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Effects of Communitywide Education on Cardiovascular Disease Risk Factors
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1990
Year
Health DisparitiesSchool HealthHealth PreventionSocial Determinants Of HealthBlood PressureCommunity Health Sciences Health DisparitiesHealth CommunicationPublic Health PracticePublic HealthCommunitywide EducationHealth EducationPublic Health InterventionTreatment CitiesCommunity Health Sciences Intervention ScienceCardiovascular EpidemiologyHealth InterventionHealth PromotionRiskChronic Disease PreventionHealth LiteracyRisk FactorsCommunity HealthEpidemiologyCardiovascular Disease Risk AssessmentCardiovascular DiseaseHealth BehaviorCommunity Health SciencesSocial EpidemiologyCardiovascular Risk Factors
The study evaluated whether communitywide health education reduces stroke and coronary heart disease risk by comparing two treatment and two control cities on changes in risk factors. Treatment cities received a 5‑year low‑cost program grounded in social learning theory, communication‑behavior change, community organization, and social marketing, delivering ~26 hours of multichannel education, while risk factors were assessed in representative cohorts and cross‑sectional surveys at baseline and follow‑ups. After 30–64 months, treatment cities achieved significant reductions in plasma cholesterol (2%), blood pressure (4%), resting pulse rate (3%), and smoking (13%), which translated into 15% lower composite mortality risk and 16% lower coronary heart disease risk, confirming the effectiveness of low‑cost programs. Published in JAMA 1990;264:359‑365.
To test whether communitywide health education can reduce stroke and coronary heart disease, we compared two treatment cities (N = 122 800) and two control cities (N = 197 500) for changes in knowledge of risk factors, blood pressure, plasma cholesterol level, smoking rate, body weight, and resting pulse rate. Treatment cities received a 5-year, low-cost, comprehensive program using social learning theory, a communication—behavior change model, community organization principles, and social marketing methods that resulted in about 26 hours of exposure to multichannel and multifactor education. Risk factors were assessed in representative cohort and cross-sectional surveys at baseline and in three later surveys. After 30 to 64 months of education, significant net reductions in community averages favoring treatment occurred in plasma cholesterol level (2%), blood pressure (4%), resting pulse rate (3%), and smoking rate (13%) of the cohort sample. These risk factor changes resulted in important decreases in composite total mortality risk scores (15%) and coronary heart disease risk scores (16%). Thus, such low-cost programs can have an impact on risk factors in broad population groups. (<i>JAMA</i>. 1990;264:359-365)