The Minnesota Heart Health Program (MHHP), is a community-based research demonstration of the effect of multiple educational strategies at the level of whole populations to encourage more healthy behavior, prevent cardiovascular diseases (CVD) and promote health. The rationale is based on the important demonstrated influence of blood pressure, blood lipids, and cigarette smoking on CVD risk and the effect of mass health behaviors on population levels of these factors. The research strategy employed has elements of control (education and comparison communities), repetition (staged introduction at annual intervals), trend measures in population samples and cohorts of individuals, dose-effect measurement according to exposure, linkage analysis between components of the program, and pooling of education and comparison results. Educational strategies include: a) direct 'hands-on' education; b) professional education to enhance prevention services; c) organization and training of community leaders; d) mass communications; and e) enhanced community support for healthy behavior. The preliminary results indicate improvements in many cognitive, behavioral and physiologic risk factor variables both in the education and in the comparison communities. For some variables, the improvements appear significantly greater in the education communities than in the comparison communities. For other variables, the improvements appear similar. This application is for support for three years to (1) complete surveillance of morbidity and mortality through a period of seven years beyond the initiation of education in each community, (2) complete the collection and processing of risk factor survey data for a period of seven years beyond the initiation of education in each community, and (3) to permit a thoughtful and thorough analysis and interpretation of all of the data available from this study to provide the maximal benefit to the public and to the research community from this major community-based health promotion program.
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