title: Lifestyle factors of a five-year community-intervention program: the Hartslag Limburg intervention.
abstract: BACKGROUND
  Community-based health promotion is a widely advocated strategy in public health to favorably alter lifestyle. The aim of this study was to investigate the net effect of a cardiovascular disease-prevention program (Hartslag Limburg) on lifestyle factors after 5 years of intervention (1998-2003).
  
  
  METHODS
  In a cohort study, 5-year mean changes in lifestyle factors (energy intake; fat intake; time spent on leisure-time physical activity; walking, bicycling, and sports; and smoking behavior) between subjects from the intervention area (n=2356) and the control area (n=758) were compared for men and women and for those with a low (less than intermediate secondary education) and a moderate (intermediate vocational or higher secondary education) or high (higher vocational education or university) educational level. Adjustments were made for age and the mean of the individual pre- and post-intervention measurement of the variable under study. When stratifying for gender, adjustments were made for educational level, and vice versa.
  
  
  RESULTS
  In general, lifestyle factors changed unfavorably in the control group, whereas changes were less pronounced or absent in the intervention group. The adjusted difference in mean change in lifestyle factors between the intervention group and the control group was significant (p<or=0.05) for energy intake (-0.2 megajoule per day among both women and those with a low educational level); fat intake (-2.5 grams per day [g/d] among women and -3 g/d among those with a low educational level); time spent walking (+2.2 hours per week [hrs/wk] among women and +2.3 hrs/wk among those with a low educational level); time spent on total leisure-time physical activity (+2.1 hrs/wk among women); and time spent bicycling (+0.6 hrs/wk among those with a low educational level).
  
  
  CONCLUSIONS
  The community intervention Hartslag Limburg succeeded in preventing age- and time-related unfavorable changes in energy intake, fat consumption, walking, and bicycling, particularly among women and those with low SES.
authors.affiliation: National Institute for Public Health and the Environment, Bilthoven, The Netherlands. Wanda.Vos@rivm.nl
authors.forename: G C Wanda
authors.initials: GC
authors.lastname: Wendel-Vos
authors.forename: Alice E
authors.initials: AE
authors.lastname: Dutman
authors.forename: W M Monique
authors.initials: WM
authors.lastname: Verschuren
authors.forename: Emma T
authors.initials: ET
authors.lastname: Ronckers
authors.forename: Andre
authors.initials: A
authors.lastname: Ament
authors.forename: Patricia
authors.initials: P
authors.lastname: van Assema
authors.forename: Jan
authors.initials: J
authors.lastname: van Ree
authors.forename: Erik C
authors.initials: EC
authors.lastname: Ruland
authors.forename: Albertine J
authors.initials: AJ
authors.lastname: Schuit
mesh_terms: D000328:Adult; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000517:prevention & control*; D015331:Cohort Studies; D003153:Community Health Services / Q000458:organization & administration* / Q000706:statistics & numerical data; D004522:Educational Status; D005260:Female; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D015397:Program Evaluation / Q000379:methods*; D012111:Residence Characteristics; D012307:Risk Factors; D040242:Risk Reduction Behavior; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D055815:Young Adult