The Stanford Five-City Project: Design and Methods

Abstract

The Stanford Five-City Project is a large experimental field study of community health education for the prevention of cardiovascular disease. It will provide data on fundamental questions in cardiovascular disease epidemiology, communication, health education, behavior change, and community organization, and will also test the ability of a potentially cost-effective program to prevent cardiovascular disease at the community level. This paper describes the purposes, hypotheses, design, and methods of the Five-City Project as a reference for future papers describing results. It is hypothesized that a 20% decrease in cardiovascular disease risk will lead to a significant decline in cardiovascular disease event rates in two treatment communities compared with three reference communities as a result of a six-year intervention program of community-wide health education and organization. Risk factor change will be assessed through four surveys of independent samples and in a repeatedly surveyed cohort. Cardiovascular disease event rates will be assessed through continuous community surveillance of fatal and nonfatal myocardial infarction and stroke.

Marketing Social Marketing in the Social Change Marketplace

“…Second, other commentators believe that, particularly for major social changes, whole communities must be the focus of interventions (see Farquar et al 1985). They argue that social norms, interpersonal influence, diffusion processes, and local leadership are powerful determinants of how social problems are addressed-and their impact can be for good or evil.…”

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“…One study (Jackson et al, 1994) that did explicitly examine the capacity of communities to carry on health promotion activities was an extended follow-on activity to the Stanford FiveCity Project, an interventional research program for heart health led by researchers from Stanford University in the 1980s (Farquhar et al, 1985(Farquhar et al, , 1990). During the 6-year intervention period, the researchers and community participants planned for maintaining the comprehensive program of heart health promotion activities after federal funding ended.…”

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“…In the late 1970s, three large community-based intervention trials were funded by the National Heart, Lung and Blood Institute: the Stanford FiveCity Project (SFCP), the Minnesota Heart Health Project (MHHP), and the Pawtucket Heart Health Project (PHHP) (32,62,122). All three targeted change in risk factors for coronary heart disease (CHD), including high blood pressure, elevated blood cholesterol levels, cigarette smoking, and obesity.…”