title: Effectiveness of a decentralized, community-related approach to reduce cardiovascular disease risk factor levels in Germany.
abstract: OBJECTIVE
  Conventional community-oriented prevention programmes have been moderately successful in reducing cardiovascular disease risk factor levels in the population. Within the German Cardiovascular Prevention Study, a new decentralized and community-related form of preventive intervention was tested.
  
  
  RESULTS
  Interested lay people and general practitioners co-operated in developing activities conducive towards a healthier lifestyle in two towns. Changes in risk factor levels were evaluated by repeated surveys of independent cross-sectional samples in two intervention communities (n=3460, baseline; 2561, final). National survey data (n=4788, baseline; 5311, final) were used to describe secular trends. Six years after the onset of intervention activities the following changes in risk factor prevalence for both sexes combined were observed in the intervention communities (95% CI in brackets): smoking -10.5% (-17.6 to -3.4); hypertension -29.0% (-38.1 to -19. 9); total cholesterol >/=250 mg. dl(-1)-8.1% (-15.4 to -0.9). In contrast to a national increase in the prevalence of obesity, this rate remained stable in the intervention communities.
  
  
  CONCLUSIONS
  Initiating preventive activities developed by community members under the responsibility of local doctors is effective in lowering cardiovascular risk factors at community level. Unlike traditional intervention programmes this new approach does not require external funding and guidance.
authors.affiliation: Abteilung Klinische Sozialmedizin, Klinikum der Universität Heidelberg, Heidelberg, Germany.
authors.forename: W
authors.initials: W
authors.lastname: Scheuermann
authors.forename: O
authors.initials: O
authors.lastname: Razum
authors.forename: R
authors.initials: R
authors.lastname: Scheidt
authors.forename: A
authors.initials: A
authors.lastname: Wiesemann
authors.forename: H
authors.initials: H
authors.lastname: von Frankenberg
authors.forename: G
authors.initials: G
authors.lastname: Topf
authors.forename: E
authors.initials: E
authors.lastname: Nüssel
mesh_terms: D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000517:prevention & control*; D003430:Cross-Sectional Studies; D005260:Female; D005858:Germany / Q000453:epidemiology; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011314:Preventive Health Services / Q000379:methods*; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D014505:Urban Population