Development of a Panvascular Health Promotion and Risk Stratification Tool for Community Screening: Grounded in Four-Level Disease Prevention Theory

Background: Panvascular disease, mainly characterized by atherosclerosis involving multiple vascular territories, poses significant morbidity and mortality risks. Early detection enables timely intervention, yet existing screening tools target single diseases, rely on expensive equipment, and are impractical for panvascular risk stratification in community settings. Based on the four-level disease prevention framework, we developed a questionnaire-based panvascular health promotion and risk stratification tool to enhance awareness and risk categorization among community residents. Methods: From March to May 2024, we performed a thorough literature search to identify panvascular risk factors and characteristics. Semi-structured interviews with community health staff explored current tools’ advantages, limitations, and improvement suggestions, yielding an initial 118-item draft. Between June and August 2024, two rounds of expert consultations refined the tool for importance, feasibility, and validity, resulting in a 31-item final version. Results: The tool features three sequential screening steps with four categories of risk prevention and management. Step 1 (tertiary prevention) screens for 13 serious vascular events. If any item is positive, screening terminates (a “stop when positive” rule) and the individual is classified into the tertiary risk group. Step 2 (secondary prevention) assesses nine high-risk characteristics. Step 3 (primary/primordial prevention) evaluates nine general risk factors. It supports physician-led or self-administered use, supplemented by basic tests like blood pressure and lipid measurements. Validity will be assessed by promotion of healthcare-seeking behavior and alignment with clinical diagnosis. Conclusion: This is the first integrated tool combining four-level prevention with panvascular risk stratification via a stepwise pathway. It empowers community residents for proactive vascular health management and risk categorization. Future validation studies are needed to verify its performance in increasing early awareness, diagnosis, and management of panvascular disease in community settings. Keywords: panvascular disease, screening tool, risk stratification, community screening, disease prevention