title: Evaluation of two strategies for heart health promotion by direct mail in a low-income urban community.
abstract: BACKGROUND
  The objective of this study was to evaluate the reach of mass mailings of heart health education print materials in a low-income, urban community. Materials included a monthly newsletter and a self-help behavior change kit, both distributed to all 12,789 households in the study community.
  
  
  METHODS
  Recall, use, and self-reported impact of the materials were measured in a cross-sectional survey of a random sample of 345 adults conducted 2 weeks after distribution of the kit and 18 months after delivery of the first newsletter.
  
  
  RESULTS
  Over one-third of the subjects (38.6%) recalled the newsletter and 27.9% had read one or more newsletters; 21.7% recalled the kit and 10.8% had read it. Few subjects had read both materials. Female gender and older age were independent correlates of having seen and read the newsletters. Older age, being widowed/separated/divorced, and infrequent physical activity were correlates of having seen and read the kit.
  
  
  CONCLUSIONS
  Although the newsletter and kit formats might appeal to different segments of the population, mass mailings of heart health education print materials in a low-income urban community can reach large numbers of individuals. The cost effectiveness of repeated mailings of short, simple newsletters might be higher than a single mailing of a more complex behavior change kit.
authors.affiliation: Department of Public Health, Montreal General Hospital, Quebec, Canada.
authors.forename: J
authors.initials: J
authors.lastname: O'Loughlin
authors.forename: G
authors.initials: G
authors.lastname: Paradis
authors.forename: G
authors.initials: G
authors.lastname: Meshefedjian
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003362:Cost-Benefit Analysis; D003430:Cross-Sectional Studies; D005260:Female; D006266:Health Education / Q000379:methods*; D006293:Health Promotion / Q000379:methods*; D006331:Heart Diseases / Q000517:prevention & control*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D010506:Periodicals as Topic / Q000592:standards*; D011177:Postal Service; D011203:Poverty; D015397:Program Evaluation; D012648:Self Care; D011795:Surveys and Questionnaires; D014504:Urban Health