Rigorous Evaluation of Health Equity Strategies to Address Heart Disease and Stroke Prevention Identified by DHDSP Evaluability Assessment Process


TTi worked with CDC’s Division of Heart Disease and Stroke Prevention (DHDSP) to develop and conduct an evaluation of an intervention designed to promote health equity and reduce disparities in congestive heart failure treatment and outcomes. In this 2-year project, TTi developed a quasi-experimental mixed-methods longitudinal design to evaluate the Grady Heart Failure Program at Grady Memorial Hospital in Atlanta, GA. This design was necessary because patients could not ethically be randomized to treatment outside of the Program if they were eligible. Patients served as their own controls through comparison of patient electronic medical record (EMR) information on hospitalizations before and after they initiated participation in the Program. The evaluation included development and implementation of measures indicative of barriers to health equity for program participants; collection of clinical and health equity data from program participants; development and implementation of a qualitative evaluation component including interviews with program staff and participants; and collection of billing data to examine cost savings realized by the program, based on hospitalizations prevented. Results developed by TTi formed the basis for multiple deliverables to DHDSP, including a briefing document, a program description, an implementation guide for sites interested in starting a similar program, an evaluation report including results of both quantitative and qualitative measures, multiple conference abstracts and presentations, and a draft manuscript for publication.