Several specific population interventions that achieved a Class I or IIa recommendation with grade A or B evidence were identified , providing a set of specific evidence -based strategies that deserve close attention and prioritization for wider implementation .
Effective interventions included specific approaches in all 6 domains evaluated for improving diet , increasing activity , and reducing tobacco use .
The writing group also identified several specific interventions in each of these domains for which current evidence was less robust , as well as other inconsistencies and evidence gaps , informing the need for further rigorous and interdisciplinary approaches to evaluate population programs and policies .
This systematic review identified and grade d the evidence for a range of population -based strategies to promote lifestyle change .
BACKGROUND Poor lifestyle behaviors , including suboptimal diet , physical inactivity , and tobacco use , are leading causes of preventable diseases globally .
Although even modest population shifts in risk substantially alter health outcomes , the optimal population -level approaches to improve lifestyle are not well established .
Declines in Acute Myocardial Infarction After Smoke-Free Laws and Individual Risk Attributable to Secondhand Smoke
Background — The estimated effects of recent pubic and workplace smoking restriction laws suggest that they produce significant declines in community rates of heart attack . The consistency of these declines with existing estimates of the relative risk of heart attack in individuals attributable to passive smoking exposure is poorly understood . The objective is to determine the consistency of estimates of reductions in community rates of heart attacks result ing from smoking restriction laws with estimates of the relative risk of heart disease in individuals exposed to passive smoking . Methods and Results — Meta-analyses of existing estimates of declines in community rates were compared with a mathematical model of the relationship between individual risk and community rates . The outcome measure is the ratio of community rates of acute myocardial infa rct ion ( after divided by before implementation of a smoking restriction law ) . There is a significant drop in the rate of acute myocardial infa rct ion hospital admissions associated with the implementation of strong smoke-free legislation . The primary reason for heterogeneity in results of different studies is the duration of follow-up after adoption of the law . The pooled r and om-effects estimate of the rate of acute myocardial infa rct ion hospitalization 12 months after implementation of the law is 0.83 ( 95 % confidence interval , 0.80 to 0.87 ) , and this benefit grows with time . This drop in admissions is consistent with a range of plausible individual risk and exposure scenarios . Conclusion — Passage of strong smoke-free legislation produces rapid and substantial benefits in terms of reduced acute myocardial infa rct ions , and these benefits grow with time
Several specific population interventions that achieved a Class I or IIa recommendation with grade A or B evidence were identified , providing a set of specific evidence -based strategies that deserve close attention and prioritization for wider implementation .
Effective interventions included specific approaches in all 6 domains evaluated for improving diet , increasing activity , and reducing tobacco use .
The writing group also identified several specific interventions in each of these domains for which current evidence was less robust , as well as other inconsistencies and evidence gaps , informing the need for further rigorous and interdisciplinary approaches to evaluate population programs and policies .
This systematic review identified and grade d the evidence for a range of population -based strategies to promote lifestyle change .
BACKGROUND Poor lifestyle behaviors , including suboptimal diet , physical inactivity , and tobacco use , are leading causes of preventable diseases globally .
Although even modest population shifts in risk substantially alter health outcomes , the optimal population -level approaches to improve lifestyle are not well established .