Request for Proposal

Evaluation of Irish Heart Foundation’s Mobile Health Unit Services

Background

High blood pressure is a risk factor for cardiovascular disease (CVD) and a major cause of stroke and heart attack (World Health Organisation, 2021).  In Ireland, cardiovascular disease is one of the leading causes of death (Central Statistics Office, 2021). An Irish study among people over 50 years of age found that 64% of the study population had high blood pressure, with 45% of the study population being unaware of this (Murphy et al., 2015). However, eighty percent of premature heart disease and stroke is preventable through positive lifestyle behaviour change (World Health Organisation, 2015).

The Mobile Health Unit offers free opportunistic community-based, nurse-led blood pressure checks to adults aged 18 years and older. Each year, the Mobile Health Unit provides up to 10,000 free blood pressure checks to communities nationwide. Our particular focus is on underserved and underprivileged groups and communities. Some of these groups include Men’s Sheds, Traveller groups, Family Resource Centres and local communities. Our flagship programme, ‘Farmers Have Hearts Cardiovascular Health Programme’, provides 1000 farmers with health checks each year. The overall aim of the health check programme is to identify individuals with high blood pressure who are unaware of this and to raise their awareness in relation to the risks of high blood pressure and cardiovascular disease. Our expert nurses provide lifestyle advice and use motivational interviewing techniques to facilitate brief behaviour change interventions to promote cardiovascular health. Clients are then advised to see their GP if their blood pressure is raised to levels which present a cardiovascular disease risk, according to defined, evidence-based thresholds.

Aim

The overall aim of the evaluation is to examine the effectiveness of the Mobile Health Unit  in relation to identifying high blood pressure in people unaware and already aware of having high blood pressure and to raise health awareness around  the risks for high blood pressure. We also wish to build on a previous evaluation which was completed in 2017 on behalf of the Irish Heart Foundation by Carlow IT (Van Doorn and Richardson, 2017).

Objectives

Indicative research objectives to be refined with selected research partner.

Intervention Objectives

1. Identify high blood pressure and provide 1-1 lifestyle advice to those who are made aware for the first time of high blood pressure.
2. Identify high blood pressure and provide 1-1 lifestyle advice to those who are already aware of having high blood pressure.
3. Insight into compliance with prescribed medication for high blood pressure among those with known high blood pressure.           
4. Raise health awareness about high blood pressure and risk factors for cardiovascular disease.
5. Identify follow up referrals to GP services after advice to do so during the blood pressure check.
6. Facilitate positive health behaviour changes.

Evaluation Outcome Indicators

1. Proportion of participants detected to have high blood pressure that were unaware of this and who were advised to see their GP.
2. Proportion of participants with high blood pressure, who are already aware of this, and who were advised to see their GP.
3. Proportion of participants known to have high blood pressure who report to be compliant/non-compliant with their prescribed medication.
4. Levels of awareness/knowledge of risk factors for cardiovascular disease and understanding of what high blood pressure is and the influencing factors. E.g., lifestyle, health behaviours, medications.
5. Proportion of participants who report follow-up with their GP after being advised to do so.
6. Levels of newly implemented positive health behaviour or increased frequency in positive healthy behaviours since baseline health check.

Scope

The evaluation of the MHU blood pressure checks will consist of two phases;

1. collection of baseline information which includes the blood pressure check readings taken by the nurse and a face-to-face survey; by the principal researcher
2. a telephone follow-up survey at Week 6 conducted by the principal researcher

Informed consent will be sought before the BP check. Baseline information will be gathered after the BP check and will focus on socio-demographics (age, sex, nationality, marital status) and health information (registered at a GP, medical card holder, awareness of existing high BP - if so medication y/n; adherence to medication y/n; last time attended a GP, smoking and habits around alcohol, health rating).

At the Week 6 phone questionnaire, the follow-up reported use of GP services, outcome of GP visit (medication, further treatment, in case of known elevated BP adjustment of treatment), knowledge on normal BP and factors influencing BP (i.e. lifestyle elements, medication), experience with the MHU BP check and future use of health checks will be explored.

The proposed evaluation may use a combination of research methods such as qualitative and quantitative data collection and analysis tools based on the researcher’s expertise and guidance in this field. A representative sample size will be chosen to reflect the total study population from the 10,000 yearly health checks provided.

Deliverables

• Collection and analysis of baseline and follow up research data
• Summary of baseline data collection
• PowerPoint presentation summary of study findings
• Submission of draft study findings as an executive summary report and a full report to help future developments and improvements of our Mobile Health Unit services.

Research timelines

The proposal should include timelines for the research activities from initial data collection to submission of final report.

Budget

The total budget including any tax and overheads for the evaluation will be up to €10,000. Pfizer, our corporate partner for 2023 have provided sponsorship for the running of the Mobile Health Unit’s day to day services and related activities. This funding provided is spent independently by the Irish Heart Foundation for the Mobile Health Unit’s activities which may include research activities selected independently by the Irish Heart Foundation.

Proposal format

This should include a detailed description of research activities, cost and timelines proposed.  The below details the method for the proposal format:

• Researcher biography including relevant experience
• Researcher roles and responsibilities
• Proposed outline of research design and methods including data collection and analysis
• Ethical approval process and timelines
• Budget breakdown of all research activities
• Timeline estimation for:
  • baseline data collection
  • follow up data collection
  • data cleaning and analysis
  • summary report writing and submission
  • final report writing and publication

Ethical Approval Process

The proposal should include a process for ethical approval to demonstrate adherence to ethical standards.

Data Protection

All research activities conducted on behalf of the Irish Heart Foundation relating to the collection, processing and storing of individual’s data must comply with national GDPR regulations, IHF’s GDPR guidelines, and the academic institute’s data protection guidelines which the researcher is an employee of.

Evaluation criteria

Proposals will be evaluated and the contract awarded based on the following criteria, not necessarily in this order:

• Researcher profile including relevant experience
• Understanding of the project – outline of all research processes and activities
• Timeframe for completion
• Cost effectiveness
• Researcher referees
• Contact details

It is advised potential applicants may be required to make a formal presentation of their proposal.

Submission Information

Proposals should be emailed to Caitriona Pollard, cpollard@irishheart.ie no later than COB on 24th March 2023.

Proposal candidates may be shortlisted for interview in March 2023 following our review process.

Any queries should be submitted to cpollard@irishheart.ie.

References

Central Statistics Office (2021) Statistics, Vital Statistics Yearly Summary. Available at: https://www.cso.ie/en/releasesandpublications/ep/p-vsys/vitalstatistics… (Accessed 11th January 2023).

Murphy, C. M., et al. (2015) "Hypertension prevalence, awareness, treatment and control in the over 50s in Ireland: evidence from The Irish Longitudinal Study on Ageing." Journal of Public Health, 38(3) pp. 450-458.

World Health Organisation (2015) Cardiovascular diseases: Avoiding heart attacks and strokes. Available at: https://www.who.int/news-room/questions-and-answers/item/cardiovascular-diseases-avoiding-heart-attacks-and-strokes (Accessed 11th January 2023).

World Health Organisation (2021) Cardiovascular Diseases. Available at:  https://www.who.int/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds) (Accessed 11th January 2023).

Van Doorn, D. and Richardson, N. (2017) Mobile Health Unit Blood Pressure Check Services Evaluation Report. Available at:    https://irishheart.ie/wp-content/uploads/2017/11/IH-MHU-Report-FINAL-091117-CLEAN.pdf (Accessed: 11th January 2023).