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 .
Joint analysis of three U.S. community intervention trials for reduction of cardiovascular disease risk.
During the 1980s three comprehensive community-based heart disease prevention trials were conducted in the United States . The Stanford Five-City Project , Minnesota Heart Health Program , and Pawtucket Heart Health Program involved 12 cities ; six received a 5 - 8 year multifactorial risk reduction program .  This analysis pools data from the three studies to delineate the common intervention effects with greater sample size and power than could be attained by the single studies . Time trends were estimated for cigarette smoking , blood pressure , total cholesterol , body mass index , and coronary heart disease mortality risk in women and men aged 25 - 64 years . The joint estimates of intervention effect were in the expected direction in nine of 12 gender-specific comparisons ; however , these were not statistically significant . The results illustrate the analytic challenges of evaluating community-based prevention trials and point to the smaller than expected net differences , rather than small sample size , as the reason for few statistically significant effects in the three U.S. prevention trials
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 .