A COST-EFFECTIVE, COMMUNITY-BASED HEART HEALTH PROMOTION PROJECT IN ENGLAND - PROSPECTIVE COMPARATIVE-STUDY

Objective: To determine whether a community based coronary heart disea se health promotion project, undertaken over four years, Was associate d with changes in the prevalence in adults of lifestyle risk factors k nown to affect the development of coronary heart disease, and to estim ate whether such an approach was cost effective. Design: Prospective, comparative study of the effects of a health promotion intervention on coronary heart disease lifestyle risk factors, assessed by postal que stionnaire sent to a randomly chosen sample, both at baseline and afte r four years. Subjects: Intervention and control populations of adults aged 18-64 in Rotherham, both from areas with a high incidence of cor onary heart disease and similar socioeconomic composition. Main outcom e measures: Changes in prevalence of lifestyle risk factors between th e control and intervention communities from 1991 to 1995. The effect o f the intervention on certain lifestyle behaviours was evaluated using multiple logistic regression to model the proportion with a particula r behaviour in the study communities as a function of age (18-40 or 41 -64 years), sex, the year of observation (1991 or 1995), and area (int ervention or control). Results: 6.9% fewer people smoked and 8.7% more drank low fat milk in the intervention area, but no other statistical ly significant changes between the areas were detected. The estimated cost per life year gained was pound 31. Conclusions: It is possible to have a cost effective impact on coronary heart disease lifestyle risk factors in a population of adults over four years using only modest r esources.