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The Otsego-Schoharie healthy heart program: prevention of cardiovascular disease in the rural US

Clinical Pharmacology Research Center & Department of Medicine, Bassett Healthcare, Cooperstown, New York, USA, nafziger{at}iex.net, The Mary Imogene Bassett Research Institute, Cooperstown, New York, USA

T.A. Erb

The Mary Imogene Bassett Research Institute, Cooperstown, New York, USA

P.L. Jenkins

The Mary Imogene Bassett Research Institute, Cooperstown, New York, USA

C. Lewis

The Mary Imogene Bassett Research Institute, Cooperstown, New York, USA

T.A. Pearson

Department of Community & Preventive Medicine, University of Rochester Medical Center, Rochester, New York, USA

Objectives: To describe a rural, hospital-based public health intervention program and to evaluate its effectiveness in cardiovascular disease (CVD) risk reduction using cross-sectional studies and a panel study.

Methods: A rural population of 158,000 located in New York state comprised the intervention population. A similar but separate population was used for reference. A multifaceted, multimedia 5-year program provided health promotion and education initiatives to increase physical activity, decrease smoking, improve nutrition, and identify hypercholesterolemia and hypertension. To evaluate the effectiveness of the intervention, surveys were conducted at baseline in 1989 (cross-sectional) and at follow-up in 1994- 95 (cross-sectional and panel). For cross-sectional studies, a random sample of adults was obtained using a three-stage cluster design. Self-reported and objective risk factor measurements were obtained. Comparison of pre- to post- changes in intervention versus reference populations was done using 2x 2randomized block ANOVA, 2 x 2 mixed ANOVA, and extension of the McNemar test.

Results: Smoking prevalence declined (from 27.9% to 17.6%) in the intervention population. Significant adverse trends were observed for high-density lipoprotein cholesterol and triglycerides. Systolic blood pressure was reduced while diastolic blood pressure remained stable. Body mass index increased significantly in both populations.

Conclusions: This rural, 5-year CVD community intervention program decreased smoking. The risk reduction may be attributable to tailoring of a multifaceted approach (multiple risk factors, multiple messages, and multiple population subgroups) to a target rural population. The study period was too short to identify changes in CVD morbidity and mortality.

Key Words: cardiovascular diseases • community health education • health survey • public health • rural health • smoking cessation.

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Scandinavian Journal of Public Health, Vol. 29, No. 56 suppl, 21-32 (2001)
DOI: 10.1177/14034948010290021501


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This Article Abstract Free Full Text (Free PDF) Free Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Nafziger, A.N. Articles by Pearson, T.A. Search for Related Content PubMed Articles by Nafziger, A.N. Articles by Pearson, T.A. Social Bookmarking                         What's this?