Skip to main content
NCBI home page
American Journal of Public Health logoLink to American Journal of Public Health
. 1995 Jun;85(6):777–785. doi: 10.2105/ajph.85.6.777

The Pawtucket Heart Health Program: community changes in cardiovascular risk factors and projected disease risk.

R A Carleton 1, T M Lasater 1, A R Assaf 1, H A Feldman 1, S McKinlay 1
PMCID: PMC1615494  PMID: 7762709

Abstract

OBJECTIVES. Whether community-wide education changed cardiovascular risk factors and disease risk in Pawtucket, RI, relative to a comparison community was assessed. METHODS. Random-sample, cross-sectional surveys were done of people aged 18 through 64 years at baseline, during, and after education. Baseline cohorts were reexamined. Pawtucket citizens of all ages participated in multilevel education, screening, and counseling programs. RESULTS. The downward trend in smoking was slightly greater in the comparison city. Small, insignificant differences favored Pawtucket in blood cholesterol and blood pressure. In the cross-sectional surveys, body mass index increased significantly in the comparison community; a similar change was not seen in cohort surveys. Projected cardiovascular disease rates were significantly (16%) less in Pawtucket during the education program. This difference lessened to 8% posteducation. CONCLUSIONS. The hypothesis that projected cardiovascular disease risk can be altered by community-based education gains limited support from these data. Achieving cardiovascular risk reduction at the community level was feasible, but maintaining statistically significant differences between cities was not. Accelerating risk factor changes will likely require a sustained community effort with reinforcement from state, regional, and national policies and programs.

Full text

PDF
777

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Anderson K. M. A nonproportional hazards Weibull accelerated failure time regression model. Biometrics. 1991 Mar;47(1):281–288. [PubMed] [Google Scholar]
  2. Assaf A. R., Lapane K. L., McKenney J. L., Carleton R. A. Possible influence of the prospective payment system on the assignment of discharge diagnoses for coronary heart disease. N Engl J Med. 1993 Sep 23;329(13):931–935. doi: 10.1056/NEJM199309233291307. [DOI] [PubMed] [Google Scholar]
  3. Carleton R. A., Lasater T. M., Assaf A., Lefebvre R. C., McKinlay S. M. The Pawtucket Heart Health Program: I. An experiment in population-based disease prevention. R I Med J. 1987 Dec;70(12):533–538. [PubMed] [Google Scholar]
  4. Elder J. P., McGraw S. A., Rodrigues A., Lasater T. M., Ferreira A., Kendall L., Peterson G., Carleton R. A. Evaluation of two community-wide smoking cessation contests. Prev Med. 1987 Mar;16(2):221–234. doi: 10.1016/0091-7435(87)90086-7. [DOI] [PubMed] [Google Scholar]
  5. Elder J. P., McKenna C. A., Lazieh M., Ferreira A., Lasater T. M., Carleton R. A. The use of volunteers in mass screening for high blood pressure. Am J Prev Med. 1986 Sep-Oct;2(5):268–272. [PubMed] [Google Scholar]
  6. Farquhar J. W., Fortmann S. P., Flora J. A., Taylor C. B., Haskell W. L., Williams P. T., Maccoby N., Wood P. D. Effects of communitywide education on cardiovascular disease risk factors. The Stanford Five-City Project. JAMA. 1990 Jul 18;264(3):359–365. [PubMed] [Google Scholar]
  7. Farquhar J. W., Fortmann S. P., Maccoby N., Haskell W. L., Williams P. T., Flora J. A., Taylor C. B., Brown B. W., Jr, Solomon D. S., Hulley S. B. The Stanford Five-City Project: design and methods. Am J Epidemiol. 1985 Aug;122(2):323–334. doi: 10.1093/oxfordjournals.aje.a114104. [DOI] [PubMed] [Google Scholar]
  8. Farquhar J. W., Maccoby N., Wood P. D., Alexander J. K., Breitrose H., Brown B. W., Jr, Haskell W. L., McAlister A. L., Meyer A. J., Nash J. D. Community education for cardiovascular health. Lancet. 1977 Jun 4;1(8023):1192–1195. doi: 10.1016/s0140-6736(77)92727-1. [DOI] [PubMed] [Google Scholar]
  9. Fawcett S. B., Mathews R. M., Fletcher R. K. Some promising dimensions for behavioral community technology. J Appl Behav Anal. 1980 Fall;13(3):505–518. doi: 10.1901/jaba.1980.13-505. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. KANNEL W. B., DAWBER T. R., KAGAN A., REVOTSKIE N., STOKES J., 3rd Factors of risk in the development of coronary heart disease--six year follow-up experience. The Framingham Study. Ann Intern Med. 1961 Jul;55:33–50. doi: 10.7326/0003-4819-55-1-33. [DOI] [PubMed] [Google Scholar]
  11. Lasater T. M., Sennett L. L., Lefebvre R. C., DeHart K. L., Peterson G., Carleton R. A. Community-based approach to weight loss: the Pawtucket "weigh-in". Addict Behav. 1991;16(3-4):175–181. doi: 10.1016/0306-4603(91)90010-f. [DOI] [PubMed] [Google Scholar]
  12. Lefebvre R. C., Lasater T. M., Carleton R. A., Peterson G. Theory and delivery of health programming in the community: the Pawtucket Heart Health Program. Prev Med. 1987 Jan;16(1):80–95. doi: 10.1016/0091-7435(87)90008-9. [DOI] [PubMed] [Google Scholar]
  13. Lefebvre R. C., Peterson G. S., McGraw S. A., Lasater T. M., Sennett L., Kendall L., Carleton R. A. Community intervention to lower blood cholesterol: the "Know Your Cholesterol" campaign in Pawtucket, Rhode Island. Health Educ Q. 1986 Summer;13(2):117–129. doi: 10.1177/109019818601300202. [DOI] [PubMed] [Google Scholar]
  14. Luepker R. V., Murray D. M., Jacobs D. R., Jr, Mittelmark M. B., Bracht N., Carlaw R., Crow R., Elmer P., Finnegan J., Folsom A. R. Community education for cardiovascular disease prevention: risk factor changes in the Minnesota Heart Health Program. Am J Public Health. 1994 Sep;84(9):1383–1393. doi: 10.2105/ajph.84.9.1383. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Marcus B. H., Banspach S. W., Lefebvre R. C., Rossi J. S., Carleton R. A., Abrams D. B. Using the stages of change model to increase the adoption of physical activity among community participants. Am J Health Promot. 1992 Jul-Aug;6(6):424–429. doi: 10.4278/0890-1171-6.6.424. [DOI] [PubMed] [Google Scholar]
  16. Salonen J. T., Slater J. S., Tuomilehto J., Rauramaa R. Leisure time and occupational physical activity: risk of death from ischemic heart disease. Am J Epidemiol. 1988 Jan;127(1):87–94. doi: 10.1093/oxfordjournals.aje.a114794. [DOI] [PubMed] [Google Scholar]
  17. Truett J., Cornfield J., Kannel W. A multivariate analysis of the risk of coronary heart disease in Framingham. J Chronic Dis. 1967 Jul;20(7):511–524. doi: 10.1016/0021-9681(67)90082-3. [DOI] [PubMed] [Google Scholar]

Articles from American Journal of Public Health are provided here courtesy of American Public Health Association

RESOURCES