History of CHAP

The Cardiovascular Health Awareness Program (CHAP) was begun in 2000 and was developed through a number of pilot projects, scientific trials, and community-wide demonstrations.

Five Phases of Development of the Community Cardiovascular Health Awareness Program

PHASE 1: What is the feasibility of offering cardiovascular health promotion sessions in local pharmacies?

Pilot Study completed in Dundas, Ontario in spring of 2001

  • Explored effective approaches to invite patients to attend local health promotion sessions involving the four pharmacies geographically close to one physician’s office.

Pilot Study completed in Ottawa, Ontario in summer of 2002

  • Explored feasibility of working with community members and primary care providers to successfully link cardiovascular risk factors collected in community health promotion sessions to family physicians and pharmacists.

Community Hypertension Assessment Trial (CHAT) completed in Ottawa and Hamilton, Ontario in 2003

  • Successfully determined  “proof of concept” of community pharmacy based blood pressure monitoring sessions led by volunteers and providing feedback to family physicians and pharmacists.

PHASE 2: Can a Cardiovascular Health Awareness Program be successfully implemented at a community level?

Community-wide implementation in Grimsby and Brockville, Ontario in 2004

  • Successfully delivered a community-wide cardiovascular disease prevention program, inviting all family physicians and pharmacists in the communities to participate. 30% of the total population of seniors 65 years and older participated.

Cardiovascular Health Assessment Diabetes (CHAD) in Grimsby, Ontario in winter 2005

  • Explored feasibility of a community health promotion program to detect type 2 diabetes in participants older than 40 years of age.

Airdrie Cardiovascular Health Awareness and Management Program (ACHAMP) in Airdrie, Alberta in 2005-06

  • Replicated the Ontario projects in Alberta with similar community uptake of the program and generation of knowledge that blood pressure reductions and lifestyle changes occur after participating in CHAP.

PHASE 3: Can CHAP work at a multi-community level?

Multi community implementation and evaluation of the Community Cardiovascular Health Awareness Program (C-CHAP) across communities Ontario in 2006

A 10-week implementation of CHAP in 20 Ontario communities:

  • 338 family physicians agreed to receive feedback on participants’ blood pressure and other risk factors
  • 214 family physicians actively invited their patients to participate in CHAP either through personalized letters, prescriptions for assessment or community-wide advertising
  • 129 pharmacies held CHAP sessions
  • 1,265 three-hour long CHAP sessions were held
  • 15,889 adults attended at least one CHAP session, representing 25% of the total older adult population in the 20 communities
  • 27,358 risk assessments were conducted
  • 577 older adult volunteers were trained as peer health educators

Hospitalization for stroke, congestive heart failure and heart attack were substantially reduced compared to 19 other communities that did not operate CHAP over the same period of time

PHASE 4: Can a sustained form of CHAP work at a community level?

Sustaining and evaluating an enhanced CHAP in communities across Ontario in 2008

  • Determined the feasibility of creating a sustainable model of CHAP for long-term implementation in communities, while also expanding several components of the program.

Reinforcing CHAP+AP in communities across Ontario from 2008- 2010

  • Delivered a robust, year round sustainable CHAP model in CHAP communities in Ontario. Worked towards developing tools and best practices to gain wide adoption and ongoing quality improvement of CHAP across the province and Canada.

PHASE 5: How do we adapt CHAP to different community situations and maintain its impact?

  • Currently, developing a program of research to adapt, implement and evaluate in large urban communities with distinct cultural groups in Laval, Québec and in York Region, Ontario, the Canadian Chronic Disease Awareness and Management Program (C-ChAMP).