IMPLICATIONS OF THE RESULTS OF COMMUNITY INTERVENTION TRIALS

This paper examines the results of population-level interventions cond ucted in three settings: entire communities, worksites, and schools. F our major conclusions ale discussed: (a) Directions for the next gener ation of community-based interventions include targeting multiple leve ls of influence; addressing social inequalities in disease risk; invol ving communities in program planning and implementation; incorporating approaches for ''tailoring'' interventions; and utilizing rigorous pr ocess evaluation. (b)In addition to randomized controlled trials, it i s time to use the full range of research phases available, from hypoth esis generation and methods development to dissemination research. (c) The public health research agenda may have contributed to observed se cular trends by placing behavioral risk factors on the social and medi a agendas. (d) The magnitude of the results of community intervention trials must be judged according to their potential public health or po pulation-level effects. Small changes at the individual level may resu lt in large benefits at the population level.