Table 4.

American Heart Association Policy Strategies to Address Stroke Systems of Care

Stroke Systems of CareAdvocacy/Policy Strategies
PreventionFederal
• Incorporate measures of physical activity levels into electronic medical records and counsel in the healthcare environment
• Advocate for regular revision and update of the “Physical Activity Guidelines for Americans”
• Obesity counseling and treatment coverage in the healthcare environment
• Robust surveillance and monitoring of obesity
• Partner with US Department of Health and Human Services to promote the Million Hearts campaign
• Work to eliminate food deserts and improve access to and affordability of healthy foods
• Reduce sodium in the food supply
• Implement the Institute of Medicine’s recommendations to reduce sodium in the food supply
• Improve food labeling to increase consumer understanding of sodium levels in packaged foods
• Advocate for robust sodium limits in procurement standards, nutrition standards in schools, and other government feeding programs
State
• Increase sports, recreational opportunities, parks, and green spaces in the community
• Support efforts to design workplaces, communities, and schools around active living and integrate physical activity opportunities throughout the day
• Support the use of zoning policy to increase access to safe places for recreation
• Create and maintain comprehensive worksite wellness programs
• Advocate for adequate prevention, diagnosis, and treatment of overweight and obesity in the healthcare environment
• Advocate for continued funding for obesity prevention research and work to ensure a strong evaluation component is a part of the implementation of new laws and programs
• Include sodium information through the use of warnings on the menu as allowed by federal law and support strategies that reduce sodium in the food supply
• Support the elimination of food deserts through policies that increase the availability of fruits, vegetables, and water in underserved neighborhoods
• Support the use of zoning policy to increase access to healthy foods and decrease access to unhealthy foods
• Support the establishment of food procurement policies that meet AHA guidelines for government offices
• Support policies that change relative prices of healthy vs unhealthy food items
• Support policies designed to encourage retailers to increase access to healthy foods while decreasing access to unhealthy foods
• Increase funding for programs that eliminate health disparities
• Promote public funding for heart disease and stroke programs
• Support policies that ensure the availability of evidence-based stroke preventive benefits in private insurance and public health programs that are consistent with the AHA position statement, “Recommended Model Benefits Package: Preventive Cardiovascular Services” and the US Preventive Services Task Force recommendations for preventive health services. Support policies that eliminate cost sharing (including copays and deductibles) associated with these stroke-related preventive services. Oppose policies that establish punitive measures within health plans for those with CVD risk factors such as tobacco use, being overweight or obese, hypertension, and high cholesterol.
EMS transportFederal/state
• Support public policy and sustainable appropriations initiatives and other activities that promote increased quality and timely use of 9-1-1 systems. This includes the ability of current and future generations of telecommunications technology to supply enhanced 9-1-1 (E9-1-1) capabilities to their customers.
• Promote the use of sustainable funding for nationally recognized emergency medical dispatch protocols and appropriate quality improvement programs among 9-1-1 dispatch agencies to ensure that bystanders promptly receive effective coaching and support and that dispatch personnel provide prearrival medical instructions
• Support public policy, sustainable appropriations, and other initiatives that promote a strong, well-trained, data-driven, quality EMS system that improves collaboration, responsiveness, and effectiveness
• Strengthen EMS systems by supporting efforts that will eliminate geographic, racial, ethnic, sex, and socioeconomic disparities in EMS care
• Using current AHA/ASA guidelines for stroke care, promote within EMSs statewide standardization and implementation of stroke training, assessment, treatment, and transportation protocols