Trial Outcomes & Findings for Assessing Effectiveness and Implementation of an EHR Tool to Assess Heart Health Among Survivors (NCT NCT03935282)

Results Overview

Discussion of non-ideal cardiovascular health (CVH) factors (yes or no). CVH discussions will be defined as patient-reported discussions with their provider for any of the seven non-ideal CVH conditions identified for that patient. Conditions include CVH factors (cholesterol, blood pressure, glucose/hemoglobin A1c) and CVH behaviors (body mass index, smoking, diet, and physical activity). Measured using survivor survey (discussions, diet, and primary care) and EHR for other CVH factors.

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

645 participants

Primary outcome timeframe

Baseline

Results posted on

2026-04-15

Participant Flow

Unit of analysis: Practices

Participant milestones

Participant milestones
Measure	Intervention - AH-HA Tool With assistance from the study team, the clinic will implement the AH-HA tool in the clinics' EPIC EHR. Providers at the intervention sites will be trained to use the tool during routine follow-up care with survivors. During a routine follow-up care appointment, the provider will use the AH-HA tool with enrolled patients. AH-HA Tool in the EPIC EHR: The Automated Heart-Health Assessment tool implemented in clinics' EPIC EHR will be used by providers during routine follow-up care appointments.	Usual Care Usual care practices will conduct routine follow-up care visits for enrolled survivors following typical clinic practice, without use of the AH-HA tool.
Pre-Visit Baseline STARTED	296 4	349 5
Pre-Visit Baseline COMPLETED	294 4	346 5
Pre-Visit Baseline NOT COMPLETED	2 0	3 0
Post-Visit Baseline STARTED	294 4	346 5
Post-Visit Baseline COMPLETED	292 4	343 5
Post-Visit Baseline NOT COMPLETED	2 0	3 0
6-Months Post-Visit STARTED	292 4	343 5
6-Months Post-Visit COMPLETED	274 4	336 5
6-Months Post-Visit NOT COMPLETED	18 0	7 0
12-Months Post-Visit STARTED	274 4	336 5
12-Months Post-Visit COMPLETED	259 4	326 5
12-Months Post-Visit NOT COMPLETED	15 0	10 0

Reasons for withdrawal

Reasons for withdrawal
Measure	Intervention - AH-HA Tool With assistance from the study team, the clinic will implement the AH-HA tool in the clinics' EPIC EHR. Providers at the intervention sites will be trained to use the tool during routine follow-up care with survivors. During a routine follow-up care appointment, the provider will use the AH-HA tool with enrolled patients. AH-HA Tool in the EPIC EHR: The Automated Heart-Health Assessment tool implemented in clinics' EPIC EHR will be used by providers during routine follow-up care appointments.	Usual Care Usual care practices will conduct routine follow-up care visits for enrolled survivors following typical clinic practice, without use of the AH-HA tool.
Pre-Visit Baseline Withdrawal by Subject	2	2
Pre-Visit Baseline Lost to Follow-up	0	1
Post-Visit Baseline Withdrawal by Subject	1	2
Post-Visit Baseline Physician Decision	1	0
Post-Visit Baseline Lost to Follow-up	0	1
6-Months Post-Visit Lost to Follow-up	13	5
6-Months Post-Visit Death	1	0
6-Months Post-Visit Withdrawal by Subject	4	2
12-Months Post-Visit Lost to Follow-up	15	7
12-Months Post-Visit Death	0	2
12-Months Post-Visit Withdrawal by Subject	0	1

Baseline Characteristics

Assessing Effectiveness and Implementation of an EHR Tool to Assess Heart Health Among Survivors

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure	Intervention - AH-HA Tool n=296 Participants With assistance from the study team, the clinic will implement the AH-HA tool in the clinics' EPIC EHR. Providers at the intervention sites will be trained to use the tool during routine follow-up care with survivors. During a routine follow-up care appointment, the provider will use the AH-HA tool with enrolled patients. AH-HA Tool in the EPIC EHR: The Automated Heart-Health Assessment tool implemented in clinics' EPIC EHR will be used by providers during routine follow-up care appointments.	Usual Care n=349 Participants Usual care practices will conduct routine follow-up care visits for enrolled survivors following typical clinic practice, without use of the AH-HA tool.	Total n=645 Participants Total of all reporting groups
Age, Categorical <=18 years	0 Participants n=193 Participants	0 Participants n=193 Participants	0 Participants n=386 Participants
Age, Categorical Between 18 and 65 years	164 Participants n=193 Participants	195 Participants n=193 Participants	359 Participants n=386 Participants
Age, Categorical >=65 years	132 Participants n=193 Participants	154 Participants n=193 Participants	286 Participants n=386 Participants
Sex: Female, Male Female	288 Participants n=193 Participants	329 Participants n=193 Participants	617 Participants n=386 Participants
Sex: Female, Male Male	8 Participants n=193 Participants	20 Participants n=193 Participants	28 Participants n=386 Participants
Race/Ethnicity, Customized Race/Ethnicity · White	233 Participants n=193 Participants	308 Participants n=193 Participants	541 Participants n=386 Participants
Race/Ethnicity, Customized Race/Ethnicity · Black or African American	35 Participants n=193 Participants	15 Participants n=193 Participants	50 Participants n=386 Participants
Race/Ethnicity, Customized Race/Ethnicity · Hispanic	14 Participants n=193 Participants	10 Participants n=193 Participants	24 Participants n=386 Participants
Race/Ethnicity, Customized Race/Ethnicity · Other/More than one race	14 Participants n=193 Participants	16 Participants n=193 Participants	30 Participants n=386 Participants
Cancer Type Breast	274 Participants n=193 Participants	255 Participants n=193 Participants	529 Participants n=386 Participants
Cancer Type Endometrial	1 Participants n=193 Participants	53 Participants n=193 Participants	54 Participants n=386 Participants
Cancer Type Other/Multiple	20 Participants n=193 Participants	40 Participants n=193 Participants	60 Participants n=386 Participants
Cancer Type Uknown	1 Participants n=193 Participants	1 Participants n=193 Participants	2 Participants n=386 Participants
Rural Residence	57 Participants n=193 Participants	56 Participants n=193 Participants	113 Participants n=386 Participants
Time Since Cancer Diagnosis	4.57 Years STANDARD_DEVIATION 3.87 • n=193 Participants	4.82 Years STANDARD_DEVIATION 3.83 • n=193 Participants	4.70 Years STANDARD_DEVIATION 3.85 • n=386 Participants
Receipt of Any Cancer Treatment	285 Participants n=193 Participants	315 Participants n=193 Participants	600 Participants n=386 Participants
Receipt of Radiation	194 Participants n=193 Participants	245 Participants n=193 Participants	439 Participants n=386 Participants
Receipt of Chemotherapy	109 Participants n=193 Participants	226 Participants n=193 Participants	335 Participants n=386 Participants
Receipt of Anthracyclines	57 Participants n=193 Participants	94 Participants n=193 Participants	151 Participants n=386 Participants
Receipt of Hormone Therapy/Aromatase Inhibitors	233 Participants n=193 Participants	196 Participants n=193 Participants	429 Participants n=386 Participants
Receipt of Monoclonal Antibodies	35 Participants n=193 Participants	51 Participants n=193 Participants	86 Participants n=386 Participants
Cardiovascular Comorbidities Hypertension/High Blood Pressure	128 Participants n=193 Participants	176 Participants n=193 Participants	304 Participants n=386 Participants
Cardiovascular Comorbidities High Cholesterol	124 Participants n=193 Participants	172 Participants n=193 Participants	296 Participants n=386 Participants
Cardiovascular Comorbidities Obesity	55 Participants n=193 Participants	151 Participants n=193 Participants	206 Participants n=386 Participants
Cardiovascular Comorbidities Diabetes	52 Participants n=193 Participants	68 Participants n=193 Participants	120 Participants n=386 Participants
Cardiovascular Comorbidities Atherosclerotic Vascular Disease (ASCVD)	22 Participants n=193 Participants	73 Participants n=193 Participants	95 Participants n=386 Participants

PRIMARY outcome

Timeframe: Baseline

Discussion of non-ideal cardiovascular health (CVH) factors (yes or no). CVH discussions will be defined as patient-reported discussions with their provider for any of the seven non-ideal CVH conditions identified for that patient. Conditions include CVH factors (cholesterol, blood pressure, glucose/hemoglobin A1c) and CVH behaviors (body mass index, smoking, diet, and physical activity). Measured using survivor survey (discussions, diet, and primary care) and EHR for other CVH factors.

Outcome measures

Outcome measures
Measure	Intervention - AH-HA Tool n=294 Participants With assistance from the study team, the clinic will implement the AH-HA tool in the clinics' EPIC EHR. Providers at the intervention sites will be trained to use the tool during routine follow-up care with survivors. During a routine follow-up care appointment, the provider will use the AH-HA tool with enrolled patients. AH-HA Tool in the EPIC EHR: The Automated Heart-Health Assessment tool implemented in clinics' EPIC EHR will be used by providers during routine follow-up care appointments.	Usual Care n=346 Participants Usual care practices will conduct routine follow-up care visits for enrolled survivors following typical clinic practice, without use of the AH-HA tool.
Proportion of Patients Reporting Discussion of at Least One Non-ideal or Missing CVH Topic	96.2 Percentage of participants Interval 93.5 to 97.8	52.2 Percentage of participants Interval 45.6 to 58.8

SECONDARY outcome

Timeframe: Baseline

Medical chart abstraction of referrals to providers regarding CVH at survivor baseline visit.

Outcome measures

Outcome measures
Measure	Intervention - AH-HA Tool n=294 Participants With assistance from the study team, the clinic will implement the AH-HA tool in the clinics' EPIC EHR. Providers at the intervention sites will be trained to use the tool during routine follow-up care with survivors. During a routine follow-up care appointment, the provider will use the AH-HA tool with enrolled patients. AH-HA Tool in the EPIC EHR: The Automated Heart-Health Assessment tool implemented in clinics' EPIC EHR will be used by providers during routine follow-up care appointments.	Usual Care n=346 Participants Usual care practices will conduct routine follow-up care visits for enrolled survivors following typical clinic practice, without use of the AH-HA tool.
Referrals to Primary Care to Manage CV Risk	28.7 percentage of participants Interval 15.7 to 46.7	24.8 percentage of participants Interval 14.2 to 39.7

SECONDARY outcome

Timeframe: Baseline

Medical chart abstraction of referrals to providers regarding CVH at survivor baseline visit.

Outcome measures

Outcome measures
Measure	Intervention - AH-HA Tool n=294 Participants With assistance from the study team, the clinic will implement the AH-HA tool in the clinics' EPIC EHR. Providers at the intervention sites will be trained to use the tool during routine follow-up care with survivors. During a routine follow-up care appointment, the provider will use the AH-HA tool with enrolled patients. AH-HA Tool in the EPIC EHR: The Automated Heart-Health Assessment tool implemented in clinics' EPIC EHR will be used by providers during routine follow-up care appointments.	Usual Care n=346 Participants Usual care practices will conduct routine follow-up care visits for enrolled survivors following typical clinic practice, without use of the AH-HA tool.
Referrals to Cardiology to Manage CV Risk	2.9 percentage of participants Interval 0.8 to 10.0	2.9 percentage of participants Interval 1.4 to 5.8

SECONDARY outcome

Timeframe: Baseline

Medical chart abstraction.

Outcome measures

Outcome measures
Measure	Intervention - AH-HA Tool n=294 Participants With assistance from the study team, the clinic will implement the AH-HA tool in the clinics' EPIC EHR. Providers at the intervention sites will be trained to use the tool during routine follow-up care with survivors. During a routine follow-up care appointment, the provider will use the AH-HA tool with enrolled patients. AH-HA Tool in the EPIC EHR: The Automated Heart-Health Assessment tool implemented in clinics' EPIC EHR will be used by providers during routine follow-up care appointments.	Usual Care n=346 Participants Usual care practices will conduct routine follow-up care visits for enrolled survivors following typical clinic practice, without use of the AH-HA tool.
Ordering of CVH-relevant Labs and Treatments to Manage CV Risk: Cholesterol Test	25 Participants	0 Participants

SECONDARY outcome

Timeframe: Baseline

Medical chart abstraction.

Outcome measures

Outcome measures
Measure	Intervention - AH-HA Tool n=294 Participants With assistance from the study team, the clinic will implement the AH-HA tool in the clinics' EPIC EHR. Providers at the intervention sites will be trained to use the tool during routine follow-up care with survivors. During a routine follow-up care appointment, the provider will use the AH-HA tool with enrolled patients. AH-HA Tool in the EPIC EHR: The Automated Heart-Health Assessment tool implemented in clinics' EPIC EHR will be used by providers during routine follow-up care appointments.	Usual Care n=346 Participants Usual care practices will conduct routine follow-up care visits for enrolled survivors following typical clinic practice, without use of the AH-HA tool.
Ordering of CVH-relevant Labs and Treatments to Manage CV Risk: Glucose Test	19 Participants	49 Participants

SECONDARY outcome

Timeframe: Baseline

Medical chart abstraction.

Outcome measures

Outcome measures
Measure	Intervention - AH-HA Tool n=294 Participants With assistance from the study team, the clinic will implement the AH-HA tool in the clinics' EPIC EHR. Providers at the intervention sites will be trained to use the tool during routine follow-up care with survivors. During a routine follow-up care appointment, the provider will use the AH-HA tool with enrolled patients. AH-HA Tool in the EPIC EHR: The Automated Heart-Health Assessment tool implemented in clinics' EPIC EHR will be used by providers during routine follow-up care appointments.	Usual Care n=346 Participants Usual care practices will conduct routine follow-up care visits for enrolled survivors following typical clinic practice, without use of the AH-HA tool.
Ordering of CVH-relevant Labs and Treatments to Manage CV Risk: A1c Test	22 Participants	1 Participants

SECONDARY outcome

Timeframe: Baseline

Medical chart abstraction.

Outcome measures

Outcome measures
Measure	Intervention - AH-HA Tool n=294 Participants With assistance from the study team, the clinic will implement the AH-HA tool in the clinics' EPIC EHR. Providers at the intervention sites will be trained to use the tool during routine follow-up care with survivors. During a routine follow-up care appointment, the provider will use the AH-HA tool with enrolled patients. AH-HA Tool in the EPIC EHR: The Automated Heart-Health Assessment tool implemented in clinics' EPIC EHR will be used by providers during routine follow-up care appointments.	Usual Care n=346 Participants Usual care practices will conduct routine follow-up care visits for enrolled survivors following typical clinic practice, without use of the AH-HA tool.
Ordering of CVH-relevant Labs and Treatments to Manage CV Risk: Cholesterol Medication	3 Participants	3 Participants

SECONDARY outcome

Timeframe: Baseline

Medical chart abstraction.

Outcome measures

Outcome measures
Measure	Intervention - AH-HA Tool n=294 Participants With assistance from the study team, the clinic will implement the AH-HA tool in the clinics' EPIC EHR. Providers at the intervention sites will be trained to use the tool during routine follow-up care with survivors. During a routine follow-up care appointment, the provider will use the AH-HA tool with enrolled patients. AH-HA Tool in the EPIC EHR: The Automated Heart-Health Assessment tool implemented in clinics' EPIC EHR will be used by providers during routine follow-up care appointments.	Usual Care n=346 Participants Usual care practices will conduct routine follow-up care visits for enrolled survivors following typical clinic practice, without use of the AH-HA tool.
Ordering of CVH-relevant Labs and Treatments to Manage CV Risk: Diabetes Medication	0 Participants	1 Participants

SECONDARY outcome

Timeframe: Baseline

Medical chart abstraction.

Outcome measures

Outcome measures
Measure	Intervention - AH-HA Tool n=294 Participants With assistance from the study team, the clinic will implement the AH-HA tool in the clinics' EPIC EHR. Providers at the intervention sites will be trained to use the tool during routine follow-up care with survivors. During a routine follow-up care appointment, the provider will use the AH-HA tool with enrolled patients. AH-HA Tool in the EPIC EHR: The Automated Heart-Health Assessment tool implemented in clinics' EPIC EHR will be used by providers during routine follow-up care appointments.	Usual Care n=346 Participants Usual care practices will conduct routine follow-up care visits for enrolled survivors following typical clinic practice, without use of the AH-HA tool.
Ordering of CVH-relevant Labs and Treatments to Manage CV Risk: Blood Pressure Medication	3 Participants	3 Participants

SECONDARY outcome

Timeframe: 1 year

Medical chart abstraction of completed visits to providers regarding CVH one year from survivor baseline visit

Outcome measures

Outcome measures
Measure	Intervention - AH-HA Tool n=274 Participants With assistance from the study team, the clinic will implement the AH-HA tool in the clinics' EPIC EHR. Providers at the intervention sites will be trained to use the tool during routine follow-up care with survivors. During a routine follow-up care appointment, the provider will use the AH-HA tool with enrolled patients. AH-HA Tool in the EPIC EHR: The Automated Heart-Health Assessment tool implemented in clinics' EPIC EHR will be used by providers during routine follow-up care appointments.	Usual Care n=336 Participants Usual care practices will conduct routine follow-up care visits for enrolled survivors following typical clinic practice, without use of the AH-HA tool.
Any Completed Visits With Primary Care Providers	63.2 percentage of participants Interval 46.9 to 77.0	74.5 percentage of participants Interval 62.2 to 83.8

SECONDARY outcome

Timeframe: 1 year

Medical chart abstraction of completed visits to providers regarding CVH one year from survivor baseline visit

Outcome measures

Outcome measures
Measure	Intervention - AH-HA Tool n=274 Participants With assistance from the study team, the clinic will implement the AH-HA tool in the clinics' EPIC EHR. Providers at the intervention sites will be trained to use the tool during routine follow-up care with survivors. During a routine follow-up care appointment, the provider will use the AH-HA tool with enrolled patients. AH-HA Tool in the EPIC EHR: The Automated Heart-Health Assessment tool implemented in clinics' EPIC EHR will be used by providers during routine follow-up care appointments.	Usual Care n=336 Participants Usual care practices will conduct routine follow-up care visits for enrolled survivors following typical clinic practice, without use of the AH-HA tool.
Any Completed Visits With Cardiology Providers	5.3 percentage of participants Interval 2.6 to 10.5	16.2 percentage of participants Interval 12.0 to 21.4

SECONDARY outcome

Timeframe: 1 year

Medical chart abstraction; Patient survey as secondary, verification source. Proportion of participants who were non-smoking at 1-year, of those who were smoking at baseline.

Outcome measures

Outcome measures
Measure	Intervention - AH-HA Tool n=274 Participants With assistance from the study team, the clinic will implement the AH-HA tool in the clinics' EPIC EHR. Providers at the intervention sites will be trained to use the tool during routine follow-up care with survivors. During a routine follow-up care appointment, the provider will use the AH-HA tool with enrolled patients. AH-HA Tool in the EPIC EHR: The Automated Heart-Health Assessment tool implemented in clinics' EPIC EHR will be used by providers during routine follow-up care appointments.	Usual Care n=336 Participants Usual care practices will conduct routine follow-up care visits for enrolled survivors following typical clinic practice, without use of the AH-HA tool.
Change in CVH Behaviors Recorded in the Past Year: Smoking Status	47.1 percentage of participants Interval 18.1 to 78.1	13.1 percentage of participants Interval 1.8 to 55.8

SECONDARY outcome

Timeframe: 1 year

Medical chart abstraction; Patient survey as secondary, verification source. Change in BMI from baseline to 1-year.

Outcome measures

Outcome measures
Measure	Intervention - AH-HA Tool n=274 Participants With assistance from the study team, the clinic will implement the AH-HA tool in the clinics' EPIC EHR. Providers at the intervention sites will be trained to use the tool during routine follow-up care with survivors. During a routine follow-up care appointment, the provider will use the AH-HA tool with enrolled patients. AH-HA Tool in the EPIC EHR: The Automated Heart-Health Assessment tool implemented in clinics' EPIC EHR will be used by providers during routine follow-up care appointments.	Usual Care n=336 Participants Usual care practices will conduct routine follow-up care visits for enrolled survivors following typical clinic practice, without use of the AH-HA tool.
Change in CVH Behaviors Recorded in the Past Year: BMI	-0.98 BMI (kg/m^2) Interval -3.01 to 1.05	0.97 BMI (kg/m^2) Interval -0.56 to 2.49

SECONDARY outcome

Timeframe: 1 year

Medical chart abstraction; Patient survey as secondary, verification source. Change in total minutes of physical activity per week from baseline to 1-year.

Outcome measures

Outcome measures
Measure	Intervention - AH-HA Tool n=274 Participants With assistance from the study team, the clinic will implement the AH-HA tool in the clinics' EPIC EHR. Providers at the intervention sites will be trained to use the tool during routine follow-up care with survivors. During a routine follow-up care appointment, the provider will use the AH-HA tool with enrolled patients. AH-HA Tool in the EPIC EHR: The Automated Heart-Health Assessment tool implemented in clinics' EPIC EHR will be used by providers during routine follow-up care appointments.	Usual Care n=336 Participants Usual care practices will conduct routine follow-up care visits for enrolled survivors following typical clinic practice, without use of the AH-HA tool.
Change in CVH Behaviors Recorded in the Past Year: Physical Activity	-32.8 minutes/week Interval -151.7 to 86.0	23.9 minutes/week Interval -66.1 to 113.9

SECONDARY outcome

Timeframe: 1 year

Medical chart abstraction; Patient survey as secondary, verification source. Change in healthy diet score from baseline to 1-year. Healthy diet score is calculated from the sum of 5 diet questions (range: 0-5) with higher scores indicating a healthier diet.

Outcome measures

Outcome measures
Measure	Intervention - AH-HA Tool n=274 Participants With assistance from the study team, the clinic will implement the AH-HA tool in the clinics' EPIC EHR. Providers at the intervention sites will be trained to use the tool during routine follow-up care with survivors. During a routine follow-up care appointment, the provider will use the AH-HA tool with enrolled patients. AH-HA Tool in the EPIC EHR: The Automated Heart-Health Assessment tool implemented in clinics' EPIC EHR will be used by providers during routine follow-up care appointments.	Usual Care n=336 Participants Usual care practices will conduct routine follow-up care visits for enrolled survivors following typical clinic practice, without use of the AH-HA tool.
Change in CVH Behaviors Recorded in the Past Year: Healthy Diet Score	0.5 diet score Interval 0.2 to 0.8	0.4 diet score Interval 0.1 to 0.6

SECONDARY outcome

Timeframe: 1 year

Medical chart abstraction; Patient survey as secondary, verification source. Change in total cholesterol from baseline to 1-year.

Outcome measures

Outcome measures
Measure	Intervention - AH-HA Tool n=274 Participants With assistance from the study team, the clinic will implement the AH-HA tool in the clinics' EPIC EHR. Providers at the intervention sites will be trained to use the tool during routine follow-up care with survivors. During a routine follow-up care appointment, the provider will use the AH-HA tool with enrolled patients. AH-HA Tool in the EPIC EHR: The Automated Heart-Health Assessment tool implemented in clinics' EPIC EHR will be used by providers during routine follow-up care appointments.	Usual Care n=336 Participants Usual care practices will conduct routine follow-up care visits for enrolled survivors following typical clinic practice, without use of the AH-HA tool.
Change in CVH Factors Recorded in the Past Year: Total Cholesterol	-1.3 total cholesterol (mg/dL) Interval -8.6 to 6.0	-0.4 total cholesterol (mg/dL) Interval -6.2 to 5.4

SECONDARY outcome

Timeframe: 1 year

Medical chart abstraction; Patient survey as secondary, verification source. Change in systolic blood pressure l from baseline to 1-year.

Outcome measures

Outcome measures
Measure	Intervention - AH-HA Tool n=274 Participants With assistance from the study team, the clinic will implement the AH-HA tool in the clinics' EPIC EHR. Providers at the intervention sites will be trained to use the tool during routine follow-up care with survivors. During a routine follow-up care appointment, the provider will use the AH-HA tool with enrolled patients. AH-HA Tool in the EPIC EHR: The Automated Heart-Health Assessment tool implemented in clinics' EPIC EHR will be used by providers during routine follow-up care appointments.	Usual Care n=336 Participants Usual care practices will conduct routine follow-up care visits for enrolled survivors following typical clinic practice, without use of the AH-HA tool.
Change in CVH Factors Recorded in the Past Year: Systolic Blood Pressure	0.1 SBP (mmHg) Interval -2.5 to 2.8	-0.2 SBP (mmHg) Interval -2.3 to 1.8

SECONDARY outcome

Timeframe: 1 year

Medical chart abstraction; Patient survey as secondary, verification source. Change in diastolic blood pressure l from baseline to 1-year.

Outcome measures

Outcome measures
Measure	Intervention - AH-HA Tool n=274 Participants With assistance from the study team, the clinic will implement the AH-HA tool in the clinics' EPIC EHR. Providers at the intervention sites will be trained to use the tool during routine follow-up care with survivors. During a routine follow-up care appointment, the provider will use the AH-HA tool with enrolled patients. AH-HA Tool in the EPIC EHR: The Automated Heart-Health Assessment tool implemented in clinics' EPIC EHR will be used by providers during routine follow-up care appointments.	Usual Care n=336 Participants Usual care practices will conduct routine follow-up care visits for enrolled survivors following typical clinic practice, without use of the AH-HA tool.
Change in CVH Factors Recorded in the Past Year: Diastolic Blood Pressure	-0.8 DBP (mmHg) Interval -2.3 to 0.8	-0.4 DBP (mmHg) Interval -1.6 to 0.8

SECONDARY outcome

Timeframe: 1 year

Medical chart abstraction; Patient survey as secondary, verification source. Change in A1c from baseline to 1-year.

Outcome measures

Outcome measures
Measure	Intervention - AH-HA Tool n=274 Participants With assistance from the study team, the clinic will implement the AH-HA tool in the clinics' EPIC EHR. Providers at the intervention sites will be trained to use the tool during routine follow-up care with survivors. During a routine follow-up care appointment, the provider will use the AH-HA tool with enrolled patients. AH-HA Tool in the EPIC EHR: The Automated Heart-Health Assessment tool implemented in clinics' EPIC EHR will be used by providers during routine follow-up care appointments.	Usual Care n=336 Participants Usual care practices will conduct routine follow-up care visits for enrolled survivors following typical clinic practice, without use of the AH-HA tool.
Change in CVH Factors Recorded in the Past Year: A1c	-0.2 A1c (%) Interval -0.7 to 0.3	0.3 A1c (%) Interval -0.1 to 0.6

SECONDARY outcome

Timeframe: 1 year

Medical chart abstraction; Patient survey as secondary, verification source. Change in glucose from baseline to 1-year.

Outcome measures

Outcome measures
Measure	Intervention - AH-HA Tool n=274 Participants With assistance from the study team, the clinic will implement the AH-HA tool in the clinics' EPIC EHR. Providers at the intervention sites will be trained to use the tool during routine follow-up care with survivors. During a routine follow-up care appointment, the provider will use the AH-HA tool with enrolled patients. AH-HA Tool in the EPIC EHR: The Automated Heart-Health Assessment tool implemented in clinics' EPIC EHR will be used by providers during routine follow-up care appointments.	Usual Care n=336 Participants Usual care practices will conduct routine follow-up care visits for enrolled survivors following typical clinic practice, without use of the AH-HA tool.
Change in CVH Factors Recorded in the Past Year: Glucose	6.3 glucose (mg/dL) Interval -4.1 to 16.7	4.4 glucose (mg/dL) Interval -2.3 to 11.2

SECONDARY outcome

Timeframe: Baseline

Measured using structured survivor survey. Health knowledge questions were adapted from a survey assessing the relative risk of cancer and cardiovascular disease in United States populations. Questions were asked on a 5-point Likert scale from Strongly Agree to Strongly Disagree. Responses were categorizes as Agree/Strongly Agree or Neutral/Disagree/Strongly Disagree. Models are estimating the proportion of participants who answered the question as Neutral/Disagree/Strongly Disagree at pre-visit baseline who then answered Agree/Strongly Agree at post-visit baseline.

Outcome measures

Outcome measures
Measure	Intervention - AH-HA Tool n=294 Participants With assistance from the study team, the clinic will implement the AH-HA tool in the clinics' EPIC EHR. Providers at the intervention sites will be trained to use the tool during routine follow-up care with survivors. During a routine follow-up care appointment, the provider will use the AH-HA tool with enrolled patients. AH-HA Tool in the EPIC EHR: The Automated Heart-Health Assessment tool implemented in clinics' EPIC EHR will be used by providers during routine follow-up care appointments.	Usual Care n=346 Participants Usual care practices will conduct routine follow-up care visits for enrolled survivors following typical clinic practice, without use of the AH-HA tool.
Patient Perception and Knowledge of CV Risks: I am Confident I Understand my Risk of Heart Disease	61.3 percentage of participants Interval 40.6 to 78.6	42.0 percentage of participants Interval 27.8 to 57.6

SECONDARY outcome

Timeframe: Baseline

Measured using structured survivor survey. Health knowledge questions were adapted from a survey assessing the relative risk of cancer and cardiovascular disease in United States populations. Questions were asked on a 5-point Likert scale from Strongly Agree to Strongly Disagree. Responses were categorizes as Agree/Strongly Agree or Neutral/Disagree/Strongly Disagree. Models are estimating the proportion of participants who answered the question as Neutral/Disagree/Strongly Disagree at pre-visit baseline who then answered Agree/Strongly Agree at post-visit baseline.

Outcome measures

Outcome measures
Measure	Intervention - AH-HA Tool n=294 Participants With assistance from the study team, the clinic will implement the AH-HA tool in the clinics' EPIC EHR. Providers at the intervention sites will be trained to use the tool during routine follow-up care with survivors. During a routine follow-up care appointment, the provider will use the AH-HA tool with enrolled patients. AH-HA Tool in the EPIC EHR: The Automated Heart-Health Assessment tool implemented in clinics' EPIC EHR will be used by providers during routine follow-up care appointments.	Usual Care n=346 Participants Usual care practices will conduct routine follow-up care visits for enrolled survivors following typical clinic practice, without use of the AH-HA tool.
Patient Perception and Knowledge of CV Risks: I Understand What Steps I Need to Take to Maintain or Improve my Heart Health	80.8 percentage of participants Interval 65.3 to 90.4	54.9 percentage of participants Interval 36.3 to 72.3

SECONDARY outcome

Timeframe: Baseline

Measured using structured survivor survey. Health knowledge questions were adapted from a survey assessing the relative risk of cancer and cardiovascular disease in United States populations. Questions were asked on a 5-point Likert scale from Strongly Agree to Strongly Disagree. Responses were categorizes as Agree/Strongly Agree or Neutral/Disagree/Strongly Disagree. Models are estimating the proportion of participants who answered the question as Neutral/Disagree/Strongly Disagree at pre-visit baseline who then answered Agree/Strongly Agree at post-visit baseline.

Outcome measures

Outcome measures
Measure	Intervention - AH-HA Tool n=294 Participants With assistance from the study team, the clinic will implement the AH-HA tool in the clinics' EPIC EHR. Providers at the intervention sites will be trained to use the tool during routine follow-up care with survivors. During a routine follow-up care appointment, the provider will use the AH-HA tool with enrolled patients. AH-HA Tool in the EPIC EHR: The Automated Heart-Health Assessment tool implemented in clinics' EPIC EHR will be used by providers during routine follow-up care appointments.	Usual Care n=346 Participants Usual care practices will conduct routine follow-up care visits for enrolled survivors following typical clinic practice, without use of the AH-HA tool.
Patient Perception and Knowledge of CV Risks: I Plan to Take Steps to Maintain or Improve my Heart Health Within the Next Year	79.2 percentage of participants Interval 48.8 to 93.8	49.5 percentage of participants Interval 33.2 to 65.9

SECONDARY outcome

Timeframe: Baseline

Measured using structured survivor survey. Health knowledge questions were adapted from a survey assessing the relative risk of cancer and cardiovascular disease in United States populations. Questions were asked on a 5-point Likert scale from Strongly Agree to Strongly Disagree. Responses were categorizes as Agree/Strongly Agree or Neutral/Disagree/Strongly Disagree. Models are estimating the proportion of participants who answered the question as Neutral/Disagree/Strongly Disagree at pre-visit baseline who then answered Agree/Strongly Agree at post-visit baseline.

Outcome measures

Outcome measures
Measure	Intervention - AH-HA Tool n=294 Participants With assistance from the study team, the clinic will implement the AH-HA tool in the clinics' EPIC EHR. Providers at the intervention sites will be trained to use the tool during routine follow-up care with survivors. During a routine follow-up care appointment, the provider will use the AH-HA tool with enrolled patients. AH-HA Tool in the EPIC EHR: The Automated Heart-Health Assessment tool implemented in clinics' EPIC EHR will be used by providers during routine follow-up care appointments.	Usual Care n=346 Participants Usual care practices will conduct routine follow-up care visits for enrolled survivors following typical clinic practice, without use of the AH-HA tool.
Patient Perception and Knowledge of CV Risks: Cancer Poses a Risk to my Health	33.4 percentage of participants Interval 13.4 to 61.9	45.0 percentage of participants Interval 22.2 to 70.2

SECONDARY outcome

Timeframe: Baseline

Measured using structured survivor survey. Health knowledge questions were adapted from a survey assessing the relative risk of cancer and cardiovascular disease in United States populations. Questions were asked on a 5-point Likert scale from Strongly Agree to Strongly Disagree. Responses were categorizes as Agree/Strongly Agree or Neutral/Disagree/Strongly Disagree. Models are estimating the proportion of participants who answered the question as Neutral/Disagree/Strongly Disagree at pre-visit baseline who then answered Agree/Strongly Agree at post-visit baseline.

Outcome measures

Outcome measures
Measure	Intervention - AH-HA Tool n=294 Participants With assistance from the study team, the clinic will implement the AH-HA tool in the clinics' EPIC EHR. Providers at the intervention sites will be trained to use the tool during routine follow-up care with survivors. During a routine follow-up care appointment, the provider will use the AH-HA tool with enrolled patients. AH-HA Tool in the EPIC EHR: The Automated Heart-Health Assessment tool implemented in clinics' EPIC EHR will be used by providers during routine follow-up care appointments.	Usual Care n=346 Participants Usual care practices will conduct routine follow-up care visits for enrolled survivors following typical clinic practice, without use of the AH-HA tool.
Patient Perception and Knowledge of CV Risks: Heart Disease Poses a Risk to my Health	57.1 percentage of participants Interval 39.7 to 72.9	31.8 percentage of participants Interval 21.6 to 44.1

SECONDARY outcome

Timeframe: Baseline

Measured using structured survivor survey. Health knowledge questions were adapted from a survey assessing the relative risk of cancer and cardiovascular disease in United States populations. Questions were asked on a 5-point Likert scale from Strongly Agree to Strongly Disagree. Responses were categorizes as Agree/Strongly Agree or Neutral/Disagree/Strongly Disagree. Models are estimating the proportion of participants who answered the question as Neutral/Disagree/Strongly Disagree at pre-visit baseline who then answered Agree/Strongly Agree at post-visit baseline.

Outcome measures

Outcome measures
Measure	Intervention - AH-HA Tool n=294 Participants With assistance from the study team, the clinic will implement the AH-HA tool in the clinics' EPIC EHR. Providers at the intervention sites will be trained to use the tool during routine follow-up care with survivors. During a routine follow-up care appointment, the provider will use the AH-HA tool with enrolled patients. AH-HA Tool in the EPIC EHR: The Automated Heart-Health Assessment tool implemented in clinics' EPIC EHR will be used by providers during routine follow-up care appointments.	Usual Care n=346 Participants Usual care practices will conduct routine follow-up care visits for enrolled survivors following typical clinic practice, without use of the AH-HA tool.
Patient Perception and Knowledge of CV Risks: I Think it is Important to Talk to my Oncology Provider About my Heart Health	61.6 percentage of participants Interval 42.0 to 78.0	24.7 percentage of participants Interval 16.3 to 35.7

SECONDARY outcome

Timeframe: Baseline

Measured using structured survivor survey. Health knowledge questions were adapted from a survey assessing the relative risk of cancer and cardiovascular disease in United States populations. Questions were asked on a 5-point Likert scale from Strongly Agree to Strongly Disagree. Responses were categorizes as Agree/Strongly Agree or Neutral/Disagree/Strongly Disagree. Models are estimating the proportion of participants who answered the question as Neutral/Disagree/Strongly Disagree at pre-visit baseline who then answered Agree/Strongly Agree at post-visit baseline.

Outcome measures

Outcome measures
Measure	Intervention - AH-HA Tool n=294 Participants With assistance from the study team, the clinic will implement the AH-HA tool in the clinics' EPIC EHR. Providers at the intervention sites will be trained to use the tool during routine follow-up care with survivors. During a routine follow-up care appointment, the provider will use the AH-HA tool with enrolled patients. AH-HA Tool in the EPIC EHR: The Automated Heart-Health Assessment tool implemented in clinics' EPIC EHR will be used by providers during routine follow-up care appointments.	Usual Care n=346 Participants Usual care practices will conduct routine follow-up care visits for enrolled survivors following typical clinic practice, without use of the AH-HA tool.
Patient Perception and Knowledge of CV Risks: I Think it is Important to Talk to my Primary Care Provider About my Heart Health	63.3 percentage of participants Interval 51.5 to 73.7	67.9 percentage of participants Interval 50.2 to 81.7

SECONDARY outcome

Timeframe: Baseline

Measured using structured survivor survey. Health knowledge questions were adapted from a survey assessing the relative risk of cancer and cardiovascular disease in United States populations. Questions were asked on a 5-point Likert scale from Strongly Agree to Strongly Disagree. Responses were categorizes as Agree/Strongly Agree or Neutral/Disagree/Strongly Disagree. Models are estimating the proportion of participants who answered the question as Neutral/Disagree/Strongly Disagree at pre-visit baseline who then answered Agree/Strongly Agree at post-visit baseline.

Outcome measures

Outcome measures
Measure	Intervention - AH-HA Tool n=294 Participants With assistance from the study team, the clinic will implement the AH-HA tool in the clinics' EPIC EHR. Providers at the intervention sites will be trained to use the tool during routine follow-up care with survivors. During a routine follow-up care appointment, the provider will use the AH-HA tool with enrolled patients. AH-HA Tool in the EPIC EHR: The Automated Heart-Health Assessment tool implemented in clinics' EPIC EHR will be used by providers during routine follow-up care appointments.	Usual Care n=346 Participants Usual care practices will conduct routine follow-up care visits for enrolled survivors following typical clinic practice, without use of the AH-HA tool.
Patient Perception and Knowledge of CV Risks: Oncology Providers Should Talk to Their Patients About Their Heart Health	63.4 percentage of participants Interval 40.6 to 81.5	23.7 percentage of participants Interval 16.0 to 33.5

SECONDARY outcome

Timeframe: Baseline

We will capture the number of eligible patient visits during which the AH-HA tool was used in intervention clinics and the total number of eligible visits to calculate the proportion of patients where AH-HA was utilized.