Electronic health record reveals community-level cardiometabolic health benefits associated with 10 years of community-based participatory research

Z Buchanan; S E Hopkins; T K Ryman; M A Austin; H W Wiener; H K Tiwari; J A Klejka; B B Boyer; A E Fohner

doi:10.1016/j.puhe.2024.04.010

Electronic health record reveals community-level cardiometabolic health benefits associated with 10 years of community-based participatory research

Public Health. 2024 May 10:232:38-44. doi: 10.1016/j.puhe.2024.04.010. Online ahead of print.

Authors

Z Buchanan¹, S E Hopkins², T K Ryman³, M A Austin¹, H W Wiener⁴, H K Tiwari⁵, J A Klejka⁶, B B Boyer², A E Fohner⁷

Affiliations

¹ University of Washington, Department of Epidemiology, Seattle, WA, USA.
² Oregon Health & Science University, Department of Obstetrics and Gynecology, Portland, OR, USA; University of Alaska Fairbanks, Center for Alaska Native Health Research, Fairbanks, AK, USA.
³ University of Washington, Department of Epidemiology, Seattle, WA, USA; Bill and Melinda Gates Foundation, Seattle, WA, USA.
⁴ University of Alabama at Birmingham, Department of Epidemiology, Birmingham, AL, USA.
⁵ University of Alabama at Birmingham, Department of Biostatistics, Birmingham, AL, USA.
⁶ Yukon-Kuskokwim Health Corporation, Bethel, AK, USA.
⁷ University of Washington, Department of Epidemiology, Seattle, WA, USA. Electronic address: afohner@uw.edu.

PMID: 38733959
DOI: 10.1016/j.puhe.2024.04.010

Abstract

Background: While a major goal of community-based participatory research (CBPR) is to improve community health; it is unclear how to measure longstanding success of CBPR.

Objective: We sought to determine the impact of ongoing CBPR on cardiometabolic health of participating communities, including in people not directly participating in research.

Methods: We used linear mixed-effects modelling with electronic medical records from 2002 to 2012 from the Yukon-Kuskokwim Health Corporation, which provides health care to all Alaska Native people in southwestern Alaska, to compare rates of change in cardiometabolic risk factors between communities that did and did not participate in ongoing CBPR beginning in 2003.

Results: We analysed 1,262,035 medical records from 12,402 individuals from 10 study and 38 control communities. Blood pressure declined faster in study than in control communities: systolic blood pressure (0.04 mmHg/year; 95% confidence interval [CI]: 0.01, 0.08); diastolic blood pressure (DBP) (0.07 mmHg/year; 95% CI: 0.04, 0.09). Body mass index increased 0.04 units/year faster in study communities than in control communities (95% CI: 0.03, 0.05). More study visits were associated with faster reduction of DBP and triglyceride levels in study communities.

Conclusions: Ongoing CBPR may improve overall cardiometabolic health in communities, perhaps by increasing engagement in health and advocacy.

Keywords: Alaska Native; Cardiometabolic; Community-engaged research; Longitudinal.