Community-wide strategies for cardiovascular health: the Minnesota Heart Health Program youth program

Abstract

The Class of 1989 Study is part of the Minnesota Heart Health Program, a population-wide research and demonstration project designed to reduce cardiovascular disease in three educated communities (1980–1990). This paper describes fiveyears of school-based behavioral health education in one of the educated communities. Education is conducted sequentially with a cohort of adolescents (the Class of 1989). The long-term outcomes of this intensive education on cigarette smoking are described, comparing smoking history, prevalence and intensity of smoking in the educated group with all of the same-grade adolescents in a matched reference community. Cohort and cross-sectional samples from the two communities, from 1983–1987, form the study population. In the educated community, 13.1% of the Class of 1989 were current smokers in 1987 compared to 22.7% in the reference community, in the cross-sectional sample. This same pattern is also seenwith the cohort sample, as well as in intensity of smoking. Overall the risk of smoking for a student in the educated community in the Class of 1989 was about half of that for students in the reference community and suggests that sustained behavioral intervention in the context of community change may be particularly efficacious for initating and maintaining health behavior with youth.