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 .
Community education for cardiovascular disease prevention. Morbidity and mortality results from the Minnesota Heart Health Program.
The Minnesota Heart Health Program was a community trial of cardiovascular disease prevention methods that was conducted from 1980 to 1990 in three Upper Midwestern communities with three matched comparison communities . A 5- to 6-year intervention program used community-wide and individual health education in an attempt to decrease population risk . A major hypothesis was that the incidence of vali date d fatal and nonfatal coronary heart disease and stroke in 30- to 74-year-old men and women would decline differentially in the education communities after the health promotion program was introduced . This hypothesis was investigated using mixed-model regression . The intervention effect was modeled as a series of annual departures from a linear secular trend after a 2-year lag from the start of the intervention program . In the education communities , 2,394 cases of coronary heart disease and 818 cases of stroke occurred , with 2,526 and 739 cases , respectively , being seen in the comparison communities . The overall decline in coronary heart disease incidence was 1.8 percent per year in men ( p = 0.03 ) and 3.6 percent per year in women ( p = 0.007 ) . For stroke , there were no significant secular trends . The authors recently published findings showing minimal effects of sustained intervention on risk factor levels . In the current report , there was no evidence of a significant intervention effect on morbidity or mortality , either for coronary heart disease or for stroke
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 .