the research project will be carried out within a short period. However, it is notable that a cross-sectional design is associated with the challenges of establishing simple associations or relationships between cause and resultant outcomes. This is because cause and outcome are investigated simultaneously during the implementation of a cross-sectional study design. A cross-sectional study is also limited as it may not measure the health-related outcomes of participants who die before the commencement of a study (Sattelmair et al., 2011). Therefore, survival bias is anticipated in the study project.
Epidemiological methods of measuring the prevalence of a health condition allow for the collection of two types of research data: primary and secondary data. Primary research data allows for the gathering of first-hand data about a specific health condition. Primary data is useful in ascertaining etiological factors and relating them to the prevalence of a health condition (Mukherjee and Patil, 2011). Nonetheless, primary research is often involving, time-consuming, and expensive (Abramson and Abramson, 2011). In the current research project, secondary data will be used to determine or measure the prevalence of coronary heart disease among adults in Coventry. Secondary data is preferred since documented data on the issue under investigation is easily available. More importantly, secondary data requires minimal financial and time resources. It is also less involved as it provides for the collection of vast amounts of data from published information sources (Sattelmair et al., 2011). Standardized data collection tools that are used in gathering secondary data also create opportunities for minimizing selection bias in the present research project. However, with secondary research, methodological challenges that were experienced by authors of secondary research documents can be transferred to the present research (Ahrens and Pigeot, 2014).
Examples of secondary data sources that will be useful to the present research include public health reports and national health surveys. Secondary data related to risk factors for coronary heart disease, such as rate of smoking, alcohol abuse, and socioeconomic variables will be collected, analyzed, interpreted,d and used to measure how they influence the prevalence of the condition among adults in Coventry. Websites reporting on public health issues affecting the adult population in Coventry will also be used as reliable sources of secondary data. This includes publications within WHO and NHS websites. Local NHS medical records will be specifically used to provide a clear picture of the prevalence of coronary heart disease among adults in Coventry.
Epidemiological Methods of Determining Interventions for Tacking Coronary Heart Disease in Adults in Coventry
After measuring the prevalence of coronary heart disease among adults in Coventry and associated etiological factors, interventions for addressing the public health issue will be identified and justified. These interventions include specific public health actions or initiatives and social programs that will be used to reduce the prevalence of coronary heart disease in adults in Coventry. The most appropriate epidemiological method of identifying interventions for addressing the public health problem is evidence synthesis. This method will allow for the analysis and interpretation of current empirical evidence on public health actions used to address coronary heart disease to identify and implement evidence-based interventions (Koepsell and Weiss, 2014). Therefore, a wide range of published studies will be analyzed to identify and support interventions that are most effective in addressing the burden of coronary heart disease in adults in Coventry. The evidence synthesis will aim to assess the strengths and setbacks of specific interventions for addressing coronary heart disease within a population. The proposed epidemiological method will be used to identify public health actions most suitable for dealing with the health issue.
The needs of stakeholders within the Coventry community will be considered in the identification and implementation of interventions for tackling coronary heart disease among adults (Ahrens and Pigeot, 2014). Health needs assessment methods will be used to determine the specific needs of the Coventry community related to the risk and morbidity of coronary heart disease among adults. Data from the needs assessment will be used to plan for effective interventions and implement them to minimize the burden of coronary heart disease in Coventry. Health needs assessment refers to an organized method of assessing the health problems affecting a specific population to guide the planning of interventions for improved health outcomes (Abramson and Abramson, 2011). The allocation of resources to public health programs and initiatives for the implementation of interventions for tackling coronary heart disease in Coventry will be informed by the findings of the health needs assessment.
Stakeholders such as public health professionals, clinicians, local healthcare organizations, and members of the Coventry community will be involved in the identification and implementation of interventions for tackling coronary heart disease. The identified stakeholders will be specifically involved in the implementation of the f community profiling method of epidemiological studies. The community profiling method is effective in determining specific lifestyle factors that influence the high prevalence of coronary heart disease among adults in Coventry (Fletcher, Fletcher, and Fletcher, 2012). Through community profiling, risk factors such as alcoholism, smoking, poor eating habits, and inactive lifestyles will be identified and associated with coronary heart disease. Community profiling provides for the use of reliable quantitative data that will be used to identify the most relevant and effective intervention for tackling coronary heart disease. Focus group discussions will also be carried out to provide stakeholders of the community to contribute towards the identification of interventions for addressing high-priority problems that contribute to the high prevalence of coronary heart disease among adults in Coventry. Consensus among community stakeholders will pave the way for planning and implementation of action that will lead to the realization of the goal of implementing identified interventions for tackling coronary heart disease.
Evidence-based interventions are recommended in the mitigation of health problems that contribute to the increasing incidence and prevalence of coronary heart disease (Koepsell and Weiss, 2014). Public health education is among the evidence-based interventions that are effective in addressing public health problems, such as coronary heart disease in the adult population. Notably, evidence on the effectiveness of policy interventions in dealing with public health problems is inconclusive. The interventions that will be applied in tackling coronary heart disease in Coventry will be assessed in the context of cost, duration of the implementation, and effectiveness in achieving desired outcomes.
Implementation of Evidence-Based Interventions to Tackle Coronary Heart Disease in Adults in Coventry
Evidence-based interventions for tackling coronary heart disease in Coventry include promoting cardiovascular health through public education programs (Ahrens and Pigeot, 2014). The intervention will be implemented within multiple settings including community forums, adult education programs, health and fitness activities, and healthcare settings. Promotional programs will also be implemented to encourage change in lifestyles and reduction of risks of developing cardiovascular disease, especially coronary heart disease. The health promotion programs will target adults in Coventry, including high-risk groups such as people from low socioeconomic groups (Mukherjee and Patil, 2011). The goal of health promotion programs will be to encourage desirable environmental and social conditions for improved cardiovascular health among adults in Coventry. In addition, the program will focus on promoting positive behavioral patterns, such as living active lives. More importantly, the health promotion program will advocate for the accessibility of screening and healthcare services for adults with increased risk of cardiovascular disease.
Coronary heart disease among adults in Coventry will also be tackled through collaborative efforts among stakeholders meant to increase training opportunities for public health professionals and clinicians in the context of cardiovascular health. Training programs will enable practitioners to implement high standards for preventing coronary heart disease and other chronic conditions of the heart (Abramson and Abramson, 2011). Technical support for screening for cardiovascular health will also be enhanced through effective training of practitioners. Additional skills and competencies will enable public health providers to implement evidence-based interventions for effective mitigation of risk factors of coronary heart disease among adults in Coventry. Collaboration among public health agencies and healthcare organizations within Coventry will result in the implementation of comprehensive training programs designed to tackle the public health problem (Koepsell and Weiss, 2014).
Expansion of data on cardiovascular health is another effective intervention for addressing the problem of coronary heart disease in Coventry. Through the expansion of health data, systematic evaluation and monitoring of programs and interventions for the reduction of risk factors for cardiovascular disease will be possible. Evaluation of the health needs of adults in Coventry with an increased risk of coronary heart disease is also possible through the expansion of health data. Ahrens and Pigeot (2014) indicate that cardiovascular health data should also be upgraded regularly to ensure that emerging needs are addressed by public health programs. Data on risk factors, mortality prevalence, and incidence rates should be upgraded and made available to stakeholders to support their efforts of addressing public health issues that influence the development of coronary heart disease in adults from Coventry.
The implementation of actions for tackling coronary heart disease in Coventry requires immediate action based on preventative methods. However, programs for tackling coronary heart disease require the commitment of local and national public health agencies (Fletcher et al., 2012). Health promotion actions for the prevention of cardiovascular disease among adults in Coventry will be focused on advancing the Health People 2020 goal. For instance, actions for improving cardiovascular health among adults in Coventry will be implemented through the prevention of risk factors, screening, and treatment. Koepsell and Weiss (2014) demonstrate that early identification of risk factors for coronary heart disease contributes significantly to the reduction of mortality from cardiovascular disease. The controllable or modifiable risk factors that will be managed in the implementation of public health programs for tackling coronary heart disease include high cholesterol, high blood pressure, smoking, obesity, physical inactivity, ty and unhealthy diet (Ahrens and Pigeot, 2014).
Monitoring and Evaluation
The RE-AIM framework will be used to monitor and evaluate the effectiveness of interventions for tackling coronary heart disease among adults in Coventry. The framework was designed to enable stakeholders to examine and assess the effectiveness of essential elements or aspects of public health programs and interventions (Gaglio, Shoup, and Glasgow, 2013). For example, the RE-AIM framework provides for the evaluation of the internal validity of public health programs in line with the epidemiological methods used to address health problems (Allen, Zoellner, Motley, and Estabrooks, 2011). The RE-AIM framework is effectively used to determine whether or not a health program or intervention is evidence-based and suitable for achieving desired goals. The specific aspects of the RE-AIM framework that will be used to evaluate interventions for the mitigation of coronary heart disease among adults in Coventry include reach, adoption, efficacy, implementation, and maintenance.
The public health program will be evaluated in the context of the number of adults in Coventry who will participate in its implementation. The efficacy of the program is the impact that it will have in tacking coronary heart disease in Coventry (Gaglio et al., 2013). Outcomes of the program, such as change in health behaviors among members of the target population will be assessed to determine the effectiveness of proposed public health interventions. The social and economic outcomes of the program implementation will specifically be assessed and monitored to determine its efficacy (Kessler et al., 2013). The adoption of the program will also be measured. Data on the number of stakeholders, including local healthcare organizations, clinicians,s and public health professionals participating in the program will also be used to determine its effectiveness.
The implementation of the public health program for tackling coronary heart disease in Coventry will be evaluated and monitored in terms of efficiency, resource utilization, cost, and time of delivery. The maintenance of the program will also be evaluated. Allen et al. (2011) explain that the maintenance of a program is measured in line with the extent to which it is institutionalized. The proposed interventions for tackling coronary heart disease in Coventry will be effective if they are institutionalized and integrated into standard practices within local healthcare organizations. In addition, the proposed interventions will be monitored for sustainability. The interventions should be able to have a lasting impact on the health conditions of adults in Coventry, especially those who have an increased predisposition to coronary heart disease (Gaglio et al., 2013).
Conclusion
Coronary heart disease is a public health problem in Coventry due to its contribution to increasing morbidity and mortality from cardiovascular disease. The public health issue is also associated with undesired social and economic effects. Coronary heart disease specifically impacts negatively on the general well-being of the adult population in Coventry. The epidemiologic approach is suitable for identifying and implementing methods for determining the prevalence of coronary heart disease in Coventry. Interventions for tackling coronary heart disease among adults in Coventry are effectively implemented using epidemiologic methods, such as cross-sectional study design, health needs assessment, and evidence synthesis. The RE-AIM framework is effective in evaluating the effectiveness of interventions for tackling coronary heart disease, such as public health education, training,g and expansion of health data.
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