The North Karelia youth project: Evaluation of two years of intervention on health behavior and CVD risk factors among 13- to 15-year old children

Abstract

A school and community based intervention to influence health behavior and cardiovascular disease (CVD) risk factors in 13- to 15-year-old children was carried out in North Karelia, Finland. The intervention was carried out on two levels: (a) an intensive intervention (II) in two schools and (b) a county-wide intervention (CI) in the rest of North Karelia. For the evaluation three matched pairs of schools were chosen: the two schools of the II, two schools to represent the CI and two schools from a reference county (R). 851 children, their parents, and their teachers were studied at the outset in 1978 and after the intervention in 1980. During the program the proportion of boys reporting to smoke at least 1–2 times per month increased 12.6% in II, 8.2% in CI and 29.7% in the R schools ( P < 0.001 between II and R) and in girls 9.0%, 18.0% and 20.0%, respectively, ( P < 0.05 between II and R). The mean serum total cholesterol was 5.1 mmol/liter in 1978 and it decreased among boys 0.5 mmol/liter in all three school groups. Among girls, the decrease was 0.43 mmol/liter (II), 0.35 mmol/liter (CI), and 0.21 mmol/liter (R) ( P < 0.01 between II and R). The mean amount of fat from milk and butter changed among boys −8 g (II), 0 g (CI), and +3 g (R) and among girls −16 g, −2 g, and −5 g, respectively (both P < 0.01 between II and R). The intervention had no effect on blood pressure although there was some reported reduction in the salt consumption in the intervention schools. A relative decrease according to the intervention level was observed among North Karelian children in occurrence of psychosomatic symptoms. The effects were not related to increases in health knowledge or changes in attitudes and did not lead, on an average, to any harmful emotional consequences.