“…In 1989, the Robert Wood Johnson Foundation made a $27 million commitment to community-based, comprehensive substance-abuse prevention programs. Concurrently, a considerable amount of new research was being sponsored by the National Institutes of Health and the National Center for Health Services Research on the effectiveness of health promotion (e. g. 49,78,86,97). Data had accumulated showing that chronic diseases could be controlled through active involvement of people in their own health care, and that patient education, self-care groups, and community efforts through mass media and face-to-face communications could bring about significant changes in health behavior and reductions in risk factors (12,60,83,90,91,103).…”