This application proposes to create a paradigm of preventive cardiology to aid in reducing the risk of cardiovascular disease among disadvantaged minorities with a demonstrated difference in cardiovascular mortality from that of the general population. A multidisciplinary, longitudinal curriculum of preventive cardiology will be established a the University of Texas Medical School. During the preclinical years, students will be acquainted with the epidemiology, pathophysiology an behavioral modification of risk factors with particular emphasis on the needs of our increasing minority populations. The new curriculum will emphasize risk factors management and prevention in a month of require study during the senior year. The multidisciplinary talent of our distinguished Health Science Center faculty from the Medical School, School of Public Health, School of Allied Health Professions, School of Nursing, Biostatistic Center and the Center for Health Promotion will contribute to the development and implementation of the curriculum. Four existing clinics will implement the preventive cardiology program. Three clinics will provide patient care for disadvantaged multi-ethnic, predominantly Hispanic and Black population in urban locations. These clinics are supported by United Way, the Harris County, and the State. Clinical teaching for our students, house staff, and fellows will be provided in these clinics, with particular attention to enhancing patient physician relationship and focusing on areas where intervention modification is likely to succeed. The program will be extended to other health providers, emphasizing a team approach. Students, house staff, and fellows will utilize education, behavior modification, and high technology (such as interactive video-disk, video-taped bilingual programs, and broad band television linkage) in community cardiology clinics. Research projects will be developed regarding prevalence of risk factors, success or failure of interventions, long-term effects of interventions, and randomized trial comparing outcomes of a preventive cardiology program with usual care.
