{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T18:35:22Z","timestamp":1793212522380,"version":"4.5.0"},"reference-count":23,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T00:00:00Z","timestamp":1791849600000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000274","name":"British Heart Foundation","doi-asserted-by":"publisher","award":["NIHR301338"],"award-info":[{"award-number":["NIHR301338"]}],"id":[{"id":"10.13039\/501100000274","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000272","name":"National Institute for Health and Care Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100030827","name":"NHS","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100030827","id-type":"DOI","asserted-by":"publisher"}]},{"name":"UK Department of Health and Social Care","id":[{"id":"https:\/\/ror.org\/03sbpja79","id-type":"ROR","asserted-by":"crossref"}]},{"name":"Greater Manchester Innovation Accelerator"},{"name":"University of Manchester British Heart Foundation Research Excellence Award","award":["RE\/24\/130017"],"award-info":[{"award-number":["RE\/24\/130017"]}],"id":[{"id":"https:\/\/ror.org\/027m9bs27","id-type":"ROR","asserted-by":"crossref"}]},{"DOI":"10.13039\/100014653","name":"NIHR Manchester Biomedical Research Centre","doi-asserted-by":"publisher","award":["NIHR203308"],"award-info":[{"award-number":["NIHR203308"]}],"id":[{"id":"10.13039\/100014653","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Patients from socioeconomically deprived and ethnically diverse backgrounds are under-represented in cardiovascular research. EARLY Heart Failure in Greater Manchester is a community-based pilot study designed to predict incident heart failure in primary care. We aimed to assess the effectiveness of recruitment strategies for engaging underserved populations and quantify the burden of unrecognized cardiovascular disease (CVD).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The prospective cohort study enrolled 550 adults aged \u226550 years with two or more cardiometabolic risk factors and no prior diagnosis of HF. Participants were recruited via (i) targeted identification using electronic health records in eight primary care centres; (ii) digital advertising and targeted social media campaign; (iii) 10 community outreach events; and (iv) direct referral from family or friends. The baseline study visit included electrocardiogram, blood sampling, and imaging.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 185 (34%) participants were from the most deprived Index of Multiple Deprivation quintile, and 97 (18%) were of non-White ethnicity. Primary care and digital advertising were the most effective recruitment strategies, enrolling 444 (81%) and 68 (12%) participants, respectively, while maintaining diverse representation. The social media campaign generated 15 207 advertisement clicks and 1012 expressions of interest at a cost of \u00a35.93 per sign-up. Community outreach events enrolled 5 (1%) participants and were resource-intensive. A substantial burden of previously unrecognized CVD was identified: 125 (23%) participants had clinically actionable cardiac abnormalities, including 46 (9%) with previously unrecognized myocardial infarction, 331 (60%) had uncontrolled blood pressure (\u2265140\/90\u2005mmHg), and 162 (30%) had elevated N-terminal pro-B-type natriuretic peptide (\u2265125\u2005pg\/ml).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Primary care-embedded and digital recruitment strategies can effectively engage underserved communities at risk of heart failure, at scale and at low cost. This population has a very high burden of unrecognized CVD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ejhf\/xuag315","type":"journal-article","created":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T11:50:00Z","timestamp":1791633000000},"source":"Crossref","is-referenced-by-count":0,"title":["Underserved communities at risk of heart failure: effectiveness of community-based recruitment strategies and burden of unrecognized cardiovascular disease"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0089-6180","authenticated-orcid":false,"given":"Nicholas","family":"Black","sequence":"first","affiliation":[{"name":"Division of Cardiovascular Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre , Oxford Road, Manchester M13 9PL ,","place":["UK"]},{"name":"BHF Manchester Centre for Heart and Lung Magnetic Resonance Research, Manchester University NHS Foundation Trust , Southmoor Road, Wythenshawe, Manchester M13 9LT ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2030-9761","authenticated-orcid":false,"given":"Fardad","family":"Soltani","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre , Oxford Road, Manchester M13 9PL ,","place":["UK"]},{"name":"BHF Manchester Centre for Heart and Lung Magnetic Resonance Research, Manchester University NHS Foundation Trust , Southmoor Road, Wythenshawe, Manchester M13 9LT ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucy","family":"Priestner","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre , Oxford Road, Manchester M13 9PL ,","place":["UK"]},{"name":"BHF Manchester Centre for Heart and Lung Magnetic Resonance Research, Manchester University NHS Foundation Trust , Southmoor Road, Wythenshawe, Manchester M13 9LT ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua","family":"Bradley","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre , Oxford Road, Manchester M13 9PL ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Hutchings","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre , Oxford Road, Manchester M13 9PL ,","place":["UK"]},{"name":"BHF Manchester Centre for Heart and Lung Magnetic Resonance Research, Manchester University NHS Foundation Trust , Southmoor Road, Wythenshawe, Manchester M13 9LT ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amrit","family":"Chowdhary","sequence":"additional","affiliation":[{"name":"BHF Manchester Centre for Heart and Lung Magnetic Resonance Research, Manchester University NHS Foundation Trust , Southmoor Road, Wythenshawe, Manchester M13 9LT ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna B","family":"Reid","sequence":"additional","affiliation":[{"name":"BHF Manchester Centre for Heart and Lung Magnetic Resonance Research, Manchester University NHS Foundation Trust , Southmoor Road, Wythenshawe, Manchester M13 9LT ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon G","family":"Williams","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre , Oxford Road, Manchester M13 9PL ,","place":["UK"]},{"name":"BHF Manchester Centre for Heart and Lung Magnetic Resonance Research, Manchester University NHS Foundation Trust , Southmoor Road, Wythenshawe, Manchester M13 9LT ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Clark","sequence":"additional","affiliation":[{"name":"BHF Manchester Centre for Heart and Lung Magnetic Resonance Research, Manchester University NHS Foundation Trust , Southmoor Road, Wythenshawe, Manchester M13 9LT ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Westwell","sequence":"additional","affiliation":[{"name":"BHF Manchester Centre for Heart and Lung Magnetic Resonance Research, Manchester University NHS Foundation Trust , Southmoor Road, 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,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alisha","family":"Tresa-Antony","sequence":"additional","affiliation":[{"name":"BHF Manchester Centre for Heart and Lung Magnetic Resonance Research, Manchester University NHS Foundation Trust , Southmoor Road, Wythenshawe, Manchester M13 9LT ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicky","family":"Timmis","sequence":"additional","affiliation":[{"name":"Health Innovation Manchester, Citylabs 1.0 , Nelson Street, Manchester ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louise","family":"Scott","sequence":"additional","affiliation":[{"name":"Health Innovation Manchester, Citylabs 1.0 , Nelson Street, Manchester ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grainne","family":"Breen","sequence":"additional","affiliation":[{"name":"Firsway Health Centre , Manchester 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