THE PAWTUCKET HEART HEALTH-PROGRAM - COMMUNITY CHANGES IN CARDIOVASCULAR RISK-FACTORS AND PROJECTED DISEASE RISK
THE PAWTUCKET HEART HEALTH-PROGRAM - COMMUNITY CHANGES IN CARDIOVASCULAR RISK-FACTORS AND PROJECTED DISEASE RISK
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DOI：
10.2105/ajph.85.6.777
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发表时间：
1995-06-01
影响因子：
12.7
通讯作者：
MCKINLAY, S
中科院分区：
文献类型：
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作者：
CARLETON, RA;LASATER, TM;MCKINLAY, S
目标。与对照社区相比，评估社区教育是否改变了RI Pawtucket的心血管危险因素和疾病风险。对18岁至年龄段的人进行了随机抽样的横断面调查，调查对象为基线、教育期间和教育后。对基线队列进行了重新检查。所有年龄段的Pawtucket公民都参加了多层次的教育、筛查和咨询计划。在对照城市，吸烟的下降趋势略大一些。在血液胆固醇和血压方面，微小的、微不足道的差异有利于Pawtucket。在横断面调查中，比较社区的身体质量指数显著增加；在队列调查中没有看到类似的变化。在教育计划期间，Pawtucket的心血管疾病预测发病率显著降低(16%)。这一差异在治疗后缩小到8%。预测的心血管疾病风险可以通过基于社区的教育来改变的假设从这些数据中得到的支持有限。在社区层面实现降低心血管风险是可行的，但在城市之间保持统计上的显著差异是不可行的。加速风险因素的变化可能需要社区的持续努力，并得到州、地区和国家政策和计划的加强。
Objectives. Whether communitywide 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.