Community education for cardiovascular disease prevention: risk factor changes in the Minnesota Heart Health Program.

Abstract

OBJECTIVES. The Minnesota Heart Health Program is a 13-year research and demonstration project to reduce morbidity and mortality from coronary heart disease in whole communities. METHODS. Three pairs of communities were matched on size and type; each pair had one education site and one comparison site. After baseline surveys, a 5- to 6-year program of mass media, community organization, and direct education for risk reduction was begun in the education communities, whereas surveys continued in all sites. RESULTS. Many intervention components proved effective in targeted groups. However, against a background of strong secular trends of increasing health promotion and declining risk factors, the overall program effects were modest in size and duration and generally within chance levels. CONCLUSIONS. These findings suggest that even such an intense program may not be able to generate enough additional exposure to risk reduction messages and activities in a large enough fraction of the population to accelerate the remarkably favorable secular trends in health promotion activities and in most coronary heart disease risk factors present in the study communities.

Intra-national variation in trends in overweight and leisure time physical activities in The Netherlands since 1980: stratification according to sex, age and urbanisation degree

“…28 Another community-based intervention achieved increased physical activity among adults. 29 Our data suggest that a specific target group for future physical activity interventions should be the younger women (20-to 39-year-old), as they spent less time on LTPA and had the steepest increase in BMI. This steep increase in BMI is in accordance with other studies.…”

Multiple health behavior change research: An introduction and overview

“…The proposal was deemed too costly, however, and the trial was never conducted. Large-scale multifactoral CVD risk factor interventions that were conducted include the Multiple Risk Factor Intervention Trial (Multiple Risk Factor Intervention Trial Research Group, 1990), the North Karelia Project (Puska, et al, 1985), the Stanford Three-City and Five-City Projects (Farquhar, et al, 1990), and the Pawtucket (Elder, et al, 1986) and Minnesota (Luepker, et al, 1994) Heart Health Programs. Youth multifactor interventions also were developed, with a movement toward comprehensive school health programs.…”

Randomized Trial of Reduced-Nicotine Standards for Cigarettes

“…The school-based educational components were complemented and supported over the entire program period by community education and organization activities intended to reduce three cardiovascular risk factors-cigarette smoking, high levels of serum cho lesterol, and elevated blood pressure-in adults of the targeted communities (Mittelmark et al 1986;Luepker et al 1994). The activities included individual risk factor screening and education, which was received by more than 60 percent of all adults; direct education sessions that were conducted in vari ous community settings, which engaged more than 30 percent of all adults; food labeling education in gro cery stores and restaurants; intensive mass media edu cation; continued education of health professionals; and community organization to engage citizens, health professionals, and community leaders in developing and carrying out annual community education plans.…”

“…These trials typically incorporate mass media strate gies into larger health education programs. Some, such as the Stanford Five-City Project (Farquhar et al 1990), the Minnesota Heart Health Program Luepker et al 1994), and the Pawtucket Heart Health Program (Elder et al 1986;Carleton et al 1995), have been aimed at modifying smoking, as well as other risk factors for cardiovascular disease. Final reports suggest that these trials have met with little success in promoting smoking cessation.…”