COEUR EN SANTE ST-HENRI - A HEART HEALTH PROMOTION PROGRAM IN A LOW-INCOME, LOW EDUCATION NEIGHBORHOOD IN MONTREAL, CANADA - THEORETICAL-MODEL AND EARLY FIELD EXPERIENCE

Study objective - Coeur en sante St-Henri is a five year, community ba sed, multifactorial, heart health promotion programme in a low income, low education neighbourhood in Montreal, Canada. The objectives of th is programme are to improve heart-healthy behaviours among adults of S t-Henri. This paper describes the theoretical model underlying program me development as well as out early field experience implementing inte rventions. Design - The design of the intervention programme is based on a behaviour change model adapted from social learning theory, the r easoned action model, and the precede-proceed model. The Ottawa charte r for health promotion provided the framework for the development of s pecific interventions. Each intervention is submitted to formative, im plementation, and impact evaluations using simple and inexpensive meth ods. Participant - The target population consists of adults living in St-Henri, a neighbourhood of 23 360 residents. Because of costs constr aints, the intervention strategy targets women more specifically. The community is one of the poorest in Canada with 46% of the population l iving below the poverty line and 20% being very poor. The age-sex adju sted ischaemic heart disease mortality in 1985-87 was 317 per 100 000 compared with 126 per 100 000 in an affluent adjacent neighbourhood. R esults - Thirty nine distinct interventions have been developed and te sted in the community, eight related to tobacco, 10 to diet, seven to physical activity, and 14 which are multifactorial. The interventions include smoking cessation adn healthy recipes contests, a menu labelli ng and healthy food discount programme in restaurants, a point of choi ce nutrition education campaign, healthy eating and smoking cessation workshops, a walking club, educational material, print and electronic media campaigns, heart health fairs, and community events. Conclusion - An integrated heart health promotion programme is feasible in low in come urban neighbourhoods but not all intervention are successful. Suc h a programme requires substantial energy and resources as well as lon g term commitment from public health departments.