title: The Pawtucket Heart Health Program: community changes in cardiovascular risk factors and projected disease risk.
abstract: OBJECTIVE
  Whether community-wide education changed cardiovascular risk factors and disease risk in Pawtucket, RI, relative to a comparison community was assessed.
  
  
  METHODS
  Random-sample, cross-sectional surveys were done of people aged 18 through 64 years at baseline, during, and after education. Baseline cohorts were reexamined. Pawtucket citizens of all ages participated in multilevel education, screening, and counseling programs.
  
  
  RESULTS
  The downward trend in smoking was slightly greater in the comparison city. Small, insignificant differences favored Pawtucket in blood cholesterol and blood pressure. In the cross-sectional surveys, body mass index increased significantly in the comparison community; a similar change was not seen in cohort surveys. Projected cardiovascular disease rates were significantly (16%) less in Pawtucket during the education program. This difference lessened to 8% posteducation.
  
  
  CONCLUSIONS
  The hypothesis that projected cardiovascular disease risk can be altered by community-based education gains limited support from these data. Achieving cardiovascular risk reduction at the community level was feasible, but maintaining statistically significant differences between cities was not. Accelerating risk factor changes will likely require a sustained community effort with reinforcement from state, regional, and national policies and programs.
authors.affiliation: Department of Medicine, Memorial Hospital of Rhode Island, Pawtucket 02860, USA.
authors.forename: R A
authors.initials: RA
authors.lastname: Carleton
authors.forename: T M
authors.initials: TM
authors.lastname: Lasater
authors.forename: A R
authors.initials: AR
authors.lastname: Assaf
authors.forename: H A
authors.initials: HA
authors.lastname: Feldman
authors.forename: S
authors.initials: S
authors.lastname: McKinlay
mesh_terms: D000293:Adolescent; D000328:Adult; D001794:Blood Pressure; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000517:prevention & control*; D003430:Cross-Sectional Studies; D003625:Data Collection; D005260:Female; D015438:Health Behavior; D006266:Health Education; D006801:Humans; D008297:Male; D008875:Middle Aged; D012237:Rhode Island / Q000453:epidemiology; D012307:Risk Factors; D012907:Smoking; D012959:Socioeconomic Factors