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

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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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More Appropriate Evaluation Methods for Community-Level Health Interventions
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“In many countries, public health measures such as mass education campaigns, dietary and lifestyle interventions, and pharmacotherapy have been shown to be effective for alleviating the burden of HTN and improving its control [21,29,30,31].”
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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 › Medicine › Public Health, Environmental and Occupational Health › 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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Effects of Communitywide Education on Cardiovascular Disease Risk Factors: The Stanford Five-City Project

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