Prevention of cardiovascular disease in Sweden: The Norsjo community intervention programme - Motives, methods and intervention components

Objectives: When epidemiologic data on cardiovascular disease (CVD) mortali ty rates in different Swedish regions were published in the early 1980s, th ere was great concern about the high CVD incidence in the northernmost coun ties of Sweden, namely Vasterbotten and Norrbotten. This paper describe the development of a Northern Sweden community intervention programme for the prevention of CVD. Methods: As there were no Swedish prototypes. the programme was designed by drawing on experiences from other community interventions. One unique emph asis of the Norsjo intervention programme was to combine a population strat egy with efforts to contact each person individually when they became 30, 4 0, 50, and 60 years of age (the primary care approach). Using the primary c are system as part of the community intervention, systematic risk factor sc reening and counselling by family medicine providers were carried out at th e same time as the community intervention programme invoked other efforts t o raise public awareness. Results: During the first 10 years of the programme > 90% of those invited participated in the individual health screening and counselling. A new food labelling system was introduced in the grocery stores, which after a few y ears became the official Swedish food labelling system. Sales statistics re garding dairy products showed a significant turnover of low fat products. A ccording to public opinion, the health screening and counselling were repor ted to be the most influential factors supporting lifestyle changes. Conclusions: It was possible in Norsjo to create a local health promotion c ollaboration between healthcare providers, grocery stores, schools, municip al authorities, and the public in order to develop a Swedish model for comm unity intervention. The different programme components were well received b y the public.