Living for Health

In 2008, the Florida Heart Research Institute (FHRI) began a cardiovascular community health screening program called Living for Health (L4H). The program targets underserved and uninsured adults in Miami-Dade County, where rates of poverty as well as hospitalizations and deaths due to stroke, heart attack and diabetes are high. The community screenings consist of blood pressure testing and quick finger sticks to check blood for total cholesterol, HDL, and glucose levels. Participants are given a baseline lifestyle survey and receive free one-on-one education on their results with emphasis on how lifestyle changes can help reduce their risk factors for chronic diseases. Anyone with clinical values outside the normal limits is urged to see a physician for medical evaluation. The screening teams are made up of individuals who match the racial and ethnic makeup of the population; educational information is provided in English, Spanish, and Creole.

There are two additional components that differentiate this program from other screening programs:
1. At-risk individuals with no physician are connected to a collaborating Federally Qualified Health Center (FQHC) that will treat them on a sliding-fee scale. Business Associate Agreements are in place which allow for sharing of HIPAA protected information and post clinical data.
2. All at-risk participants are followed by phone at one, three, and when funding is available, at six and 12 months from the initial screening to provide additional education, encourage them to seek treatment and capture post lifestyle data.

The goal of the program is to identify and follow underserved adult residents with undiagnosed or untreated high blood pressure, cholesterol or glucose, provide education to encourage healthy lifestyle changes and encourage them to seek treatment – anyone without a primary care physician is referred to a participating FQHC.

Among those participants who were followed over time and were able to be reached by phone, there were significant increases in healthy food consumption as well as significant decreases in smoking, fat consumption, and fast food frequency.

As of December 2012 (four and a half years from program implementation), over 9,400 people from the target population had been screened. Fifty nine percent had high-risk clinical values for blood pressure, cholesterol and/or glucose, and were referred to a physician for follow up treatment and followed for up to one year by FHRI. Among those participants who were followed over time and were able to be reached by phone, there were significant increases in fruit, vegetable, and grain consumption as well as significant decreases in smoking, fat consumption, and fast food frequency. Among those people referred for medical follow up who sought treatment at a participating FQHC and for whom there was post 1-3.5 month clinical data, 50% moved from high-risk to borderline or normal levels in one or more high-risk categories.