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Cited by 462Health Promotion and Cardiovascular PreventionCardiovascular Health and Risk FactorsPublic Health Policies and Education

Effects of Communitywide Education on Cardiovascular Disease Risk Factors: The Stanford Five-City Project

Farquhar, John W.·1990·JAMA
DOI 10.1001/jama.1990.03450030083037
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Abstract

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. (JAMA. 1990;264:359-365)

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  • Community- and school-based long-term media and education campaigns have been effective in improving dietary habits of adults, school-age children, and younger children, as well as reducing adiposity and cardiovascular risk factors in adults.

    “Community- and school-based long-term media and education campaigns have also been effective in improving dietary habits of adults, school-age children, and younger children,45–48 as well as reducing adiposity and cardiovascular risk factors in adults.49”

    From Population Approaches to Improve Diet, Physical Activity, and Smoking Habits: A Scientific Statement From the American Heart Association (2012) · cites this paper as [49]

  • After 3 to 5 years of intervention, compared with controls, the Stanford Five-City Project intervention communities saw improvements in several cardiovascular risk factors, including lower blood cholesterol, blood pressure, resting heart rate, weight gain, and smoking prevalence.

    “After 3 to 5 years of intervention, compared with controls, the intervention communities saw improvements in several cardiovascular risk factors, including lower blood cholesterol, blood pressure, resting heart rate, weight gain, and smoking prevalence.49”

    From Population Approaches to Improve Diet, Physical Activity, and Smoking Habits: A Scientific Statement From the American Heart Association (2012) · cites this paper as [49]

  • Intensive community-level media and education interventions that targeted physical activity as part of a comprehensive set of health factors and behaviors produced mixed results, with benefits on risk factors in 1 study but no clear benefits in the other 2 studies compared with secular trends.

    “These interventions produced mixed results, with benefits on risk factors seen in 1 study49 but without clear benefits in the other 2 studies, as compared with secular trends.61,62”

    From Population Approaches to Improve Diet, Physical Activity, and Smoking Habits: A Scientific Statement From the American Heart Association (2012) · cites this paper as [49]

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Authors
Farquhar, J. W.
Corresponding author
Farquhar, John W.
Venue
JAMA
Publisher
American Medical Association (AMA)
Published
1990-07-18
Volume
264
Issue
3
Pages
359
ISSN
  • 0002-9955 (ISSN-L)
  • 0098-7484
DOI
10.1001/jama.1990.03450030083037
OpenAlex
W4301237366
Cited by
448
References
0
Citations by year
2026: 2 · 2025: 1 · 2024: 3 · 2023: 6 · 2022: 6 · 2021: 4 · 2020: 4 · 2019: 4 · 2018: 10 · 2017: 6 · 2016: 9 · 2015: 11 · 2014: 13 · 2013: 12 · 2012: 11
FWCI
24.18
Type
journal article
Language
en
Open access
closed
Locations
JAMA (publishedVersion)
Funders
National Heart, Lung, and Blood Institute (HL21906)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Health Promotion and Cardiovascular Prevention
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
  • Health Sciences › Health Professions › General Health Professions › Public Health Policies and Education
Keywords
cardiovascular risk factors, stroke prevention, coronary heart disease prevention, social learning theory, social marketing, blood pressure, serum cholesterol, smoking prevalence, body weight, resting heart rate, mortality risk score, community-based intervention

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