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American Journal of Epidemiology Vol. 134, No. 3: 235-249
Copyright © 1991 by The Johns Hopkins University School of Hygiene and Public Health

research-article

Effect of Long-term Community Health Education on Body Mass Index: The Stanford Five-City Project

C. Barr Taylor1,, Stephen P. Fortmann2, June Flora3, Susan Kayman4, Donald C. Barrett5, Darius Jatulis6 and John W. Farquhar2

1Stanford Center for Research in Disease Prevention and the Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine Stanford CA
2Stanford Center for Research in Disease Prevention and the Department of Medicine, Stanford University School of Medicine Stanford CA
3Stanford Center for Research in Disease Prevention and the Department of Communication, Stanford University School of Medicine Stanford, CA
4Kaiser Permanente Medical Group, Regional Health Education Department Oakland, CA
5University of California, San Francisco, Prevention Sciences Group San Francisco, CA.
6Stanford Center for Research in Disease Prevention, Stanford University School of Medicine Stanford, CA.

Reprint requests to Dr.C. Barr Taylor, Stanford Centre for Research in Disease Prevention, 1000 Welch Road, Palo Atto, CA 94304-1885

Being overweight is a risk factor for cardiovascular heart disease and other medical problems. The purpose of this study was to examine the effect of a community-wide cardiovascular risk reduction trial (the Stanford Five-City Project) on body mass index. In the Stanford Five-City Project, two treatment cities (n = 122,800) received a 6-year mass media and community organization cardiovascular risk reduction intervention. Changes in the treatment cities were compared with two control cities (n = 197,500) for changes in knowledge of risk factors, blood pressure, plasma cholesterol level, smoking rate, body mass index, and resting pulse rate after 5-1/3 years of the education program. Both cohort and cross-sectional (independent) samples were used in the study. In the independent surveys, subjects in the treatment communities gained significantly less weight than subjects in the control communities (0.57 kg compared with 1.25 kg) over 6 years. In the cohort, there were no significant overall differences. The study provides some evidence that a community health education program may help reduce weight gain over time, but more effective methods must be developed if this important risk factor is to be favorable affected in broad populations. Am J Epidemiol 1991;134:235–49.

body mass index; cardiovascular diseases; community medicine; health education; mass media; obesity


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