Pawtucket Heart Health Program

This study has been completed.
Sponsor:
Information provided by:
National Heart, Lung, and Blood Institute (NHLBI)
ClinicalTrials.gov Identifier:
NCT00005151
First received: May 25, 2000
Last updated: June 23, 2005
Last verified: July 2000
  Purpose

To conduct a community-based research and demonstration project in cardiovascular disease prevention in the town of Pawtucket, Rhode Island. Targeted risk factors included high blood pressure, elevated blood cholesterol, obesity, cigarette smoking, and sedentary living. To evaluate the program, risk factor surveys on a cross-sectional and cohort basis were conducted along with mortality and morbidity surveillance both in Pawtucket and in the non-intervention comparison town of New Bedford, Massachusetts.


Condition
Cardiovascular Diseases
Heart Diseases
Hypercholesterolemia
Hypertension
Obesity
Cerebrovascular Accident
Coronary Disease
Atherosclerosis

Study Type: Observational

Resource links provided by NLM:


Further study details as provided by National Heart, Lung, and Blood Institute (NHLBI):

Study Start Date: August 1980
Estimated Study Completion Date: July 1997
  Hide Detailed Description

Detailed Description:

BACKGROUND:

The Pawtucket Heart Health Program arose from a concern that the needs of society could not be met through palliative treatment of coronary heart disease. In 1977, a program designed to facilitate rehabilitation and, hopefully, to provide possible secondary preventive measures for patients with symptomatic coronary heart disease was begun. Simultaneously, the conviction grew that the national interest would be served by careful research into whether or not coronary heart disease was preventable through modification of those aspects of individual and group behavior which influenced the major cardiovascular risk factors in free living populations.

The Pawtucket Heart Health Program was designed to foster community ownership and active participation in a culture change process. A population-wide atherosclerosis risk factor reduction was anticipated as a result of applying an independent variable based upon Social Learning Theory. Emphases on individual factors, on physical environmental factors, and on sociocultural influences on behavior were designed to produce persisting risk factor change followed by morbidity - mortality rate reduction for the population of the city.

DESIGN NARRATIVE:

Selection of an intervention community and a control community was carried out early in the design of the Pawtucket Heart Health Program. Census data, as updated through 1975, were used to identify two communities with between 40,000 and 100,000 people and with stability of in-migration and out-migration necessary for long-term follow-up. The two communities were carefully matched for socio-demographic variables.

Both communities underwent baseline random-sample surveys which demonstrated similar levels of cardiovascular risk factors in the populations of each city. Effective community intervention began in 1983. Total intervention was 7.5 years. Specific objectives of the intervention included a six percent reduction in total cholesterol, a 6 mm Hg reduction in systolic blood pressure, a 30 percent relative reduction in active smokers, a two percent reduction in body weight and body mass index, a 2 ml/kg/minute increase in estimated maximal oxygen uptake, and a 15 percent reduction in fatal and non-fatal cardiovascular disease event rates. Educational techniques used by the program included: print, radio and televised messages; small group behavior change programs delivered by trained lay volunteers; community and worksite-based blood pressure reduction, cholesterol and multiple-risk factor screening, counseling and referral events; self-help programs; school curricula; smoking prevention programs; risk behavior change competitions; shelf-labeling in grocery stores and menu-labeling in restaurants to indicate low sodium and low fat foods.

The effectiveness of the program was evaluated by biennial random household risk factor surveys, a morbidity and mortality surveillance system and other methods. In the risk factor survey, households were randomly selected. Within each sampled household, a single respondent was selected from eligible adults. A household interview and testing protocol was administered in the home and includes questions about diet, exercise, smoking, behavior and knowledge of cardiovascular disease. Physiological measures included height, weight, blood pressure, total cholesterol, triglycerides, high-density-lipoprotein bound cholesterol and serum cotinine. A subsample was given a step test to estimate maximum oxygen uptake as a measure of fitness. A second subset completed a Willett diet questionnaire. There were five cross-sectional household surveys of approximately 2,800 individuals per survey. The initial cross-sectional survey was converted to a cohort survey for measurement again in 1986-1987 and in 1988-1989. The third cross-sectional survey was also converted to a cohort survey for simultaneous measurement with the 1987-1988 and 1989-1990 cross-sectional samples.

Both communities were screened for morbidity and case-fatality rates for coronary heart disease and stroke. Morbidity and mortality data were obtained from seven area hospitals and the State Health Departments of Rhode Island and Massachusetts. Outcome criteria were developed collaboratively by the Pawtucket Heart Health Program, the Stanford Five-City Multifactor Risk Reduction Study, and the Minnesota Heart Health Program, to maximize the scientific value of the conclusions drawn from the three studies and to allow pooling of final data. Surveillance was complete for 1980 to 1983 and continued through 1993.

  Eligibility

Genders Eligible for Study:   Male
Accepts Healthy Volunteers:   No
Criteria

No eligibility criteria

  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

No Contacts or Locations Provided
  More Information

Publications:
Siconolfi SF, Carleton RA, Elder JP, Bouchard PA: Hypotension After Exercise and Relaxation. In: Canto RC (Ed), Clinical Sports Medicine, Collamore Press, Lexington, Mass, Chapter 11, 1983
McKinlay SM, Kipp DM, Johnson P, Downey K, Carleton RA: A Field Approach for Obtaining Physiological Measures in Surveys of General Populations: Response Rates, Reliability, and Costs. Health Survey Research Methods: Proceedings of the Fourth Conference on Health Survey Research Methods. Washington, DC, 1982. DHHS Pub. No. (PHS) 84-3346, 1984
Siconolfi SF, Carleton RA, Lasater TM: Relationship Between Physical Activity Questionnaire and Maximal Oxygen Uptake. Circulation, Supplement, October, 1984
Sennett LL, Peterson G, Elder JP, Lasater TM, Carleton RA: A Community-Based Approach to Weight Loss: The Pawtucket 'Weigh-In.' Chapter in Clinical Sports Medicine, Third Edition, Canto RC (Ed), Collamore Press, Lexington, Mass, in Press, 1985
Siconolfi SF, Lasater TM, Elder JP, Garber CE, Carleton RA: Normal Blood Pressure Reactivity to Mental Stress in Borderline Hypertensive Patients. J Cardiac Rehab, 6:383-398, 1986
Peterson GS, Lefebvre RC, Ferreira A, Sennett L, Lazieh M, Carleton RA: Strategies for Cholesterol Lowering at the Worksite, J Nutr Educ, 18(1), 1986
McKinlay SM, McGraw SA, Assaf AR, Kipp DM, Carleton RA: An Innovative Approach to the Evaluation of Large Community Programs. In: Baum A, Herd JA, (Eds). Perspectives in Behavioral Medicine, Volume 3. Academic Press, Inc. New York, 1987
Elder JP, Abrams DB, Beaudin P, Carleton RA, Lasater TM, Lazieh M, Peterson G, Schwertfeger R: Behavioral Community Psychology and the Prevention of Heart Disease: Community Level Applications of the Pawtucket Heart Health Program. In: Baum A, Herd A, (Eds). Perspectives in Behavioral Medicine, Volume 3. Academic Press, Inc. New York, 1987
Lasater TM, Elder JP, Carleton RA, Abrams DB. The Pawtucket Heart Health Program: Prospects and Process. In: Baum A, Herd JA (Eds). Perspectives in Behavioral Medicine, Volume 3. Academic Press, Inc. New York, 1987
Harden EA, Lefebvre RC, Fuchs V, Lasater TM, Carleton RA: Telemarketing for Health Promotion. Am J Prev Med, 1987
Nelson DJ, et al: A Campaign Strategy for Weight Loss at Worksites. Health Educ Res: Theory and Practice, 2:27-31, 1987
Lefebvre RC: Primary Prevention of Coronary Heart Disease: A Review of Multifactor Prevention Trials. In: Hersen M, Eisler PM, Miller PM (Eds), Progress in Behavior Modification, (Vol. 21). Newburg Park, CA: Sage Publication, 1987

ClinicalTrials.gov Identifier: NCT00005151     History of Changes
Other Study ID Numbers: 1022
Study First Received: May 25, 2000
Last Updated: June 23, 2005
Health Authority: United States: Federal Government

Additional relevant MeSH terms:
Atherosclerosis
Arteriosclerosis
Coronary Disease
Coronary Artery Disease
Cardiovascular Diseases
Heart Diseases
Hypertension
Cerebral Infarction
Stroke
Hypercholesterolemia
Arterial Occlusive Diseases
Vascular Diseases
Myocardial Ischemia
Brain Infarction
Brain Ischemia
Cerebrovascular Disorders
Brain Diseases
Central Nervous System Diseases
Nervous System Diseases
Hyperlipidemias
Dyslipidemias
Lipid Metabolism Disorders
Metabolic Diseases

ClinicalTrials.gov processed this record on September 16, 2014