The Advocacy and Policy Committee collaborates with partners to ensure that cardiovascular health issues are represented at all levels of government and sets the council's legislative agenda. The committee works to connect CVH Council members with states that have policies or legislation related to heart disease, stroke, and their risk factors. A work group established by this committee explores strategies to influence national initiatives to address heart disease and stroke risk factors.

The Capacity Building Committee develops training programs and mentors state programs in cardiovascular health and program management. This committee has established a data work group to oversee several special projects and the CVH Council's internal evaluation.

The Communications Committee informs council members on internal and external activities related to cardiovascular health.

The Internal Council Organization Committee, whose priorities are membership development and council operations, maximizes resources to ensure that the council functions innovatively, efficiently, and effectively. The committee recruits state representatives from within and reviews operating guidelines, the strategic plan, and funding sources annually.

The Partnerships Committee identifies and collaborates with external groups, organizations, and individuals to advocate for, develop, and implement cardiovascular health programs and policies. This committee, in partnership with the Advocacy and Policy Committee, established a work group to provide training for American Heart Association staff to ensure that volunteers understand and value the work of state programs.

Control high blood pressure and high blood cholesterol. State programs are working in these two priority areas in health care, community, and worksite settings, and two articles from CDC authors address these issues (2,3).

Increase knowledge of stroke signs and symptoms and the need to call 9-1-1. Jurkowski et al (4) describe an evaluation of a media campaign in a four-county area of New York about the signs and symptoms of stroke and find a significant delay in seeking treatment for acute stroke. Having a history of seeking medical care emerged as a predictor for not seeking care for acute stroke. This article conveys the need for educational efforts to emphasize the seriousness of stroke symptoms and the need for emergency response. Wall et al (5) describe an evaluation of the stroke awareness animation from the Stroke Heroes Act FAST campaign in Massachusetts and find it to be effective in increasing and sustaining knowledge of stroke signs and symptoms.

Improve emergency response. In the last several years, more states have begun to focus on emergency response to acute cardiac and stroke events. A common first step is to assess the current system, as Tsai (6) did with the Minnesota Stroke Partnership. Its survey of emergency medical services (EMS) directors and hospitals identified several strengths of the system, including a perception that EMS dispatchers considered stroke an emergency event, existence of policies to notify the destination hospital of an incoming patient suspected to be experiencing a stroke, and a perception that hospital staff attend to these patients immediately. Recommendations for improvements included standardizing prehospital assessment of these patients, developing and implementing standard emergency department protocols and standing orders, developing inpatient care protocols and pathways, and providing training in best practices to ensure the highest quality of care for patients with stroke.

Improve quality of care. Meyer et al (7) describe how Maine's CVH and EMS programs have partnered to use prehospital data to plan and evaluate the state's heart disease and stroke program. This article offers several descriptive statistics about the data set, including the rate of transport runs for stroke and cardiac events and time-to-scene and overall transport times. Maine's CVH and EMS programs have formed the Maine HeartSafe Community Initiative, which recognizes local EMS services for their efforts and provides awareness and educational opportunities about heart disease and stroke. Next steps include linking EMS data to emergency department and hospital data sets for a more complete picture of the quality of care provided to patients with acute myocardial infarction or stroke.