Skip to main content
Log in

Evaluating community-based preventive cardiovascular programs: Problems and experiences from the North Karelia project

  • Research Reports
  • Published:
Journal of Community Health Aims and scope Submit manuscript

Abstract

Among the different approaches to the study of cardiovascular disease prevention are community-based programs. This type of program concerns a whole community and the intervention takes advantage of the existing service structure and community organization. The evaluation assesses the feasibility, effects on risk factor and disease reduction, costs, process, and other consequences associated with the program. Several such programs have recently been launched in the United States and some other countries. The first major community-based control program was the North Karelia project in Finland, started in 1972 and recently evaluated for its first five-year period. This paper discusses the problems in evaluating community-based CVD control programs on the experiences obtained in the North Karelia project.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Puska P, Tuomilehto J, Salonen J, Nissinen A, Virtamo J, Bjorkqvist S, Koskela K, Neittaanmaki L, Takalo T, Kottke T, Mäki J, Sipilä P, Varvikko P:The North Karelia Project. Evaluation of a Comprehensive Community Program for Control of Cardiovascular Diseases in North Karelia, Finland. World Health Organization, Regional Office for Europe, Copenhagen 1981.

    Google Scholar 

  2. Puska P, Tuomilehto J, Salonen J, Neittaanmäki L, Mäki J, Virtamo J, Nissinen A, Koskela K, Takalo T: Changes in coronary risk factors during comprehensive five-year community program to control cardiovascular diseases (North Karelia project).Br Med J 2:1173–1178, 1979.

    Google Scholar 

  3. McAlister A, Puska P, Salonen JT, Tuomilehto J, Koskela K: Theory and action for Health Promotion: Illustrations from the North Karelia Project.Am J Public Health 72:43–50, 1982.

    Google Scholar 

  4. Farquhar JW: The community-based model of lifestyle intervention trials.Am J Epidemiol 108:103–111, 1978.

    Google Scholar 

  5. Campbell DT, Stanley JC:Experimental and Quasi-experimental Designs for Research. Chicago, Rand McNally Co, 1963.

    Google Scholar 

  6. Keys A:Coronary heart disease in seven countries. Am Heart Asso Monograph No. 29, New York, 1970.

  7. Puska P, Mustaniemi H: Incidence and presentation of myocardial infarction in North Karelia, Finland.Acta Med Scand 197:211–216, 1975.

    Google Scholar 

  8. Karvonen M, Keys A, Orma E, Fidanza F, Brozek J: Cigarette smoking, serum cholesterol, blood pressure and body fatness. Observations in Finland.Lancet i:492–494, 1959.

    Google Scholar 

  9. Rimpelä M: Trends in the smoking habits in Finland in 1949 and 1960-77.Sosiaalilääketieteellinen Aikakauslehti 15:108–120, 1978.

    Google Scholar 

  10. Valkonen T, Niemi ML: The development of male mortality by county and cause of death in Finland in 1961–75. Department of Sociology, University of Helsinki, Working Papers No. 10, 1980.

  11. Glasunov I, Dowd J, Jaksic Z, Kesic G, Ray O, Steinberger C, Stromberg J, Vuletio S: Methodological aspects of the design and conduct of preventive trials in ischaemic heart disease.Int J Epidemio 2:137–143, 1973.

    Google Scholar 

  12. Puska P, Virtamo J. Tuomilehto J, Mäki J, Neittaanmäki L: Cardiovasvular risk factor changes in three-year follow-up of a cohort in connection with a community program (the North Karelia project).Acta Med Scand 204:381–388, 1978.

    Google Scholar 

  13. Farquhar JW, Wood PD, Breitrose H, Haskell WL, Meyer AJ, Maccoby N, Alexander JK, Brown BW Jr, McAlister Al, Nash JD: Community education for cardiovascular health.Lancet 1:1192–1195, 1977.

    Google Scholar 

  14. Salonen JT:Smoking and Dietary Fats in Relation to Estimated Risk of Myocardial Infarction Before and During a Preventive Community Program. Publications of the University of Kuopio, Community Health Series, Original Reports 1/1980.

  15. World Health Organization:Myocardial Infarction Community Registers. Public Health in Europe 5. Copenhagen, WHO/EURO, 1976.

    Google Scholar 

  16. Hatano S, et al: Experience from a multicentre stroke register: A preliminary report. Bull WHO54: 541–553, 1976.

    Google Scholar 

  17. Hatano S, et al.: Observer variations in the diagnosis of stroke. WHO Collaborative study on the control of stroke in the community.Jpn Heart J 18:171–177, 1977.

    Google Scholar 

  18. Hjerman I: The randomized “Smoking-Lipid Trial” of the Oslo Study. Abstract. V International Symposium on Atherosclerosis. Houston 6.–9.11.1979.

  19. Kuller LH: Prevention of cardiovascular disease and risk factor intervention trials.Circulation 61:26–30, 1980.

    Google Scholar 

  20. World Health Organization:Report of a Joint HQ/EURO Meeting on Comprehensive Cardiovascular Community Control Programs. Geneva, 24–26 November 1977.

Download references

Authors

Additional information

Pekka Puska and Aulikki Nissinen are with the Department of Epidemiology, National Public Health Institute, Mannerheimintie 166, SF-00280 Helsinki 28, Finland. Pekka Puska and Jukka T. Salonen are with the Research Institute of Community Health (North Karelia project), University of Kuopio, P.O. Box 138, SF-70101 Kuopio 10, Finland. Jaako Tuomilehto is with the World Health Organization Headquarters, Cardiovascular Unit, 1211 Geneva 27, Switzerland. Thomas E. Kottke is with the Laboratory of Physiological Hygiene, School of Public Health, University of Minnesota, Minneapolis, MN 55455, U.S.A. Communication concerning the manuscript should be addressed to Prof. Pekka Puska

Rights and permissions

Reprints and permissions

About this article

Cite this article

Puska, P., Salonen, J.T., Tuomilehto, J. et al. Evaluating community-based preventive cardiovascular programs: Problems and experiences from the North Karelia project. J Community Health 9, 49–64 (1983). https://doi.org/10.1007/BF01318933

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01318933

Keywords

Navigation