Implementation of Evidence-Based Behavioral Interventions for Cardiovascular Disease Prevention in Community Settings: A Scientific Statement From the American Heart Association

Abstract

Extending cardiovascular disease prevention beyond health care settings is needed to improve population health and to advance health equity. Furthermore, evidence-based practices in community settings leverage assets and strengths (eg, community trust, reach) of organizations and practitioners. Using the Roadmap for Leveraging Implementation Science to Achieve Cardiovascular Health Equity, we conducted a narrative review to determine the scope of studies describing implementation strategies of cardiovascular health evidence-based practices in community settings and to identify bright spots and gaps in what is known about implementing cardiovascular health evidence-based practices in community settings. Evidence for the effect of interventions delivered in community settings to improve cardiovascular health behaviors is emerging in various community settings. Evidence-based practices were identified, selected, and culturally adapted through community engagement, particularly in faith-based and social service/other settings (eg, salons/barbershops). We found several interventions and adaptations aimed at improving outcomes in groups that have historically been excluded by the health care system. The Designing for Dissemination and Sustainability approach supports consideration of contextual factors (eg, alignment of evidence-based practice with the mission, workflow, time, and priorities of the setting) in selecting and adapting evidence-based practices. Development of implementation strategies must engage those who will be asked to implement the intervention and the organization in which it will be implemented. Key research opportunities include high-quality studies that explicitly compare well-specified implementation strategies in various community settings. Taken together, there are bright spots and opportunities for enhanced impact through implementation of evidence-based practices for cardiovascular disease prevention in community settings.