@article{842f08429ba94797994a524cd8895d5e,
title = "Organizational and community approaches to community-wide prevention of heart disease: The first two years of the pawtucket heart health program",
abstract = "The Pawtucket Heart Health program (PHHP) is a federally funded research and demonstration project for the primary prevention of coronary heart disease (CHD) in a community. This article presents a discussion of the first 26 months of this intervention, divided into its three phases. PHHP staff initially approached the intervention city through local organizations to accomplish risk-factor behavior change in the population. After 11 months, PHHP complemented its programs in organizations with activities open to all city residents, in order to accelerate participation by the population. Seven months into this phase, it was decided that community activities should be the major focus of the intervention approach to assure a level of participation adequate to make a measurable impact. The third phase has shown the greatest percentage of public participation, demonstrating the complementary nature of organization and community interventions and of the translation of social learning theory into principles for primary prevention in a community.",
author = "Elder, {John P.} and McGraw, {Sarah A.} and Abrams, {David B.} and Andrea Ferreira and Lasater, {Thomas M.} and Helene Longpre and Peterson, {Gussie S.} and Rick Schwertfeger and Carleton, {Richard A.}",
note = "Funding Information: {\textquoteright} Supported by Grant ROI HL 23269, awarded by the National Heart. Lung, and Blood Institute. Department of Health and Human Services. Z A previous version of this paper was presented at the Annual Meeting of the American Public Health Association, October 1984. Anaheim. Calif. 3 To whom reprint requests should be addressed. Funding Information: The PHHP is a research and demonstrationp roject funded by the U.S. National Heart, Lung, and Blood Institute to changet he cardiovascularr isk status of the residents of a predominantly blue-collar community of 72,000i n south- easternN ew England. PHHP is testing whether communitya ctivation via volunteer recruitmenta nd deploymentw ill change cardiovasculard iseasek nowledge and risk factors; whether thesec hanges,i n turn, will be manifesteda s changesi n measuredr isk-factor variables; and whether the altered risk factors will become manifesti n a reduction in age-specific,a theroscleroticd isease-relatedm orbidity and mortality. This determinationw ill be accomplishedb y comparingc ross-sectional, cohort, and morbidity/mortalitys urveillanced ata from Pawtucket,R hode Island, to those of a sociodemographicallys imilar city. The entire project has been funded for the period 1980-1 991. The conceptual model of PHHP is based on the principles of social learning theory. The individual is considered to be a self-determiningo rganism who interacts with environmental stimuli through the mechanismso f reciprocal determinism, modeling, and related social-psychologicalf actors (2). Generalization, the spreado f behavioral changef rom a person who has initially changedt o individuals in the person{\textquoteright}s social network, is a key concept in the PHHP intervention. It is hoped that generalizationw ill result in the diffusion of behavior change throughoutt he intervention community. PHHP{\textquoteright}s intervention was designed to introduce behavior-change activities through social networks. Behavior-changep rogramsa nd activities that provide participantsw ith the skills to stop smoking,c ontrol their blood pressure,i mprove their diets, control their weight, cope with stress, and increaset heir exercise are offered to individuals, small social groups, and organizationsi n the city. Participants are taught not only to changet heir own risk-factor behaviors, but also to encourageo ther individuals in their social networks to alter their risk-factor behaviors and work for changes in their physical environment. Risk-factor screenings,n ewspapera rticles, and self-help programsa re also used to promote healthful lifestyles in city residents. Copyright: Copyright 2014 Elsevier B.V., All rights reserved.",
year = "1986",
month = mar,
doi = "10.1016/0091-7435(86)90081-2",
language = "English (US)",
volume = "15",
pages = "107--117",
journal = "Preventive Medicine",
issn = "0091-7435",
publisher = "Academic Press Inc.",
number = "2",
}