The name is absent

Nutrition and Coronary Heart Disease

reference group. This is different from a number of other studies which used
neighbouring communities as reference groups (for example, Stanford and North
Karelia), thereby creating potential ‘influences’ from the intervention community to the
reference community (Hoffineister et. al, 1996).

The evidence from the German study was chosen for four main reasons. First, the
interventions used in the German study could easily be translated into the South
Western Sydney community. Second, the evidence presented in the German study
reported on the link between risk factors and risk of CHD. Third, the study used a
sound methodology. Finally, there is consistent evidence that community interventions
can be translated across to other communities.

This last point is essential if we are to be able to use the evidence from the German
study and apply it to the South Western Sydney region. Clearly, this requires evidence
that suggests the interventions used on a German population can be effective in the
South Western Sydney community.

Some recent studies suggest that measures of effectiveness can be translated across
communities as long as the intervention is well targeted (Shea et al, 1996; Baxter et al,
1997; Brown et al, 1996; Lee et al; 1994). Having this evidence allows use of the
German study results based on the assumption that these results can be applied to the
epidemiological profile of the South Western Sydney area.

Behaviour modification

In health education programs, effectiveness is clearly in the realm Ofbehavioural
change models. In other words, how successful is the intervention at modifying the
behaviour of an individual, group or community? There are many types Ofbehavioural
change models. Some models focus on the behaviour of the individual, whilst others
focus on modifying the behaviour of a group or community.

Typically, community based approaches deal with the social and physical environments
that determine behaviour (Puska, 1996). Individual based approaches recognise that
different people need different types of messages to modify their behaviour. Ideally, the
two types of approaches should interact and reinforce each other (Kok et al. 1996).

CHERE Project Report 11 - November 1999

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