[Role and interactions of the cardiologist in a regional institutional project of primary prevention].
BACKGROUND
Evidence is available in support of the policies for a population-wide approach to shifting risk factor distribution; on the other side, setting up enduring projects of primary prevention is difficult, as well as gathering the right experts.


METHODS
In 1999 the Piedmont Region's Administration set up a multi-year intervention with the aim at reducing risk factors and increasing protective factors of oncologic and cardiovascular diseases in the general population, particularly in disadvantage groups. The cardiologists played a primary role by supporting the project of evidence-based guidelines, producing bibliographic reviews and spreading coronary risk maps. A main group of trainers was set up in each Local Health Service to promote a system of counseling lifestyles, with the central reference of the general practitioner activity. As a second step, a mass-media campaign has been set up using health advertisements on newspapers, television, public transports, notice-boards on the following subjects: nutrition, hypertension, tobacco, physical activity, stress; warehouses, food markets, trains and squares were involved. Moreover, a newsletter review has been published since January 2000, to produce basic models, most effective interventions and recommendations for their implementation.


RESULTS
A new care for the primary prevention and counseling arguments as well as the need for continuous training to promote preventive actions were shown to general practitioners. A system to identify the best channels, communication ways and the most effective messages for healthy lifestyles was settled. A model of monitoring risk factor changes and protective behaviors in the population, describing social differences, was established to better plan and assess effective interventions.


CONCLUSIONS
After more than half a century of productive public health science, there is an urgent need that Government Administrations steer their health policies towards determinants of health and create the best conditions to make citizens to improve their lifestyle.
Soffiantino
Francesco
F
Divisione di Cardiologia, Fondazione S. Maugeri, IRCCS, Via per Revislate, 13, 28010 Veruno, NO. fsoffiantino@fsm.it
Sclavo
Maria Grazia
MG
Giannuzzi
Pantaleo
P
Ravazzi
Pier Antonio
PA
D002309:Cardiology / Q000458:organization & administration*; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D019317:Evidence-Based Medicine; D006801:Humans; D007558:Italy; D010819:Physician's Role; D017410:Practice Guidelines as Topic; D011322:Primary Prevention / Q000458:organization & administration*; D012041:Regional Medical Programs / Q000458:organization & administration*
Ruolo ed interazioni del cardiologo in un progetto istituzionale regionale di prevenzione primaria.