Comparison of "Rose Questionnaire Angina" to exercise thallium scintigraphy: different findings in males and females.

Validation of the London School of Hygiene (Rose) Questionnaire with objective measures of myocardial ischemia is incomplete. Therefore, we compared the Rose Questionnaire with exercise thallium-201 myocardial scintigraphy in 147 male and 97 female patients with chest pain referred for clinical exercise testing. Of those with "Rose Questionnaire angina", 26% of the females and 73% of the males had positive thallium-201 scans.

Using the stages of change model to increase the adoption of physical activity among community participants.

Purpose: This study examined the use of the stages of change model to design an exercise intervention for community volunteers.

Design: The "Imagine Action" campaign was a community-wide event incorporating the involvement of local worksites and community agencies. Community members registering for the campaign were enrolled in a six-week intervention program designed to encourage participation in physical activity.

Is aerobic dance an effective alternative to walk-jog exercise training?

In order to compare the physiological effects of an 8 week aerobic dance program to those of a walk-jog exercise training program, 60 male and female University employees ages 24-48 years were randomly assigned to an aerobic dance program (N = 22), a walk-jog program (N = 24), or a sedentary control group (N = 15). Subjects who had an exercise compliance rate less than or equal to 85% were dropped from the study, as were control subjects who had scheduling conflicts or illnesses precluding post-treatment testing. Thirty-five subjects completed the 8 week period with a compliance rate greater than or equal to 85%, leaving 14 in the aerobics group, 11 in the walk-jog group and 10 in the control group.

Enhancing adherence to referral advice given at blood cholesterol screenings: impact on participant follow-up and physician behavior.

Adherence to referral recommendations given to participants at blood cholesterol screening programs is a critical aspect of these efforts to help detect and control high blood cholesterol in the US adult population. In this study, 386 participants who had received two consecutive blood cholesterol measurements above 240 mg/dl (6.21 mmol/l) were interviewed by telephone 3 months after their second measurement (May 1987 - May 1988).

The threshold for myocardial ischemia varies in patients with coronary artery disease depending on the exercise protocol.

It is generally accepted that angina pectoris and, presumably, myocardial ischemia occur at a fixed heart rate-systolic blood pressure product in a given patient. This concept of a fixed threshold has recently been challenged. To evaluate the effects of varying exercise intensity on the ischemic threshold, 33 patients with coronary artery disease and provokable myocardial ischemia, documented by thallium-201 myocardial perfusion imaging, underwent two exercise tests 2 to 7 days apart.

A successful physician training program in cholesterol screening and management.

Method: Thirty-six resident physicians received a blood cholesterol training program which included training in blood cholesterol screening using a fingerstick method and a desktop analyzer, diet assessment and counseling, and a management protocol for follow-up diet and drug treatment. The program also included feedback to residents about their blood cholesterol screening activity, incentives, and biweekly articles in the department newsletter.

Results: Between 1986-1987 (baseline) and 1987-1988 (intervention), the percentage of the target patient population (ages 20-65 years, nonpregnant, not screened in the previous year) that was screened for hypercholesterolemia in this primary care practice increased from 16.

Correlates of expected success at health habit change and its role as a predictor in health behavior research.

Perceived ability to change health habits successfully is undoubtedly an important factor underlying personal health behavior. This report examines expected success in changing future habits, using a sample of community-resident adults 18-65 years of age (n = 1,367). One set of analyses used expected success as a dependent variable, whereas another set used it as an independent variable for health behavior and knowledge indices.

Are people more health conscious? A longitudinal study of one community.

Secular changes in cardiovascular health awareness, knowledge and behavior were observed in four biennial cross-sectional surveys and a cohort survey in a New England community. These changes are not related to more health promotion activities in the social milieu of respondents, but are more likely due to national mass media health campaigns, the effects of which may influence outcomes of community-based cardiovascular disease prevention studies.

Community-based approach to weight loss: the Pawtucket "weigh-in".

The Pawtucket Heart Health Program (PHHP), in its attempt to treat obesity in the community, has delivered many traditional group and self-help weight loss programs. However, in order to reach a sufficient number of people to produce a public health impact in Pawtucket, PHHP devised a monthly city-wide "weigh-in." This program, designed to be delivered by volunteers, allowed individuals to set a weight loss goal and pledge a monetary incentive toward this goal.

The Pawtucket Heart Health Program. Influencing adolescent eating patterns.

The Pawtucket Heart Health Program, a research effort testing a process of community activation for cardiovascular risk factor behavior change, risk factor change, and coronary heart disease event rate change, utilizes risk factor behavior change programs for the entire population of a northeastern city. A diversity of nutrition programs designed to teach new skills and to alter the nutrition environment have been delivered. These include group programs, highlighting restaurant menus, labeling grocery shelf items, screening for blood cholesterol levels accompanied by nutritional counseling, and provision of programs in schools.

Use of population-based data to assess risk factor profiles of blue and white collar workers.

In light of increasing interest in the workplace as a site for primary prevention of chronic disease, more information concerning the current health status of workers is needed. This report compares "blue collar" (n = 2118) and "white collar" (n = 1900) respondents from a population-based random sample survey conducted in two southeastern New England communities. The specific responses were to a household interview and physiological measures emphasizing the risk factors for cardiovascular disease.

Training health professionals and lay volunteers to deliver cholesterol screening and education programs.

The National Heart, Lung, and Blood Institute of the National Institutes of Health launched the National Cholesterol Education Program (NCEP) in 1985. With the goal of reducing the prevalence of elevated blood cholesterol in the United States, the NCEP aims to raise awareness and understanding in both health professionals and the general public of high blood cholesterol levels as a risk factor for coronary heart disease. Public interest in blood cholesterol measurement has created an enormous market for cholesterol screening and education programs.

Marketing cardiovascular disease risk reduction programs at the workplace. The Pawtucket Heart Health Program experience.

The workplace offers a unique setting in which to offer CVD risk reduction programs. Marketing these programs involves at least two distinct processes. First, a corporation must agree to accept and support workplace health programming.

Health practice correlates in three adult age groups: results from two community surveys.

Independently done surveys of a target population can make an important contribution to knowledge about the determinants of personal health behavior by highlighting variables that consistently emerge as significant predictors. This investigation examined the correlates of four health practice and knowledge indices related to cardiovascular disease (CVD) in two baseline community surveys of the Pawtucket Heart Health Program (N = 2,413; N = 2,808). An additional dimension was the use of three adult age groups (18-29, 30-49, 50-64) in conducting the analyses.

Pawtucket Heart Health Program point-of-purchase nutrition education program in supermarkets.

Point-of-purchase nutrition education in supermarkets is one intervention strategy of the Pawtucket Heart Health Program, a community cardiovascular disease prevention program in Pawtucket, Rhode Island. Using consumer intercept interviews, awareness of shelf labels and their effect on purchase behavior have been continuously evaluated. Between 1984 and 1988, the percent of shoppers who could identify correct labels increased from 11 percent to 24 percent (95% confidence intervals of difference: 7.

Volunteers as providers of heart health programs in churches: a report on implementation.

Abstract This project studies the use of church volunteers to reduce cardiovascular disease risk factors among their fellow church members. Our findings focus on the first 12 months of the project and address the following questions: 1) Can volunteers implement these programs with no on-site professional staff? 2) Are volunteer efforts facilitated by a local volunteer task force? and 3) Are implementation efforts aided by readily available professional staff involvement? In the intervention churches, 220 certified Risk Factor Leaders conducted 82 group programs with 740 registrants and 104 blood pressure screenings with 1,834 contacts. Our study shows volunteers to be effective implementers of heart health programs in churches.

Heart healthy cook-offs in home economics classes: an evaluation with junior high school students.

The Pawtucket Heart Health program works closely with the 23 parochial and public schools in Pawtucket, R.I., to educate students and teachers about heart health promotion.

Characteristics of volunteers who deliver health education and promotion: a comparison with organization members and program participants.

The use of volunteers in this culture for community health endeavors is an understudied area. Yet, there may be many potential benefits for utilizing volunteers in the delivery of community health education and promotion. Volunteers may have more immediate access to their peers, credibility, and familiarity with the cultural environment and organization elements.

Information-seeking about health in a community sample of adults: correlates and associations with other health-related practices.

Action by individuals to acquire information about their health has been an element incorporated throughout theory, research, and programs related to health promotion. This report describes an attempt to determine if an information-seeking dimension could be empirically identified in a general community-resident sample, and if so, to examine some of its characteristics. A total of 281 adults aged 18-75 were contacted by telephone using random digit dialing and were interviewed about a variety of personal health practices.

Efficacy of an incentive-based community smoking cessation program.

Although the number of smokers has declined in recent years, many people remain resistant to traditional smoking cessation programs. Therefore, new and innovative approaches have been attempted. This study describes the application and effects of a community-wide smoking cessation program over three successive years.

A comparison of perceived and objective CVD risk in a general population.

This report examines correspondence between perceived and objective (American Heart Association's RISKO) risk of heart attack and stroke in a randomly selected sample from two surveys (n = 4,171) conducted in each of two New England cities, in 1981-82 and 1983-84, respectively. Results confirmed prior reports that people tend to underestimate their CVD (cardiovascular disease) risk and showed that estimates of those at lowest risk were most accurate.

Performance characteristics of a blood cholesterol measuring instrument used in screening programs.

Four experiments were conducted to assess the precision and accuracy of the Boehringer Mannheim Diagnostics Reflotron, an instrument that is being adopted by many public health groups to conduct blood cholesterol screening programs. Our study is one of the first to evaluate and document the instrument's performance characteristics. Successive generations of reagent tabs supplied by the manufacturer were tested against a reference laboratory method standardized by the Centers for Disease Control.