Capital Health – Hamilton Diagnostic Services Updates

Chronic Disease

Cardiac Opportunities for Resilience and Empowerment (CORE)

Capital Health’s Cardiac Opportunities for Resilience and Empowerment (CORE) Program aims to improve the lives of Trenton residents insured through Medicaid who are diagnosed with cardiovascular disease and address barriers to cardiac health. CORE helps people self-manage their heart conditions by connecting them with care providers, community education and screening programs, and guidance for healthy eating. The program is part of a grant awarded through the Collaborative for Equity in Cardiac Care, a five-year initiative funded by the Merck Foundation to improve access to high-quality, person-centered health care for people living with heart conditions in the United States. Capital Health is one of 11 grant awardees in the United States.

Residents in the City of Trenton face a number of systemic barriers and inequities:

  • Life expectancy is 4.4 years less than in other measured cities.
  • 26% percent of the population lives below the poverty line.
  • The incidence of cardiovascular disease (such as hypertension) affects more than one third of the community.

CORE Program goals are to:

  • Reduce cardiovascular risk.
  • Improve health awareness and knowledge.
  • Support lasting lifestyle changes.
  • Increase access to community resources.
  • Provide support with social needs including (but not limited to) food insecurity, housing, and transportation.

What We Offer

The CORE Program addresses key health issues like nutrition and physical activity; blood pressure, cholesterol, and blood sugar management; weight and sleep health management; and tobacco cessation. The journey starts with a referral from primary care or hospital clinicians, community outreach, or self-referrals. This is followed by an initial assessment conducted by a Population Care coordinator to identify goals and objectives for the participant. When appropriate, patients are connected with community health workers through Trenton Health Team to address social barriers such food or shelter insecurity.

Our services include:

  • Heart health screenings.
  • Personalized care plans.
  • Pharmacist-led medication management.
  • Wellness follow-ups.
  • Health education and coaching.
  • Community engagement and education.

Participants will also have on-going support with self-managing their cardiac health and tracking their progress using the MyDataHelps app.

Connect to the CORE App

Participants in the CORE Program can receive additional on-going support through our dedicated app. Click here to enroll in the app today!

Contact Us

Ask your doctor for a referral or contact us directly to enroll in the CORE Program.

Lattwana Anderson, RN, CCM
Population Care Coordinator
Office: 609-815-7543
[email protected]

Shamiese B. Dunagan, MS, BA
Program Coordinator
Office: 609-775-9808
Mobile: 640-293-2696
[email protected]