American Journal of Epidemiology Vol. 144, No. 3: 264-274
Copyright © 1996 by The Johns Hopkins University School of Hygiene and Public Health
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Effect of Community Health Education on Physical Activity Knowledge, Attitudes, and Behavior
The Stanford Five-City Project
From the Stanford Center for Research in Disease Prevention, Stanford University School of Medicine, Stanford, CA
Reprint requests to Dr. William L. Haskell, Stanford Center for Research in Disease Prevention, Stanford University School of Medicine, 730 Welch Road, Suite B, Palo Aito, CA 94304.
The authors studied the effectiveness of community-wide health education on physical activity knowledge, attitudes, self-efficacy, and behavior. Random samples of residents aged 18–74 years who lived in four central California cities (baseline, n = 1, 056 men and 1, 183 women) were evaluated in 1979–1980 and approximately every 2 years thereafter to obtain four Independent samples. Moreover, every subject in the initial independent samples was asked to return for follow-up every 2 years thereafter; subjects who completed all four examinations constituted the cohort sample (n = 408 men and 499 women). Two medium-sized cities received health education and two similarly sized cities served as controls. Results indicated little consistent evidence of a treatment effect on physical activity knowledge, attitudes, or self-efficacy in either men or women. Among physical activrty measures, there was an indication of a positive treatment effect for men in the independent samples for estimated daily energy expenditure and percent participation in vigorous activities (p < 0.01), and for women in the independent (p = 0.014) and cohort (p < 0.01) samples for engagement in the number of moderate activities. These results underscore the need for development of more effective interventions to change physical activity than is provided by a broad-based, community-wide health education program and for more sensitive and reliable measures of knowledge, attitudes, and behavior with regard to physical activity. Am J Epidemiol 1996; 144: 264–74.
cardiovascular diseases; coronary disease; exercise; health education; physical fitness
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