Shea S, Basch C E, Wechsler H, Lantigua R
Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY, USA.
Am J Public Health. 1996 Feb;86(2):166-71. doi: 10.2105/ajph.86.2.166.
This report summarizes 6 years of experience in a large community-based cardiovascular disease prevention program in a predominately minority, urban setting.
The program seeks to reduce cardiovascular disease risk factors in an area of approximately 240,000 people in New York, NY; this population includes many Latino immigrants of low educational attainment and socioeconomic status. All program materials were in Spanish and English and at a low literacy level.
Major elements that achieved high levels of reach and support were a marketing campaign promoting low-fat milk, exercise clubs, and a Spanish-language smoking cessation video. Program elements that did not meet expectations or were abandoned were school-based smoking prevention initiatives, cholesterol screening, and efforts to involve local physicians. At the end of 6 years, the program was transferred to a local community organization.
Conclusions are that it is feasible to implement a complex cardiovascular disease prevention program in a socially disadvantaged urban community; that additional evaluation research is needed; that such programs can be transferred from an academic center to a community organization; and that such programs are unlikely to be sustained effectively without external resources.
本报告总结了在一个以少数族裔为主的城市环境中开展的大型社区心血管疾病预防项目六年的经验。
该项目旨在降低纽约市一个约有24万人的地区的心血管疾病风险因素;该人群包括许多受教育程度低和社会经济地位低的拉丁裔移民。所有项目材料均为西班牙语和英语,且读写难度低。
获得广泛推广和支持的主要项目包括推广低脂牛奶的营销活动、健身俱乐部以及一部西班牙语戒烟视频。未达预期或已被放弃的项目包括学校控烟倡议、胆固醇筛查以及让当地医生参与的努力。在六年结束时,该项目被移交给了当地一个社区组织。
结论是在社会处境不利的城市社区实施复杂的心血管疾病预防项目是可行的;需要进行更多评估研究;此类项目可以从学术中心转移到社区组织;而且没有外部资源,此类项目不太可能有效持续下去。