回顧社區健康介入計畫: 以預防心血管疾病為例

This article used community heart health projects as examples to review the trend and development of community-based intervention programs in the US and European countries. The author explored the reasons for why there was no significantly effective outcome in many of these large-scale programs, and discussed the study designs and health indictors of such programs. From both review and discussion, the author suggested future research strategies in community-based intervention studies. Since the 1970s, many American and European research institutes have supported large-scale community-based intervention programs aiming at preventing cardiovascular diseases. In many programs, the prevalence of risk factors and cardiovascular disease had been lowered in the intervened communities that were the subject of intervention. The controlled community, however, also showed the same secular changes over in the long-term research period. Statistically speaking, there were no significant differences between the experimental and control groups. The author reviewed some new research designs and new approaches in community-based intervention studies. As a conclusion, the author suggest that future community-based studies should consider environmental and policy changes as well as individual behavior changes; apply both qualitative and quantitative methods, replace individual-level indicators with community-level indicators, and shift the directorship of the program from investigators to community participants.