Oldenburg Niki C, Duval Sue, Luepker Russell V, Finnegan John R, LaMarre Heather, Peterson Kevin A, Zantek Nicole D, Jacobs Ginny, Straka Robert J, Miller Karen H, Hirsch Alan T
Cardiovascular Division, University of Minnesota Medical School, MMC 508, 420 Delaware St SE, Minneapolis, MN 55455. E-mail:
University of Minnesota, Minneapolis, Minnesota.
Prev Chronic Dis. 2014 May 15;11:E83. doi: 10.5888/pcd11.130378.
Cardiovascular diseases are the leading causes of disability and death in the United States. Primary prevention of these events may be achieved through aspirin use. The ability of a community-based intervention to increase aspirin use has not been evaluated. The objective of this study was to evaluate an educational intervention implemented to increase aspirin use for primary prevention of cardiovascular disease in a small city in Minnesota.
A community-based intervention was implemented during 16 months in a medium-sized community in Minnesota. Messages for aspirin use were disseminated to individuals, health care professionals, and the general population. Independent cross-sectional samples of residents (men aged 45-79, women aged 55-79) were surveyed by telephone to identify candidates for primary prevention aspirin use, examine their characteristics, and determine regular aspirin use at baseline and after the campaign at 4 months and 16 months.
In primary prevention candidates, regular aspirin use rates increased from 36% at baseline to 54% at 4 months (odds ratio = 2.05; 95% confidence interval, 1.09-3.88); the increase was sustained at 52% at 16 months (odds ratio = 1.89; 95% confidence interval, 1.02-3.49). The difference in aspirin use rates at 4 months and 16 months was not significant (P = .77).
Aspirin use rates for primary prevention remain low. A combined public health and primary care approach can increase and sustain primary prevention aspirin use in a community setting.
心血管疾病是美国导致残疾和死亡的主要原因。通过使用阿司匹林可能实现对这些疾病的一级预防。基于社区的干预措施提高阿司匹林使用率的能力尚未得到评估。本研究的目的是评估在明尼苏达州一个小城市实施的一项教育干预措施，以增加阿司匹林用于心血管疾病一级预防的使用率。
在明尼苏达州一个中等规模的社区实施了为期16个月的基于社区的干预措施。向个人、医疗保健专业人员和普通人群传播了关于使用阿司匹林的信息。通过电话对居民（年龄在45 - 79岁的男性，年龄在55 - 79岁的女性）的独立横断面样本进行调查，以确定一级预防使用阿司匹林的候选人，检查他们的特征，并确定在基线时以及活动开展后4个月和16个月时的阿司匹林常规使用率。
在一级预防候选人中，阿司匹林常规使用率从基线时的36%增加到4个月时的54%（优势比 = 2.05；95%置信区间，1.09 - 3.88）；在16个月时维持在52%（优势比 = 1.89；95%置信区间，1.02 - 3.49）。4个月和16个月时阿司匹林使用率的差异不显著（P = 0.77）。
用于一级预防的阿司匹林使用率仍然较低。公共卫生和初级保健相结合的方法可以在社区环境中提高并维持用于一级预防的阿司匹林使用率。
