Heart smart: a multifaceted cardiovascular risk reduction program for grade school students.

Abstract Heart Smart Program is a health education intervention for grades kindergarten through six which encourages the acquisition and maintenance of health-enhancing behaviors. These include nutritious eating habits; physical fitness and exercise; saying "no" to cigarette smoking, alcohol, and drugs; and control of stress. Social Cognitive Theory is used to derive the necessary training concepts for children with reinforcement of these concepts occurring in six areas: the curriculum, school lunch, staff development, physical activity, environment, and parental support. The necessary training mechanisms provide mastery experiences, knowledge transfer, role modeling, and emotional and physiological feedback. The program incorporates the influence of the social environment on learning and builds support from parents, teachers and school staff.