One day during the onset of the COVID-19 pandemic, Lawrence General Hospital staff member Christina Wolf was sitting at her kitchen table listening to a webinar on population health when inspiration struck.
The webinar centered around how to achieve health equity at a time when that seemed all but impossible, given the social determinants of medical care being laid bare during the coronavirus crisis.
“The speaker was a physician leader from a large health system in New York who said, ‘If you want to improve the health of a population, manage their blood pressure,’” Wolf, Lawrence General’s executive director of population health and care continuum, remembered. “He said by doubling down on managing blood pressure, primary care providers can prevent cardiovascular disease and improve patient outcomes. We decided to take that a step further.”
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Wolf took that tidbit back to her Lawrence General colleagues Virgilio Velez, RN, who also serves as the hospital’s Diversity, Health Equity and Inclusion officer, and Director of Cardiovascular Services Kathy Caredeo, RN. The group made a simple – yet significant – decision: Utilizing funds obtained from the Cummings Foundation prior to the pandemic to address heart and vascular disease they’d develop a campaign to go into the greater Lawrence community and start offering blood pressure screenings free of charge.
The goal, according to Velez, was two-fold. Most importantly, the community health screenings team strives to meet locals where they’re at – culturally
and socially – while empowering patients to make decisions about their own health care.
To date, the community health screening team has held blood pressure screenings at farmers markets, street fairs, barbershops, and churches. Most screenings take place in Lawrence, but the team also traveled to the North Shore Pride celebration in Salem, Mass., and will have a table at Andover’s Active Living and Health Fair on September 8. The hope is to blanket Lawrence General’s entire coverage area, which includes cities across the Merrimack Valley and southern New Hampshire.
At each screening event, at least one nurse is present, Wolf said, to offer clinical expertise and make patients aware of blood pressures that may require immediate medical attention. Over the summer, that nurse was Sarah Weintraub, a student from Regis College pursuing a master’s in public health who volunteered her time with Lawrence General. Any hospital staff member is welcome to volunteer, Wolf said, with nursing and medical assistants and EMTs having pitched in to take blood pressures, and other non-clinical staff lending a hand with administrative tasks.
The hospital recently welcomed its first ever Community Engagement Fellow Kaleena Leguerre, a Merrimack College graduate student, to the team to oversee logistics for the screenings program.
When patients are screened and counseled about their blood pressures, they also have the option to be connected to a primary care doctor at either Lawrence General or Greater Lawrence Family Health Center, according to Velez.
“We follow up with the patient and ask what they want to do (about their results),” Velez said. “A lot of people say, ‘I sort of knew I had high blood pressure, but I’ve been busy (and haven’t had time to address it). Others will tell us they’re on blood pressure medication, or they don’t want to take any more pills. Then we have a chance to talk to them about the risk of stroke or heart attack and how that would impact their lives.”
Velez, who is bilingual and able to communicate with the community’s Spanish-speaking population, said breaking down the language and literacy barrier has paid dividends.
He recalled a instance where an older female patient was hesitant to fill out consent forms in order to receive her screening, but once Velez spoke to her in Spanish and assisted in filling out the forms, she agreed to be screened.
“It’s about having a dialogue with somebody about their health, meeting them where they are and providing access,” Velez said.
According to Wolf, the team took more than 250 blood pressures this summer alone. Of the pressures taken, approximately 60% met criteria for high blood pressure. Only 25% of patients screened who had high blood pressure were currently taking medication, she said.
The American Heart Association categorizes a normal blood pressure as 120/80 and an elevated pressure as between 120-129/80. High blood pressure, or hypertension, starts at 130/80. Blood pressure can improve with heart-healthy habits like following a balanced diet and getting regular exercise.
Like Velez, Wolf considers it a job well done if she’s able to change just one person’s mind about something as simple as knowing their numbers.
“People are busy. We’re basically putting ourselves in their way. When Virgilio offered screenings outside of a barbershop, everyone going in had to make the decision to get their blood pressure checked,” Wolf said. “They don’t have to make that decision any other day – they just go in and get their hair cut. We see a lot of hesitation in men – especially middle-aged men. I’d see their wives drag them over (to get their blood pressure checked) and I’d say, ‘Don’t you want to be here for your kids?’ You have to meet people where they’re at.”
Caredeo, the hospital’s director of Cardiovascular Services, sees tremendous value in the screenings program – and is eager for it to expand.
“It’s all about continuing our commitment to providing the best quality of care to our patients and our community,” Caredeo said. “Community outreach initiatives are extremely important to directly affect the community’s behavior to help reduce the risk of cardiovascular disease.”
Are you a Lawrence General employee interested in joining the community outreach team? Do you participate in a community/church group or neighborhood association that could benefit from a free screening? Email Christina Wolf at christina.wolf@lawrencegeneral.org or Virgilio Velez at virgilio.velez@lawrencgeneral.org for more information.