Program

Feb 24, 2012

OVERVIEW

The Stanford Adolescent Heart Health Program is
a school-based program designed to help high school students develop a heart
healthy lifestyle in order to prevent the risk of cardiovascular disease. An
experimental evaluation of the program found positive impacts on knowledge of
cardiovascular risks, self reported risk behaviors, and physiological risk
factors.

DESCRIPTION OF PROGRAM

Target population:
High
school students

The program is a
school-based intervention that focuses on multiple factors that may lead to
cardiovascular disease. The goals of the program are to encourage adolescents
to adopt a heart healthy lifestyle, teach them cognitive and behavioral skills
to help them make changes in their behavior and environment, help them develop
skills for resisting influences to return to old habits or adopt bad habits, and
provide them with opportunities to practice using the skills in order for them
to feel confident in their ability to use their newly acquired behaviors.

The program
includes 20 classroom sessions led by instructors with academic backgrounds or
experience in health-related fields. The sessions take place during physical
education class time and each session lasts for 50 minutes. The first session
is an introduction to the program. The next 12 are divided into units that
focus on topics such as physical activity, nutrition, cigarette smoking, and
stress. Special emphasis is placed on the immediate effects on quality of life,
but the potential long-term benefits of adopting healthy behaviors are also
discussed. Then, students participate in a two-session game in which they are
divided into teams and quizzed on information and skills that were introduced to
them in the previous 12 sessions. The last five sessions train students in
problem-solving and help them develop an action plan for behavior change during
which each student chooses a specific long-term goal to change their lifestyle.

EVALUATION(S) OF PROGRAM

Killen, J.D.,
Robinson. T. N., Telch, M. J., Saylor, K. E., Maron, D. J., Rich, T., & Bryson,
S. (1989). The Stanford adolescent heart health program. Health Education
Quarterly,
16, 263-286.

Killen, J. D.,
Telch, M. J., Robinson, T. N., Maccoby, N. M., Taylor, C. B., & Farquhar, J. W.
(1988). Cardiovascular disease risk reduction for tenth graders.Journal of
the American Medical Association, 260
(12), 1728-1733.

Evaluated population:
Tenth-graders in four northern California high
schools were evaluated. The total sample consisted of 1,447 students, the
majority of whom (70 percent) were 15 years old. Most (69 percent) participants
were white, 13 percent were Asian, 6 percent were Hispanic, and 2 percent were
Black. Fifty percent of the sample had fathers who had completed at least four
years of college.

Approach:
The four participating senior high schools were from two school districts.
Within each district, one school was randomly assigned to receive the special
intervention and one school served as the comparison school. All tenth graders
in each treatment school attended the intervention sessions three days each week
for seven weeks, and the intervention was delivered as part of the regular
physical education curriculum. Measurements of cardiovascular risk knowledge,
physical activity, food preferences, tobacco use, height, weight, body mass
index (BMI), skin fold thickness, resting heart rate, and blood pressure were
collected at baseline and at a follow-up assessment two months post-
intervention.

Results: The
program had a significant impact on cardiovascular risk knowledge: students in
intervention schools improved their test scores more than students in control
schools.

The program had
significant impacts on all self-reported behaviors. A higher proportion of
students in the intervention group who did not exercise regularly at baseline
reported exercising regularly at follow up (intervention group, 30 percent;
control group, 20 percent). Students in intervention schools were also more
likely to prefer “heart-healthy” snack items than students in the control group.
Also, more students in the intervention group who smoked on a monthly basis or
less at baseline quit smoking at follow-up (intervention group, 29 percent;
control group,18 percent), and fewer of these students became regular smokers
(intervention group: 6 percent, control group: 10 percent) when compared to the
control group. However, the intervention did not have an impact on smoking
frequency for students who had never smoked at baseline or students who were
regular smokers at baseline.

The intervention
had positive impacts on all physiological variables (resting heart rate, BMI,
and skin fold thickness). However, changes in diastolic blood pressure had
positive impacts on females in the control group. No impacts were found for
systolic blood pressure. Students in intervention schools reduced their resting
heart rate significantly more than students in control schools and fared better
on measures of BMI and skin fold thickness.

While the results
are promising, there are some limitations. First, follow-up assessments took
place only two months after the completion of the educational program.
Therefore, it is unclear whether the gains observed in the treatment group will
be maintained over a longer period of time. Second, only two schools were
included in the study. The generalizability of the findings depends, in part,
on whether the study population is representative of the general population.
Despite the limitations, the results of the study strongly suggest that it is
possible to increase adolescents’ understanding of factors that may lead to
cardiovascular disease, to modify behaviors that can lead to the disease, and to
affect changes in some physiological health risks.

SOURCES FOR MORE INFORMATION

References

Killen, J.D.,
Robinson. T.N., Telch, M.J., Saylor, K.E., Maron, D.J., Rich, T., Bryson, S.
(1989). The Stanford adolescent heart health program. Health Education
Quarterly,
16. 263-286.

Killen,
J.D., Telch, M.J., Robinson, T.N., Maccoby, N.M., Taylor, C.B., Farquhar, J.W.
(1988). Cardiovascular disease risk reduction for tenth graders.Journal of
the American Medical Association, 260
(12), 1728-1733.

KEYWORDS:
Adolescence (12-17), Youth (16+), School-based, High School, Nutrition, Tobacco
Use, Males and Females (co-ed), White/Caucasian, Asian, Health
Status/Conditions, Skills Training

Program
information last updated 2/24/2012.