‘Activate’ helps Canadians lower risk of heart disease and stroke

The Heart and Stroke Foundation of Canada has entered Phase 2 of a free program called Activate – a 3-year preventive program that aims to help 7,000 Canadians with pre-hypertension to lower their risk through healthy eating, smoking cessation, stress management, and regular exercise.

This is taking place after a successful start to Phase 1, which saw over 90 percent of participants complete the program with excellent results.

The program focuses on people over age 40 with a BP (blood pressure) between 121 and 139, otherwise known as ‘pre-hypertensive.’ High blood pressure is the number one risk for stroke and a leading risk factor for heart disease.

“Without intervention, half of pre-hypertensive people in Canada over age 60 will go on to develop high blood pressure within four years,” said Doug Roth, Chief Financial & Administrative Officer and Head of Social Enterprise for Heart & Stroke. “The goal of Activate is to provide participants with the tools to empower them to make positive lifestyle changes to turn around this dangerous trajectory, and reduce the risk of heart disease and stroke.”

The program is free for participants. To enrol, people must be over 40 years old, not have diabetes, and must not be on blood pressure medication.

They can book an appointment at heartandstroke.ca/activate or at participating YMCA or Shoppers Drug Mart locations in the Greater Toronto Area, Oakville, and Oshawa.

“Enrolment can even be done at the workplace, an experience that adds to the peer support aspect,” said Erin Kim, Strategic Initiatives Lead of the Activate program. “It promotes the idea that people are not alone, that others are going through the same thing, and that help is available – if you want it. There is absolutely no cost to becoming involved, and we invite interested companies to contact us for more information.”

Once enrolled, participants gain access to an online health platform with curated content and support from a personal health coach. They may also consult with a Loblaw in-store dietitian to learn about healthy eating.

Program sponsor YMCA of Greater Toronto is offering a two-month free membership and will waive the renewal fees if participants continue their membership – a good will gesture that benefits everyone. In addition, participants are rewarded with PC Optimum points for healthy behaviour while using the platform.

“The name Activate was chosen because the hope is that people will activate themselves, make lifestyle changes for the better to live healthier lives,” said Kim. “In 2018, we had 527 participants, and in 2019, enrolment will increase to 4,100 around the Greater Toronto Area.”

Activate is a $3.4 million program where, through working in partnership with MaRS Innovation, the funding is being provided by socially minded investors who are repaid by the Public Health Agency of Canada – if the program achieves its health outcome goals.

“The program is performance-based where the investors take on the financial risk. If we can prove that participants make improvements to their health – and that the program works – there are greater outcome payments for investors,” said Roth. “If we don’t achieve our target outcomes, the investors can lose the majority of their funds.”

“Investors like the funding model because their backing can generate both a social impact and a financial return. The government likes it because it allows them to push health innovation while managing risk, and Heart & Stroke likes it because without this funding we wouldn’t be able to run this program for Canadians,” added Roth.

Volunteers in the program have either a nursing background, or are students in healthcare programs such as wellness coaching. They are trained to enrol participants, take their blood pressure, and encourage them to join the program.

Online coaches all have a healthcare background; and some even work at NexJ Health – the company providing the online platform. Coaches help people adopt healthy behaviours, answer health-related questions, and help people navigate the platform.

Access to the online platform is done via a user’s own smartphone, tablet or desktop, and the program is designed to be simple, easy, and fun for people of all levels of experience with technology.

Once goals are set, through a guided assessment or a discussion with a coach, the participant’s progress is monitored over six months. “It provides many modes of communication and information including motivational messages from health coaches, informative articles, and suggested activities on the app. It is meant for people who want to make lifestyle changes,” said Kim.

After six months, participants discuss their overall progress and the lifestyle changes they’ve made. If they like, they can continue using the online platform for another six months, and participate in community wellness days with the YMCA.

Success of the program comes down to the results we can help participants achieve. “In our initial cohort in 2018 involving 527 people, the results were better than anticipated,” said Roth. “Our target is to have the blood pressure of participants stay flat and in this initial group we were able to lower the aggregate blood pressure by 5 mmHg in the systolic rate – e.g. 135 over 90 to 130 over 90. If we can help participants control their blood pressure, research has proven this will lead to fewer strokes and heart attacks, which is really exciting.”

Roth believes the program has the potential to be expanded in other ways. “The idea behind Activate is empowering people to make better choices by giving them the tools to eat better, be more active, manage stress and to stop smoking. These lifestyle behaviours are not unique to just preventing heart disease and stroke.

“In addition to expanding Activate to more locations, we see the potential to use our learnings to support more integrated health prevention initiatives. We are keen to work with others who share our vision of preventative healthcare.”