0
September 23, 1988, Vol 260, No. 12 >
ARTICLE | September 23, 1988

Cardiovascular Disease Risk Reduction for Tenth Graders: Title and subTitle BreakA Multiple-Factor School-Based Approach FREE

Joel D. Killen, PhD; Michael J. Telch, PhD; Thomas N. Robinson, MD, MPH; Nathan Maccoby, PhD; C. Barr Taylor, MD; John W. Farquhar, MD
[+] Author Affiliations

Reprint requests to the Center for Research in Disease Prevention, Stanford University School of Medicine, 1000 Welch Rd, Palo Alto, CA 94304 (Dr Killen).


JAMA. 1988;260(12):1728-1733. doi:10.1001/jama.1988.03410120074030
Text Size: A A A
Published online
Article
References

All tenth graders in four senior high schools (N = 1447) from two school districts participated in a cardiovascular disease risk-reduction trial. Within each district, one school was assigned at random to receive a special 20-session risk-reduction intervention and one school served as a control. At a two-month follow-up, risk factor knowledge scores were significantly greater for students in the treatment group. Compared with controls, a higher proportion of those in the treatment group who were not exercising regularly at baseline reported regular exercise at follow-up. Almost twice as many baseline experimental smokers in the treatment group reported quitting at follow-up, while only 5.6% of baseline experimental smokers in the treatment group graduated to regular smoking compared with 10.3% in the control group. Students in the treatment group were more likely to report that they would choose "heart-healthy" snack items. Beneficial treatment effects were observed for resting heart rate, body mass index, triceps skin fold thickness, and subscapular skin fold thickness. The results suggest that it is feasible to provide cardiovascular disease risk-reduction training to a large segment of the population through school-based primary prevention approaches.

(JAMA 1988;260:1728-1733)

REFERENCES

1 +
Stamler J:  Improved lifestyles: Their potential for the primary prevention of atherosclerosis and hypertension in childhood , in Lauer RM, Shekelle RB (eds): Childhood Prevention of Atherosclerosis and Hypertension . New York, Raven Press, 1980;.
2 +
Berenson GS: Cardiovascular Risk Factors in Children . New York, Oxford University Press Inc, 1980;.
3 +
Coates TJ, Perry C, Killen JD, et al:  Primary prevention of cardiovascular disease in children and adolescents , in Prokop CK, Bradley LA (eds): Medical Psychology . Orlando, Fla, Academic Press Inc, 1981;.
4 +
Lauer RM, Shekelle RB (eds): Childhood Prevention of Atherosclerosis and Hypertension . New York, Raven Press, 1980;.
5 +
Paffenbarger RS, Wolf PA, Notkin J, et al:  Chronic disease in former college students: I. Early precursors of fatal coronary heart disease . Am J Epidemiol 1966;;83:314-328.
6 +
Thorne MC, Wing AL, Paffenbarger RS:  Chronic disease in former college students: Early precursors of nonfatal coronary heart disease . Am J Epidemiol 1968;;87:520-529.
7 +
Lauer RM, Connor WL, Leaverton PE, et al:  Coronary heart disease risk factors in school-children: The Muscatine study . J Pediatr 1975;;86:697-706.
8 +
Frerichs RR, Srinivasan SR, Webber LS, et al:  Serum cholesterol and triglycerides in 3446 children from a biracial community: The Bogalusa heart study . Circulation 1976;;54:302-309.
9 +
Frank GC, Voors AW, Schilling PE, et al:  Dietary studies of rural school children in a cardiovascular survey . J Am Diet Assoc 1977;;71:31-35.
10 +
Fryer BA, Lamkin GH, Vivian VM:  Diets of preschool children in the North American region . J Am Diet Assoc 1971;;59:228-232.
11 +
Cigarette Smoking Among Teenagers and Young Women , publication (PHS) 79-5006. US Dept of Health, Education, and Welfare, 1979;.
12 +
Killen JD:  Prevention of adolescent tobacco smoking: The social pressures resistance training approach . J Child Psychol Psychiatry 1985;;26:7-15.
13 +
Walter HJ, Hofman A, Vaughan RD, et al:  Modification of risk factors for coronary heart disease . N Engl J Med 1988;;318:1093-1100.
14 +
Parcel GS, Simons-Morton BG, O'Hara NM, et al:  School promotion of healthful diet and exercise behavior: An integration of organizational change and social learning theory interventions . J Sch Health 1987;;57:150-156.
15 +
Bandura A: Social Foundations of Thought and Action . Englewood Cliffs, NJ, Prentice-Hall Inc, 1986;.
16 +
Robinson TN, Killen JD, Taylor CB, et al:  Perspectives on adolescent substance use: A defined population study . JAMA 1987;;258:2072-2076.
17 +
Pechacek T, Murray DM, Luepker RV, et al:  Measurement of adolescent smoking behavior: Rationale and methods . J Behav Med 1984;;7:123-140.
18 +
Keys A, Flaminio F, Karvonen MJ, et al:  Indices of relative weight and obesity . J Chronic Dis 1972;;25:329-343.
19 +
Killeen J, Vanderburg D, Harlan WR:  Application of weight-height ratios and body indices to juvenile populations: The National Health Examination Survey data . J Chronic Dis 1978;;31:529-537.
20 +
Skinfold Thickness of Youths 12-17 Years , Vital and Health Statistics series 11, No. 32. Rockville, Md, Health Resources Administration, 1974;.
21 +
Goodstadt MS, Sheppart MA, Chan GC:  An evaluation of two school-based alcohol education programs . J Alcohol Studies 1982;;43:352-369.
22 +
Bauman KE, Koch GG:  Validity of self-reports and descriptive and analytical conclusions: The case of cigarette smoking by adolescents and their mothers . Am J Epidemiol 1983;;118:90-98.
23 +
Single E, Kandel DB, Johnson B:  The reliability and validity of drug use responses in a large scale longitudinal survey . J Drug Issues 1975;; 5:426-443.
24 +
Rosner B, Cook NR, Evans DA, et al:  Reproducibility and predictive values of routine blood pressure measurements in children . Am J Epidemiol 1987;;126:1115-1125.
25 +
Biglan A, Ary DV:  Methodological issues in research on smoking prevention , in Bell C, Battjes R (eds): Prevention Research: Deterring Drug Abuse Among Children and Adolescents . National Institute on Drug Abuse, 1985;.
26 +
Graham JW, Flay BR, Johnson CA:  Group comparability: A multiattribute utility approach to the use of random assignment with small numbers of aggregated units . Evaluation Rev 1984;;8:247-260.
27 +
Johnston LD, O'Malley PM, Bachman JG: Drug Use Among American High School Students, College Students, and Other Young Adults: National Trends Through 1985, US Dept of Health and Human Services publication (ADM) 86-1450. National Institute on Drug Abuse, 1986;.
28 +
Barnes GM, Welte JW:  Patterns and predictors of alcohol use among 7-12th grade students in New York State . J Alcohol Studies 1986;;47:53-62.

Figures

Tables

Interactive Graphics

Video

Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

1 +
Stamler J:  Improved lifestyles: Their potential for the primary prevention of atherosclerosis and hypertension in childhood , in Lauer RM, Shekelle RB (eds): Childhood Prevention of Atherosclerosis and Hypertension . New York, Raven Press, 1980;.
2 +
Berenson GS: Cardiovascular Risk Factors in Children . New York, Oxford University Press Inc, 1980;.
3 +
Coates TJ, Perry C, Killen JD, et al:  Primary prevention of cardiovascular disease in children and adolescents , in Prokop CK, Bradley LA (eds): Medical Psychology . Orlando, Fla, Academic Press Inc, 1981;.
4 +
Lauer RM, Shekelle RB (eds): Childhood Prevention of Atherosclerosis and Hypertension . New York, Raven Press, 1980;.
5 +
Paffenbarger RS, Wolf PA, Notkin J, et al:  Chronic disease in former college students: I. Early precursors of fatal coronary heart disease . Am J Epidemiol 1966;;83:314-328.
6 +
Thorne MC, Wing AL, Paffenbarger RS:  Chronic disease in former college students: Early precursors of nonfatal coronary heart disease . Am J Epidemiol 1968;;87:520-529.
7 +
Lauer RM, Connor WL, Leaverton PE, et al:  Coronary heart disease risk factors in school-children: The Muscatine study . J Pediatr 1975;;86:697-706.
8 +
Frerichs RR, Srinivasan SR, Webber LS, et al:  Serum cholesterol and triglycerides in 3446 children from a biracial community: The Bogalusa heart study . Circulation 1976;;54:302-309.
9 +
Frank GC, Voors AW, Schilling PE, et al:  Dietary studies of rural school children in a cardiovascular survey . J Am Diet Assoc 1977;;71:31-35.
10 +
Fryer BA, Lamkin GH, Vivian VM:  Diets of preschool children in the North American region . J Am Diet Assoc 1971;;59:228-232.
11 +
Cigarette Smoking Among Teenagers and Young Women , publication (PHS) 79-5006. US Dept of Health, Education, and Welfare, 1979;.
12 +
Killen JD:  Prevention of adolescent tobacco smoking: The social pressures resistance training approach . J Child Psychol Psychiatry 1985;;26:7-15.
13 +
Walter HJ, Hofman A, Vaughan RD, et al:  Modification of risk factors for coronary heart disease . N Engl J Med 1988;;318:1093-1100.
14 +
Parcel GS, Simons-Morton BG, O'Hara NM, et al:  School promotion of healthful diet and exercise behavior: An integration of organizational change and social learning theory interventions . J Sch Health 1987;;57:150-156.
15 +
Bandura A: Social Foundations of Thought and Action . Englewood Cliffs, NJ, Prentice-Hall Inc, 1986;.
16 +
Robinson TN, Killen JD, Taylor CB, et al:  Perspectives on adolescent substance use: A defined population study . JAMA 1987;;258:2072-2076.
17 +
Pechacek T, Murray DM, Luepker RV, et al:  Measurement of adolescent smoking behavior: Rationale and methods . J Behav Med 1984;;7:123-140.
18 +
Keys A, Flaminio F, Karvonen MJ, et al:  Indices of relative weight and obesity . J Chronic Dis 1972;;25:329-343.
19 +
Killeen J, Vanderburg D, Harlan WR:  Application of weight-height ratios and body indices to juvenile populations: The National Health Examination Survey data . J Chronic Dis 1978;;31:529-537.
20 +
Skinfold Thickness of Youths 12-17 Years , Vital and Health Statistics series 11, No. 32. Rockville, Md, Health Resources Administration, 1974;.
21 +
Goodstadt MS, Sheppart MA, Chan GC:  An evaluation of two school-based alcohol education programs . J Alcohol Studies 1982;;43:352-369.
22 +
Bauman KE, Koch GG:  Validity of self-reports and descriptive and analytical conclusions: The case of cigarette smoking by adolescents and their mothers . Am J Epidemiol 1983;;118:90-98.
23 +
Single E, Kandel DB, Johnson B:  The reliability and validity of drug use responses in a large scale longitudinal survey . J Drug Issues 1975;; 5:426-443.
24 +
Rosner B, Cook NR, Evans DA, et al:  Reproducibility and predictive values of routine blood pressure measurements in children . Am J Epidemiol 1987;;126:1115-1125.
25 +
Biglan A, Ary DV:  Methodological issues in research on smoking prevention , in Bell C, Battjes R (eds): Prevention Research: Deterring Drug Abuse Among Children and Adolescents . National Institute on Drug Abuse, 1985;.
26 +
Graham JW, Flay BR, Johnson CA:  Group comparability: A multiattribute utility approach to the use of random assignment with small numbers of aggregated units . Evaluation Rev 1984;;8:247-260.
27 +
Johnston LD, O'Malley PM, Bachman JG: Drug Use Among American High School Students, College Students, and Other Young Adults: National Trends Through 1985, US Dept of Health and Human Services publication (ADM) 86-1450. National Institute on Drug Abuse, 1986;.
28 +
Barnes GM, Welte JW:  Patterns and predictors of alcohol use among 7-12th grade students in New York State . J Alcohol Studies 1986;;47:53-62.

Letters

Submit a Letter
CME Course for:


You need to register in order to view this quiz.


To understand the clinical management of acute heart failure syndromes.
Accreditation Information The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
To view and print your certificate and access a summary of your CME courses go to My CME.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s “Cited By” API will populate this tab (http://www.crossref.org/citedby.html).
Compression-Only CPR: Pushing the Science Forward
Cone
AAM 2010;304:1493-1495.
All you need to read in the other general journals
BMJ 2010;341:c5893-c1494.
Submit a Response

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.

© 2012 American Medical Association. All Rights Reserved.
Powered bySilverchair Information Systems