Farquhar J W, Fortmann S P, Flora J A, Taylor C B, Haskell W L, Williams P T, Maccoby N, Wood P D
Center for Research in Disease Prevention, Stanford University School of Medicine, Palo Alto, CA 94304.
JAMA. 1990 Jul 18;264(3):359-65.
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.
为了测试社区范围内的健康教育是否能降低中风和冠心病的发病率，我们比较了两个实施干预措施的城市（N = 122,800）和两个对照城市（N = 197,500）在危险因素知识、血压、血浆胆固醇水平、吸烟率、体重和静息心率方面的变化。实施干预措施的城市接受了一项为期5年的低成本综合项目，该项目采用社会学习理论、沟通行为改变模型、社区组织原则和社会营销方法，使居民接受了约26小时的多渠道、多因素教育。在基线以及随后的三次调查中，通过代表性队列研究和横断面调查对危险因素进行了评估。经过30至64个月的教育，队列样本的血浆胆固醇水平（2%）、血压（4%）、静息心率（3%）和吸烟率（13%）出现了有利于干预组的显著净下降。这些危险因素的变化导致综合总死亡风险评分（15%）和冠心病风险评分（16%）显著降低。因此，这类低成本项目能够对广大人群的危险因素产生影响。
