new frontiers in cvd aging / disease - youth / health › ~ › media › non-clinical ›...
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ACC New York, Dec 10, 2017 No Disclosures
New Frontiers in CVD Aging / Disease - Youth / Health
Science Health Education
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Aging / Disease - Youth / Health
B
B
BProm.
HealthSubcl.
DiseaseStable
Disease
WindowYoung
Our Future
Behav.Change
AdherenceSimplicity
25 50 100
25 50 100
A
Present
Too Late Earlier
1. EconomicA
A0
2. Scientific
V Fuster, JACC 2015; 66: 1627
EnvironmentHealth Policy
3. Educational
0
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Primordial
SecondaryPrimary
50/50
From Aging / Disease to Youth / Health
6) SHE
7) HARLEMVILLAGEMEXICO
4) 1)
2)
5) IIIP
HRP
Surgery InterventionPharmacology.ImagingGenetics/Tr
PESA AWHS TANSNIP
3) AGING )
NHLBI $-1
50-100 yrs
25-50 yrs
00-25 yrs
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JN Giedd. Scientific American 2015;312:32
6). Child’s Brain Development Less Networking Brings Atention
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GENERALPUBLIC
3-5CHILDREN 6-8 9-14
EDUCATIVE GOAL: HEALTHY HABITS FOR CHILDREN BETWEEN 3 & 5 YRS
6a).COLOMBIA – CHILDREN’S PROGRAM
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In Children’s KAH Mean Scores*
40.0
50.0
60.0
70.0
80.0
90.0
100.0
0 18 36
Scor
e (m
ean)
Knowledge Attitudes Habits (physical activity)
p< 0.001p< 0.001
p< 0.001
p< 0.001
p< 0.001
The Amer J of Med 2012; 126, 27The Amer J of Med 2013;126:1122Bogota – 25,000
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JL Peñalvo, V Fuster et. al. JACC 2015;65:1065. - 10,000,
6b). Changes In Anthropometric Variables At Each FU In Overweight Children
Body Mass Index (BMI)
Waist Circumference (WC)
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CHILDREN’S – BOGOTA, SPAIN, NEW YORK – N = 50,000
The Amer J of Med 2013;126:1122 - J. Amer. Coll. Card. 2015;65:1065J. Amer. Coll. Card. 2017(In Press)
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CHILDREN’S PROGRAM - SPAIN
10
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Primordial
SecondaryPrimary
50/50
From Aging / Disease to Youth / Health
6) SHE
7) HARLEMVILLAGEMEXICO
4) 1)
2)
5) IIIP
HRP
Surgery InterventionPharmacology.ImagingGenetics/Tr
PESA AWHS TANSNIP
3) AGING )
NHLBI $-1
50-100 yrs
25-50 yrs
00-25 yrs
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BARRIERS TO IMPLEMENTATION OF A HEALTH PROMOTION PROGRAM IN HARLEM, NY
THE FAMILIA STUDYAn AHA Strategically Focused Research Network Study
Sameer Bansilal, MD, MS, Rajesh Vedanthan, MD, MPH, Risa Jaslow, MS, RDN, Martha Hadley, PhD, Amy Siskind, PhD, Carmina Marcial, MA, Ana Victoria Soto,
MD, Claire Kofler, BS, Zahi A Fayad, PhD, Valentin Fuster, MD,PhD
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O
Start
Start
Children3 Groups
Caregivers3 Groups
PPP
PPP
Teachers
OI I
IOO
OO O
O
OOO
O
KAH-BEAMol. Genomics KAH-BEA S-KAH-BEA
BEWATPoint of Care.
3D-USMol. Genomics
OIPII II
O
IP
Contr./Interv.
S-BEWATPoint of Care
BEWATPoint of Care
3D-US Mol. Genomics
1st Yr 2nd Yr 3rd Yr 4th Yr
Intervention.Intervention
Control
IIIPPPPI
KAH-BEA = Knowledge, Attitude, Habit, -BMI, Exercise, Alimentation ; FUSTER-BEWAT = BP, Exercise, Weight, Alimentation, Tobacco; S=Sustained
(1)
(2)
(3)
(3)(1)
(2)
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Lanzamiento de la versión internacional THE CIRCLE OF HEALTH
Actividades previstasInteractive “Circle of Health” - App
www.thecircleofhealth.org
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Children’s Health & Biology: The Effect of DisparitiesIcahn School of Medicine at Mount Sinai ( ISMMS)
December 13th, 2017
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16
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Project I: Background
17
Fuster V et al. Am Heart J. 2017;187:170-181
Har
lem
, NY
Colo
mbi
a
Fuster V et al. Am J Med. 2013;126(1):27-35
Spai
n
Fuster V et al. J Am Coll Cardiol.2015;66(14):1525-34
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Project I: Aims
18
Objective: The effect of disparities on CHILDREN's HEALTHoutcomes following a health promotion educational intervention in preschool children.
Variables modulating such outcomes:Aim 1. Impact of socio-economic differences at the family level.
Aim 2. Factors that impact the teachers’ efficacy in implementing the educational intervention and health outcomes in children.
Aim 3. Effect of school environment in implementing the educational intervention and health outcomes in children.
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Project I: Methods and Feasibility
19
CHILDREN´SHEALTH
Socio-economic (Family)
SchoolTeachers
• Prospective educational intervention• Public preschools in all five boroughs of NYC• Children between 3 and 5 years of age• Evidence-based health promotion
educational curriculum• Duration of intervention: 5 months• Follow-up: 24 months
• Variables impacting children´s health1. Socio-economic 2. Teachers 3. School environment
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Primordial
SecondaryPrimary
50/50
From Aging / Disease to Youth / Health
6) SHE
7) HARLEMVILLAGEMEXICO
4) 1)
2)
5) IIIP
HRP
Surgery InterventionPharmacology.ImaginGenetics/Tr
PESA AWHS TANSNIP
3) AGING )
NHLBI $-1
50-100 yrs
25-50 yrs
00-25 yrs
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21Confidential, for Internal and Investigator use only
CARDONA MEXICO
PERU ?
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EDUCATION (7)CARDONA – MEXICO – PERU ?
HARLEM
US -SPAINGRENADA - SPAIN
KENYA
SPAINBOGOTA
Con
tinu
ity
Villages(3)
Family (1)
Adults (5)
Children (2)
CONCEPTS, SCIENTIFIC STUDIES, NPOs
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Global Health Future Role of the United States
National Academies of Sciences, Engineering & MedicineNew Engl. J. Med. 2017; 377:1292 - JACC 2017 (In Press)
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Report Conceptual Model
26Maximizing Return
Catalyzing Innovation G.H. Leadership Smart Financing
Global Health
Security
Continuous Communicable
Threats
Saving and
Improving the Lives of Women
and Children
Promoting Cardiovascular
Health and Preventing
Cancer
SECURING AGAINST GLOBAL THREATS
ENHANCING PRODUCTIVITY AND ECONOMIC GROWTH
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Lancet 2017; 389: 77
Lancet 2017; 389: 91
Lancet 2017; 389: 103
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1. Nutrition & Diet 2. Healthy Weight 3. Exercise & Physical Activity 4. Tobacco-Free Lifestyle 5. Blood Pressure 6. Cholesterol7. Blood Sugar8. Psychological Health
Cardiovascular Health PromotionEight Factors to be Addressed
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Cardiovascular Health PromotionFour Questions to be Answered
1. Pathophysiological Effects: Detrimental impact that adverse RFs & behaviors can cause to the CV system, from molecular to clinical levels
2. Mechanistic/Triggering Factors: Desmotivators of good health: at personal, community or societal levels.
3. Role of Preventive Action: Motivators of good health: at personal, community/educational or societal/authoritative
4. Competencies for training: Standarized methods of education that impact on health promotion.
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ACC New York, Dec 10, 2017 No Disclosures
New Frontiers in CVD Aging / Disease to Youth / Health
Science Health Education