A recent study sponsored by Icahn School of Medicine, Mount Sinai and the American Heart Association found that both individual and group-based heart disease prevention management courses were more beneficial for reduced patient risk than standard lifestyle management. As the social determinants of health contribute to a cardiovascular disease crisis in America, evidence points to imminent need for disease prevention efforts. Enter the FAMILIA study.
Recently, MD Magazine reported on the FAMILIA study sponsored by the Icahn School of Medicine, Mount Sinai in collaboration with the American Heart Association. MD Magazine interviewed one of the lead investigators—Valentin Fuster, MD, PhD, Physician-in-Chief and Head of Cardiovascular Institute at Mount Sinai. Dr. Fuster emphasized the need for “societal adjustment toward more heart disease-preventive lifestyle practices.”
What were the FAMILIA Studies?
As reported in Clinicaltrials.gov, FAMILIA included two projects. They dealt with the problem of childhood obesity centering in the Latino and African American predominant Harlem district within Manhattan, NY. A crisis has arrived and it its ethnic minorities and the poor with a vengeance. For example, childhood obesity has more than doubled over the past 30 years. Nearly one-third of children aged 6 to 11 are now obese. Society now faces a high probability that these children are likely to become obese adults and face a significant risk for the development of diabetes, hypertension, heart disease and cancer.
The study investigators sought to address the hypothesis that habits are formed early in life and that children can help their parents live healthier lives. The investigators attempted to test this hypothesis by evaluating the impact of an educational program focusing on diet, physical activity, knowledge of the human body, and management of emotions for preschool children aged 3 to 5 years, their parents/caregivers and teachers.
The investigators assessed environment factors, facilitators and barriers to implementation of a health promotion educational program tailored for preschoolers in Harlem, New York. The goal: use the data to tailor an educational program for children in Harlem. Moreover, investigators sought to evaluate effectiveness of such program in children aged 3 to 5 by randomly assigning blocks of schools to a 4-month educational and playful health promotion intervention or to usual curriculum. Additionally, the sponsors designed components of the study to engage the children’s parents and teachers. American Heart Association is a collaborator and the mission of the study aligns with their “Building healthier lives, free of cardiovascular diseases and stroke.”
As Dr. Fuster noted to Kevin Kunzman in MD Magazine first and foremost he believes there is much that can be done to help the “underserved population.” It is an absolute myth that there is nothing that can be done. This positive affirmation that significant impacts can be achieved with the target population is the first major breakthrough to progress. “Fascinating results” resulted from the intensive surveilling of 600 children (3-6) applying the health promotion and disease management program for 50 hours over 4 months. The study sponsors found significant improvements in the intervention group versus the group with no controls. Follow the link to read the interview.
Call to Action: America faces a health crisis on multiple fronts. We recently highlighted the frightening increase in deaths based on heart failure alone. We have emphasized the dangers to society of the obesity crisis. Dr. Fuster knows that action must happen now or human suffering and costs will only spiral further out of control. We have the power, ability, and wherewithal to change course, but it will take concerted action as health professionals, communities, workplaces and local government collaborate based on evidence-based approaches to turn around the trends toward a positive direction. It is better to prevent disease and promote better health in childhood—before it is too late. Social Determinants of Health are contributory factors that must be incorporated into data-driven, targeted and patient or community-centric programs—funding should be tied to results.
Valentin Fuster, MD, PhD, Physician-in-Chief and Head of Cardiovascular Institute at Mount Sinai