Background: USPSTF evidence-based recommendations for the use of low-dose aspirin for primary prevention of cardiovascular disease were published in 2009. We describe a statewide campaign using innovative methods to educate the public and health communities about appropriate aspirin use. Methods/design: The “Ask About Aspirin” initiative is designed to lower the number of first heart attacks and strokes in the State of Minnesota by promoting the appropriate use of low dose aspirin. A health system intervention combined with an aspirin awareness media campaign will be evaluated in a pragmatic group randomized controlled trial including 267 primary care clinics within 84 health systems over a four year period. Matched pairs of geographic territories will be randomized to intervention (12 territories) or control (12 territories). The primary outcome of appropriate aspirin use will be measured at the individual level, by community-based telephone surveys of 100 participants in each of the 24 geographically determined clusters. Discussion: We briefly describe the rationale for the interventions being studied, as well as the major design choices. Rigorous research designs such as the one described here are necessary to determine whether evidence-based recommendations can be effectively disseminated in multiple health systems. Trial registration: ClinicalTrials.gov: NCT02607917.
Bibliographical noteFunding Information:
As with any community-based educational effort, prior support from community leaders is important. The program sought and attained support from the Minnesota Department of Health and the Minnesota Medical Association. The Community Advisory Board also included representation from the American Heart Association (AHA), the American College of Cardiology (ACC), the Institute for Clinical Systems Improvement (ICSI), the Minnesota Academy of Family Physicians (MAFP), and Minnesota Community Measurement (MNCM). Nonetheless, concerns from those in the professional community and media about widespread use of a medication are always an issue. It is also clear that some clinics will not be interested in participating.
Supported by: NHLBI R01HL126041 and the Lillihei Heart Institute .
© 2021 The Authors
- Cardiovascular diseases
- Cluster randomized trial
- Group-randomized trial
- Primary prevention