Is it feasible to maintain a structured education and follow-up program, including medical students, for the primary prevention of coronary artery disease in the community over time?
O Soran, S M Guven, S Akbag, S G Demiral, D Sonmez, S Oksuz, P Ugurluel, D Aras, R Yildiz, M Karahan, P GunelAbstract
Background and aim
Previous research suggests that primary prevention programs for coronary artery disease (CAD) can improve health-related behavioral outcomes. However, maintaining these programs can be very challenging and costly mainly due to staffing. Thus, the current study was designed to assess the feasibility, effectiveness, and long-term maintenance of a structured, enhanced education and follow-up program for CAD prevention in an area where the diverse population and economy are major issues.
Methods
Coronary Artery Disease Prevention Project was designed to utilize medical school students to conduct the entire project under the supervision of professors. This longitudinal prospective study began after obtaining ethical committee approval and included two different education and training phases; in the first phase, every year, between 2016 and 2025, third-year medical students underwent a one-year, specially designed, training program on primary prevention for CAD. In the second phase, every year, a series of conferences on primary prevention for CAD were organized by our University for underserved populations. Participants were prospectively assigned to an intervention where pre and post conference knowledge were collected and assessed. Every intervention was conducted by specially trained 4th year medical students and an education booklet which was specifically designed for this study was given to the participants. Every other month thereafter, for 6 months, each participant was followed by phone. At the 6 month follow up, data was collected to assess the impact of enhanced education and follow–up program on behavioral outcomes.
Results
A total of 245 participants were enrolled; 64% were women, mean age was 41.50±12.39 years, 36% were not working. Mean BMI was 27.30±4.99 kg/m2. Overall, at baseline evaluation, knowledge on CAD risk factors, primary prevention measures, diet and daily exercise habits were very poor. After the enhanced education and follow-up program there was a significant improvement on the knowledge of CAD risk factors and primary prevention measures (p<0.001). The follow-up program led the participants to implement those positive changes into their lives and maintain a healthy lifestyle. More importantly, this model program was successfully implemented for almost a decade.
Conclusions
The results of our study indicated that a structured enhanced education and follow-up program, utilizing medical students, can be maintained over time in primary prevention for coronary artery disease in an economically disadvantaged community, yielding successful outcomes. This model program not only serves the public interest but also fosters early active engagement between medical students and patients throughout their careers.