Simulating and Evaluating Local Interventions to Improve Cardiovascular Health
Figure 1. Simulation model for cardiovascular
disease (CVD) outcomes. This diagram depicts major health conditions related to
CVD and their causes. Boxes identify risk factor prevalences modeled as dynamic stocks. The population flows associated with
these stocks � including people entering the adult population, entering the
next age category, immigration, risk factor incidence, recovery,
cardiovascular event survival, and death � are not shown. This diagram consists of word phrases (representing model variables) connected by one-way arrows (representing causal linkages). These words and arrows are in different colors and styles whose meaning is explained in the title and key accompanying the figure. In the center of the diagram are several variables in plain black text, some in boxes representing dynamic stocks and all having both incoming and outgoing arrows. Proceeding from top to bottom and left to right, these variables are 損sychosocial stress,� 揾ealthiness of diet,� 揺xtent of physical activity,� 搖tilization of quality primary care,� 揹iagnosis and control,� 搊besity� (in a box), 搒moking� (in a box), 揷hronic disorders� (with 揾igh cholesterol,� 揾igh blood pressure,� and 揹iabetes,� together in a box), 搒econdhand smoke,� 損articulate air pollution,� and 揻irst-time cardiovascular events and deaths.� Concepts in purple italic text (representing interventions) lie around the top and left edges of the diagram, having no arrows coming into them, but all having outgoing blue arrows linking into the plain black text variables listed above. The links (moving clockwise from lower left to upper right) are as follows: • 揂ccess to and marketing of weight loss services� links to 搊besity.� • 揂ccess to and marketing of physical activity options� links to 揺xtent of physical activity.� • 揂ccess to and marketing of healthy food options� as well as 搄unk food taxes and sales/marketing regulations� link to 揾ealthiness of diet.� • 揂ccess to and marketing of mental health services� and 搒ources of stress� link to 損sychosocial stress.� • 換uality of primary care provision� and 揂ccess to and marketing of primary care� link to 搖tilization of quality primary care.� • 揂nti-smoking social marketing,� 搕obacco taxes and sales/marketing regulations,� 揳ccess to and marketing of smoking quit products and services,� and 搒moking bans at work and public places� link to 搒moking.� • 揝moking bans at work and public places� also links to 搒econdhand smoke.� • 揂ir pollution control regulations� links to 損articulate air pollution.�
Blue-arrow links also indicate causal connections among the plain black text variables. The links are as follows: • 揈xtent of physical activity� and 搖tilization of quality primary care� link to 損sychosocial stress.� • 揢tilization of quality primary care� links to 揹iagnosis and control.� • 揚sychosocial stress,� 揾ealthiness of diet,� 揺xtent of physical activity,� 搖tilization of quality primary care,� and 搒moking� link to the 搊besity� box. • 揢tilization of quality primary care� and 損sychosocial stress� link to the 搒moking� box. • 揚sychosocial stress,� 揾ealthiness of diet,� 揺xtent of physical activity,� 揹iagnosis and control,� 搊besity,� and 搒moking� link to the 揷hronic disorders� box. • 揝moking� links to 搒econdhand smoke.� • 揝moking,� 揷hronic disorders,� 搒econdhand smoke, and 損articulate air pollution� link to 揻irst-time cardiovascular events and deaths.� To the right of 揻irst-time cardiovascular events and deaths� and leading to it with blue arrows are 2 variables in black italic text with no incoming arrows: 揹ownward trend in CV event fatality� and 損opulation aging.� In the lower right corner of the diagram, in plain brown text, is 揷osts from cardiovascular and other risk factor complications and from utilization of services.� Leading to this variable are brown arrows from 損sychosocial stress,� 搊besity,� 搖tilization of quality primary care,� 搒moking,� 揷hronic disorders,� and 揻irst-time cardiovascular events and deaths.� |
|
|
|
|
|
|
 |
