Lifestyle Factors of a Five-Year Community-Intervention Program: The Hartslag Limburg Intervention
Background
Community-based health promotion is a widely advocated strategy in public health to favorably alter lifestyle. The aim of this study was to investigate the net effect of a cardiovascular disease–prevention program (Hartslag Limburg) on lifestyle factors after 5 years of intervention (1998–2003).
Methods
In a cohort study, 5-year mean changes in lifestyle factors (energy intake; fat intake; time spent on leisure-time physical activity; walking, bicycling, and sports; and smoking behavior) between subjects from the intervention area (n=2356) and the control area (n=758) were compared for men and women and for those with a low (less than intermediate secondary education) and a moderate (intermediate vocational or higher secondary education) or high (higher vocational education or university) educational level. Adjustments were made for age and the mean of the individual pre- and post-intervention measurement of the variable under study. When stratifying for gender, adjustments were made for educational level, and vice versa.
Results
In general, lifestyle factors changed unfavorably in the control group, whereas changes were less pronounced or absent in the intervention group. The adjusted difference in mean change in lifestyle factors between the intervention group and the control group was significant (p≤0.05) for energy intake (−0.2 megajoule per day among both women and those with a low educational level); fat intake (−2.5 grams per day [g/d] among women and −3 g/d among those with a low educational level); time spent walking (+2.2 hours per week [hrs/wk] among women and +2.3 hrs/wk among those with a low educational level); time spent on total leisure-time physical activity (+2.1 hrs/wk among women); and time spent bicycling (+0.6 hrs/wk among those with a low educational level).
Conclusions
The community intervention Hartslag Limburg succeeded in preventing age- and time-related unfavorable changes in energy intake, fat consumption, walking, and bicycling, particularly among women and those with low SES.
aNational Institute for Public Health and the Environment, Bilthoven, The Netherlands
bDivision of Human Nutrition, Wageningen University, Wageningen, The Netherlands
cDepartment of Health Organisation Policy and Economics, Maastricht University, Maastricht, The Netherlands
dDepartment of Health Education and Promotion, Maastricht University, Maastricht, The Netherlands
eDepartment of General Practice, Maastricht University, Maastricht, The Netherlands
fNetherlands Institute for Health Promotion and Disease Prevention, Woerden, The Netherlands
gInstitute of Health Science, Vrije Universiteit (VU University), Amsterdam, The Netherlands
Address correspondence and reprint requests to: G.C. Wanda Wendel-Vos, PhD, National Institute for Public Health and the Environment, P.O. Box 1, 3720 BA, Bilthoven, The Netherlands
ABSTRACT