Fostering better heart health in rural America

RAINELLE, West Virginia — Once a month, Sarah Ward and Ashley Berry get cooking.

They set up a table at Rainelle Medical Center — a Federally Qualified Health Center (FQHC) in rural West Virginia — then turn on the camera and go live through social media to encourage community members to make heart-healthy meals.

Using recipes from the American Heart Association's Simple Cooking with Heart website, they demonstrate how to whip up tasty, nutritional meals such as black bean and avocado wraps or pineapple and chicken kabobs.

Sometimes, Berry throws in creative touches of her own, like adding purple cabbage and encouraging kids who may be watching to get involved in making family meals.

"Getting to play with your food makes it more exciting," she says with a smile.

Berry, a licensed practical nurse, knows she has to grab the attention of every generation if she's going to make a dent in the chronic disease that plagues Rainelle and much of rural West Virginia. The state has some of the highest rates of hypertension, heart disease and diabetes in the nation. With the help of a myriad of AHA programs, tools and resources, she and her colleagues are starting to make a difference.

The AHA provides assistance to nearly 50 clinics and FQHCs throughout West Virginia — and about 1,400 outpatient organizations throughout the nation — through major programs such as Target: BP, Check. Change. Control. Cholesterol and Target: Type 2 Diabetes. A host of smaller initiatives are also raising awareness and offering resources to communities struggling with cardiovascular disease and its risk factors.

Wide-ranging impact

It's the job of AHA community impact directors to assess how well each state is doing addressing cardiovascular health at its hospitals, clinics and FQHCs, and to encourage those facilities to enroll patients in each of its three flagship programs.

Enrolled facilities report annual blood pressure, cholesterol and blood glucose control rates and receive awards and recognition from the AHA for meeting or exceeding target goals. Each program provides toolkits and resources that support health care organizations in their cardiovascular prevention efforts.

The impact directors also forge partnerships with local foundations and other organizations, such as libraries or dental clinics, connecting them to health care facilities to broaden their reach, especially in rural areas where access to care is limited.

In West Virginia, this work also includes partnerships with college campuses, where AHA staff provide CPR training to incoming students and nutritional training to students who run campus food pantries, helping ensure healthier food items are available to those in need.

It's been six years since Rainelle Medical Center partnered with the AHA, tapping into all three major program areas.

AHA resources support much of the clinic's work. This can include providing nutritional guidelines and recipes for the cooking demonstrations, helping secure grants for validated, at-home blood pressure monitoring devices or supplying educational materials about lowering blood pressure, cholesterol and blood glucose levels to a healthy range.

When clinics and FQHCs enroll in AHA programs, they get staff training in areas that contribute to better heart health. These can include nutrition, the most current research on how to accurately take blood pressure readings and how to incorporate heart-healthy habits and practices into everyday life.

Both Berry and Ward, a diabetes specialist, took that information to heart — and made changes to what they ate and how much they exercised.

Berry lost 80 pounds and improved her cholesterol and blood pressure levels. She said she was motivated "not just for myself and my family, but to provide a better model for my community as well."

It's a model that works.

When Rainelle Medical Center first started working with the AHA, just 57% of its patients had their blood pressure under control. Today, that hypertension control rate is 71%. The goal is 70% or higher.

Learning healthy living

Almost three hours west, Williamson Health and Wellness Center is one of 41 clinics in the state that earned recognition from the AHA last year for achieving that goal. Nationally, 1,300 of the 1,400 sites enrolled in Target: BP met or exceeded that goal.

In Williamson, wellness center staff use AHA resources to leverage local food donation and community health worker programs, sharing nutritional information and offering heart-healthy cooking classes. This assistance has helped 57-year-old Craig Warren try new foods and learn healthier ways to prepare his meals.

"Believe it or not, I can eat cauliflower now," said Warren, a self-proclaimed "burger and fries guy" who battles Type 2 diabetes, and heart and kidney disease.

Warren can also monitor his own blood pressure using a state-of-the-art, validated blood pressure device supplied through a grant the AHA secured. That program has helped to provide about 2,000 loaner devices statewide.

Tony Delong also received one, after an inferior blood pressure device his insurance covered gave incorrect readings. "I don't think I could have done what I did to control my blood pressure without that new cuff," he said.

Delong, who also has diabetes, credits support from AHA programs and wellness center staff with helping him cut his blood glucose levels in half, lowering his A1C from a high of 14% to 7% over a three-month period. The nutrition education and other support he received encouraged him to make dramatic dietary changes and take up volunteer work in the center's community garden.

Delong said he returns the favor by volunteering his time delivering boxes of healthy food to others in need and helping the wellness center whenever he's asked. That also includes driving people who have no other transportation to their clinics for podiatry, dental, primary care, pediatric and behavioral health visits.

The AHA is behind a lot of what the wellness center does, he said. "This is my way of giving back."