Correspondence to Martha N. Hill, PhD, RN, Johns Hopkins University, 525 Wolfe St, Baltimore, MD 21205-2110.
As noted in my
Presidential Address at the 70th Scientific Sessions of the American
Heart Association,1
cardiovascular disease and stroke remain the No. 1 and
No. 3 causes of death, respectively, of all
Americans.2 This is due in part to a gap that
exists between effective interventions in clinical trials to improve
patient care and outcomes and daily practice of healthcare
professionals as well as daily behavior of patients and the
public.3 4 5 6 7 8 9 10 11 12 To increase its contribution to the
AHA's mission, which is to reduce morbidity and mortality due to heart
disease and stroke, the AHA research program continues to support
talented researchers who are advancing our knowledge about genetics, as
well as meritorious behavioral and clinical research reviewed through
the Behavioral Science, Epidemiology, and
Prevention Study Group created 5 years ago. The AHA has recently
undergone dramatic changes in organizational structure and processes to
increase efficiency and effectiveness in meeting its mission. These
changes have led to the development of more highly focused efforts in
communications, public advocacy, fund-raising, and education to
leverage AHA's resources as the leading nongovernment agency fighting
heart disease and stroke.
Another topic discussed in my President's Address was the importance
of establishing science priorities and developing effective strategies
for achieving goals related to the AHA's mission. The AHA must
consider the full spectrum of science, from investigations of
mechanisms with the basic sciences studied in the laboratory, to
investigations of therapies with the clinical sciences studied in
healthcare settings, to investigations of prevention with the social
and behavioral sciences studied in communities. In addition to
continuing to support the most meritorious basic science research, the
AHA also must support research that responds more directly to the needs
of patients with heart disease or stroke and their families. In
responding to the challenge of establishing research priorities in
clinical and behavioral medicine, AHA science volunteers have
developed, with the generous financial contributions of the AHA
Pharmaceutical Roundtable members, a new targeted research program
entitled Cardiovascular Care and Outcomes Research.
The need for care and outcomes research, including access to quality
care, coordinated delivery of health care, clinical effectiveness and
cost-effectiveness, informed choices by patients, patient adherence,
and health promotion at the individual, group, and community levels is
reflected in AHA scientific and policy statements, including:
The new AHA Cardiovascular Care and Outcomes
research program will provide a mechanism to evaluate the impact of
translating cardiovascular science into clinical
practice guidelines intended to improve practice and thereby improve
patient care and outcomes. For example, the AHA is using its
evidence-based guidelines to develop recommendations for Health
Employer Data and Information Set (HEDIS) measures related to the
primary and secondary prevention of cardiovascular
disease and stroke. The development of future effective recommendations
for improving healthcare depends on funds supporting patient care and
outcomes research. Such research will support AHA collaboration with
partners including the National Committee for Quality Assurance, the
Foundation for Accountability, the Agency for Health Care Policy
Research, the American College of Cardiology, the
American College of Family Practice, the Health Care Quality Alliance,
and many other organizations. Through the new targeted research
program, the AHA can stimulate academic health science centers to
enhance existing health education, behavioral medicine, and health
services research programs.
Clearly, the AHA has limited resources to fund the wide array of
research needed to improve the prevention and treatment of
cardiovascular disease and stroke; however, the AHA can
continue to demonstrate leadership by encouraging other government
agencies and foundations to join us in supporting this needed research.
Research focusing on human health is not new, but if we are to improve
the effectiveness of patient care over time, especially for underserved
high-risk populations, we must commit our creativity and scientific
rigor to meeting this challenge. Research is needed to develop
effective tools and methodologies harnessing new communications
technology. Research is also needed to implement and evaluate programs
that lead to behavior change among patients, healthcare providers, and
healthcare organizations over time.
The purpose of the new AHA targeted research program is to stimulate
innovative and methodologically rigorous research designed to improve
the prevention or treatment of heart disease and stroke. The
description for this program was conceived by an expert advisory panel
cochaired by Richard Carleton, MD, and Harlan Krumholz, MD, with
liaison members from the Research Committee and the Research Peer
Evaluation Committee. Additional members included Gregory Burke, MD;
Jaqueline Dunbar-Jacob, PhD, RN; Elaine Eaker, ScD; Mark Hlatky, MD;
David Pryor, MD; and Elaine J. Stone, PhD, with myself as an ex officio
member and Terry Bazzarre, PhD, as staff scientist. Susan Lund and
Carrie Patton were attending staff members.
At the present time, $6.3 million is available to fund
approximately 5 to 12 grants beginning January 1999. The maximum amount
per grant will be $500 000 for up to 3 years of funding. Principal
investigators must have a doctoral degree and a full-time faculty/staff
appointment at a nonprofit organization in the United States.
Individuals and multidisciplinary teams are encouraged to apply.
Letters of intent are due May 15, 1998, and the application deadline is
July 15, 1998. Requests for application materials and information can
be obtained from the AHA Office of Research Administration (telephone
214-706-1341) or on the AHA's home page
(http://americanheart.org).
The AHA will focus on promoting this new research program during the
next year and needs your support to encourage researchers to submit
innovative and methodologically rigorous proposals that are responsive
to the scope of this program. Promising results can then be confirmed
by additional research and translated directly into practice, thus
improving patient care and outcomes.
References
© 1998 American Heart Association, Inc.
Editorials
New Targeted AHA Research Program
Cardiovascular Care and Outcomes
Key Words: Editorials • AHA Medical/Scientific Statements • prevention • patient care
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