THE STANFORD FIVE-CITY PROJECT: DESIGN AND METHODS

TLDR

The Stanford Five‑City Project is a large experimental field study of community health education aimed at preventing cardiovascular disease. The study seeks to determine whether a six‑year community‑wide health education program can lower cardiovascular disease risk by 20 % and reduce event rates in two treatment cities compared with three reference cities, while also generating foundational data on epidemiology, communication, health education, behavior change, and community organization. Risk factor changes are evaluated through four cross‑sectional surveys and a repeated cohort, and cardiovascular events are monitored continuously via community surveillance of fatal and nonfatal myocardial infarction and stroke.

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 continous community surveillance of fatal and nonfatal myocardial infarction and stroke.