“…These programs are aimed at entire populations , which are usually geographi cally defined , and they attempt to change health behavior and disease risk through mass media campaigns, activation of existing community organiza tions, or changes in the physical or sociocultural environment. Several large programs of this kind have been mounted for cardiovascular disease preven tion (30,33,44,56,71), as reviewed by Shea & Basch (79,80), and the approach is increasingly being applied to other disease areas and populations (3, 34,67,89,92). As investment in community-based programs has grown, so has the importance of evaluating their effectiveness, as evidenced in part by the recent publications of Green & Lewis (38) and Bracht (6).…”