Abstract
This chapter describes theories and methods underlying successful comprehensive community-based health promotion, and provides four examples. These studies represent well the field of experimental epidemiology, involving defined populations and often done following insights derived from observational epidemiology. Three of these were designed to reduce risk factors for cardiovascular disease (CVD), and relied heavily on locally available channels of mass communication in addition to community organizing and other education methods, relatively low-cost approaches with the potential to reach and change lifestyle behaviors of entire populations, in contrast to traditional individual or group counseling. One example, studying alcohol-involved trauma, used only community organizing to promote adherence to existing laws, rather than public education for behavior change. By community organizing we mean the process of enlisting community leaders in support of project goals, and also in insuring their continued support. The Stanford Prevention Research Center (SPRC), beginning in 1972, pioneered development of the intervention methods of comprehensive community-based CVD prevention and other methods of health promotion and chronic disease prevention. SPRC was connected to all four examples, either as initiator (for two studies) or collaborator (for two studies). This review also describes the theoretical background, methods of intervention, the past history of such studies, the cultural basis for barriers to change and lessons learned for the future.
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Keywords
- Smoking Cessation
- Social Cognitive Theory
- Social Marketing
- Tobacco Control Program
- Adolescent Substance Abuse
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References
Aldana S (2001) Financial impact of health promotion programs: a comprehensive review of the literature. Am J Health Promotion 15:296–320
Altman DG, Flora JA, Fortmann SP, Farquhar JW (1987) The cost-effectiveness of three smoking cessation programs. Am J Public Health 77:162–165
Bandura A (1986) Social foundations of thought and action: A social cognitive theory. Prentice-Hall, Englewood Cliffs, NJ
Baker L, Wagner TH, Singer S, Bundorf MK (2003) Use of the internet and e-mail for health care information: Results from a national survey. JAMA 289:2400–2406
Bezruchka S (2000) Is globalization dangerous to our health? Western J of Medicine 172:332–334
Cahill J (1983) Structural characteristics of the macroeconomy and mental health: Implications for primary prevention research. Am J Community Psychology 11:553–571
Cartwright D (1949) Some principles of mass persuasion. Hum Relations 2:253–267
The Catalonia Declaration: Investing in Heart Health (1996) Declaration of the Advisory Board, Second International Heart Health Conference 1995. Department of Health and Social Security of the Autonomous Government of Catalonia, Barcelona, Spain
The Chinese Classics: The Great Learning, one of four books written 2000 years ago
Colditz GA (2001) Cancer culture: Epidemics, human behavior, and the dubious search for new risk factors. Am J Public Health 91:357–359
Farquhar JW, Maccoby N, Wood P, Alexander JK, Breitrose H, Brown BW, Haskell WL, McAlister AL, Meyer AJ, Nash JD, Stern MP (1977) Community education for cardiovascular health. Lancet 1:1192–1195
Farquhar JW, Fortmann S P, Flora JA, Taylor CB, Haskell WL, Williams PT, Maccoby N, Wood PD (1990) The Stanford Five-City Project: Effects of communitywide education on cardiovascular disease risk factors. JAMA 264:359–365
Farquhar JW, Fortmann SP, Flora JA, Maccoby N (1991) Methods of communication to influence behaviour. In: Holland WW, Detels R, Knox G (eds) Oxford textbook of public health, 2d edn, vol. 2. Oxford University Press, Oxford
Flora JA, Maccoby N, Farquhar JW (1989) Communication campaigns to prevent cardiovascular disease: The Stanford studies. In: Rice R, Atkin C (eds) Public communication campaigns. Sage, Beverly Hills, CA, pp 233–252
Flora JA, Saphir MN, Schooler C, Rimal RN (1997) Toward a framework for intervention channels: Reach, involvement and impact. Ann Epidemiol S7: S104–S112
Fortmann SP, Flora JA, Winkleby MA, Schooler C, Taylor CB, Farquhar JW (1995) Community intervention trials: Reflections on the Stanford Five-City Project. Am J Epidemiol 142(6):576–586
Green LW, Kreuter MW (1991) Health promotion planning: an educational and environmental approach, 2nd edn. Mayfield Publishing, Mountain View (CA)
Holder HD, Wallack L (1986) Contemporary perspectives for prevention of alcohol problems: An empirically-derived model. J Public Health Policy 7:324–330
Holder HD, Salz RF, Grube JW, Treno AJ, Reynolds RI, Voas RB, Gruenewald PJ (1997) Summing up: Lessons from a comprehensive community prevention trial. Addiction 92(S2):S293–S301
Kotler P (1975) Marketing for nonprofit organizations. Prentice Hall, Englewood Cliffs, New Jersey
Lefebvre RC, Flora JA (1988) Social marketing and public health interventions. Health Educ Q 15:299–315
MacIntyre S (2000) The social patterning of exercise behaviours: The role of personal and local resources. British J of Sports Medicine 34:6
Medical News and Perspective (1994) New disease prevent effort goes by the book. JAMA 13: 993–994
Pierce JP, Evans N, Farkas NJ (1994) Tobacco use in California. An evaluation of the Tobacco Control Program 1989–1993. La Jolla (California), University of California, San Diego
Puska P, Nissinen A, Tuomilehto J, Salonen JT, Koskela K, McAlister A, Kottke TE, Maccoby N, Farquhar JW (1985) The community-based strategy to prevent coronary heart disease: Conclusions from the ten years of the North Karelia Project. Ann Review of Public Health 6:147–193
Puska P (1995) Experience with major subprogrammes and examples of innovative interventions. In: Puska P, Nissinen A, Vartianinen E (eds) The North Karelia Project. Helsinki University Printing House, Helsinki, pp 159–167
Robinson TN, Killen JD, Taylor CB, Telch MJ, Bryson SW, Saylor KE, Maron DJ, Maccoby N, Farquhar JW (1987) Perspectives on adolescent substance abuse: A defined population study. JAMA 258:2027–2076
Roberts DF, Maccoby N (1973) Information processing and persuasion: counter-arguing behavior. In: Kline F, Clarke P (eds) Sage Communication Research Annuals, vol II. Sage Publications, Beverly Hills, CA
Rogers E (1983) Diffusion of innovations. Free Press, New York
Schooler C, Farquhar JW, Fortmann SP, Flora JA (1997) Synthesis of findings and issues from community prevention trials. Ann Epidemiol S7: S54–S68
The Osaka Declaration, health, economics and political action: stemming the global tide of cardiovascular disease (2001) Declaration of the policy board. The Fourth International Heart Health Conference, Osaka
Travers KD (1997) Reducing inequities through participatory research and community empowerment. Health Education and Behavior 24:344–356
Truett J, Cornfield J and Kannel E (1967) Multivariate analysis of the risk of coronary heart disease in Framingham. J Chronic Disease 20:511–524
Victoria Declaration on Heart Health (1992) Declaration of the Advisory Board, First International Heart Health Conference. Health and Welfare Canada, Victoria (Canada)
Victorian Health Promotion Foundation (1994) Annual report, 1994. Vic Health, Victoria (Australia)
Williams PT, Fortmann SP, Farquhar JW, Varady A, Mellen S (1981) A comparison of statistical methods for evaluating risk factor changes in community-based studies: An example from the Stanford Three Community Study. J Chron Disease 34:565–571
World Health Organization (1986) Report of a WHO Expert Committee. Community prevention and control of cardiovascular disease. Technical Report Series No. 732. World Health Organization, Geneva
World Health Report (1997) Conquering suffering, enriching humanity. World Health Organization, Geneva
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Farquhar, J.W., Fortmann, S.P. (2005). Community-based Health Promotion. In: Ahrens, W., Pigeot, I. (eds) Handbook of Epidemiology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-26577-1_33
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DOI: https://doi.org/10.1007/978-3-540-26577-1_33
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