Cholesterol screening: observed cholesterol reduction in a prospective study in Norway

The general public of the City of Bergen, Norway was Invitedto participate in a cholesterol screening programme in October1988. Participants received the results of the cholesterol screeningand nutritional information from trained health personnel. Ashort questionnaire was mailed to all 354 participants 1–2weeks after the initial cholesterol screening. In March 1990,all participants were invited to have their cholesterol levelsre-examined. Psychosocial factors believed to be predictiveof future serum cholesterol changes were assessed at baselinealong with demographic variables. The majority of participants(61%) reduced their cholesterol level from October 1988 to March1990, and the average reduction in cholesterol level for thetotal population was 4.0%. Baseline cholesterol levels, beingconfident of one's own ability to change one's diet (self-efficacy),seeing heart disease risk reduction as very important, and maritalstatus were factors that significantly predicted successfulcholesterol reduction 18 months later.     

Parental and peer influences on smoking among young adults: ten-year follow-up of the Oslo youth study participants

This study was designed to investigate the impact of family and peer role models during the early adolescent years on smoking onset and on subsequent daily smoking among young adults. Baseline data were collected from a sample of 827 students and their parents in 1979. Participating students were recruited among 5th, 6th and 7th graders (11–14 years old) attending six schools in Oslo, Norway. The same students were invited to participate in a 2-year follow-up survey in 1981 and in a 10-year follow-up survey in 1989 when their average age was 23.4 years. Both at baseline and in 1981, smoking (experimental or regular) was strongly associated with smoking behaviour of friends and siblings. Parental smoking and parents ‘educational level were not significant predictors of their offspring's smoking in 1979. While friends’ smoking in 1979 or 1981 remained a significant bivariate predictor of daily smoking in 1989, mother's baseline smoking emerged, in multivariate analysis, as the most important long-term predictor of daily smoking among young adults. These results point to the importance of including parents in smoking prevention efforts targeting adolescents.     

The rationale behind early prevention of cardiovascular disease in young people

The rationale for primary prevention of cardiovascular disease(CVD) in young people is based on the applicability to youthof the causal aetiologic model of CVD among adults. Young peoplein developed countries exhibit early atherosclerotic lesions,as well as elevated physiological risk factors. Young peoplein the United States consume a higher fat diet than recommended,approximately half are physically active and nearly 1 in 5 graduatefrom high school as regular cigarette smokers. Not only arerisk factors and risk behaviours evident in youth, but theyappear to track through adolescence and into adulthood. Thisreview suggests that early prevention efforts are prudent andmay be critical.     

Community-wide cardiovascular disease prevention in young people: Long-term outcomes of the Class of 1989 Study

The Class of 1989 Study, as part of the Minnesota Heart HealthProgram, examines 2 cohorts of adolescents in 2 communitiesin northcentral US. The goal of the study was to reduce therisk of cardiovascular disease among young people in one ofthe cohorts through changes in smoking, eating patterns andphysical activity levels. Because of its importance as a healthbehaviour, alcohol use was also addressed, even though it wasnot a specific target of the Minnesota Heart Health Program.The behaviour patterns of both cohorts were surveyed annuallyin schools from 1983 to 1989. One cohort additionally was exposedto 5 years of behavioural health education in their schools,peer leadership and a community-wide programme for adults. Thebehaviour health education curricula focused on skills, competencies,role models and norms for healthier behaviour. Students in theeducated cohort demonstrated significant reductions in smokingfrom 1984 to 1989. Females in the educated cohort also consistentlyreported significantly healthier eating habits and physicalactivity patterns than the reference cohort. Short-term changesin alcohol use were also noted among both males and females,consistent with the results of other research studies of school-basedprogrammes. Results for eating patterns and physical activitypatterns with males were not as robust as with females. Nevertheless,behavioural health programmes in schools coordinated with community-wideeducation and campaigns with adults appears promising.     

Twelve year follow-up of a school-based health education programme: The Oslo Youth Study

The Oslo Youth Study (1979–1981) was designed to evaluatethe impact of a school-based health education programme targetingstudents' eating patterns, physical activity levels and cigarettesmoking. The study was implemented with participants from 6combined elementary and junior high schools, half of whom receivedthe educational programme. In the autumn of 1991, students enrolledas part of the Oslo Youth Study grade cohorts in 1981 were invitedto participate in a follow-up study. The purpose of this studywas to investigate the potential long-term impact of the OsloYouth Study health education programme. A total of 711 subjectscompleted a questionnaire in 1991 (an overall participationrate of 75.1%). Analysing the cross-sectional data obtainedin 1991, we observed no overall long-term positive impact ofeither the smoking, nutrition or physical education programmes.Among the 1979–1991 cohort participants, we found thatsubjects exposed to the educational programme reported a significantlyhigher prevalence of regular vigorous exercise than did subjectsfrom comparison schools (49 versus 40%; p=0.01). No similareffect was seen with smoking or eating behaviour. The resultsfrom this 12 year follow-up study seem to confirm findings fromprevious studies indicating that school-based education canhave a positive short-term impact on health-related behaviours,but that these effects tend to disappear over time.     

Testicular Function after Radiotherapy to Inverted ‘Y’ Field for Malignant Lymphoma

Testicular function was estimated by sperm counts, hormone assays and recording of reported conceptions in 9 patients irradiated for malignant lymphoma. The treatment had been an inverted ‘Y’ field including the inguinal regions with, in addition, a mantle field in 8 patients. Azoospermia or severe oligozoospermia was found in all but 1 patient, and the FSH levels were uniformly elevated. Testosterone and LH were within normal limits except in 2 patients with slightly subnormal testosterone levels. 7 of the patients were married to women of fertile age, and in 3 cases the wife became pregnant and gave birth to a healthy child. The time lapses from irradiation to conception were 18, 40 and 57 months. 2 of these patients had severe oligozoospermia on examination 2 and 4 months respectively from conception. Thus fertility may possibly be underestimated by sperm counting and hormone assays after this type of radiotherapy.     

Evaluation of two student and teacher involved alcohol prevention programmes

Two versions of a school-based alcohol prevention programme for 7th grade students were evaluated against a non-treated comparison condition. Both programme versions were based on a social-cognitive theory approach to alcohol prevention, and differed in the level of role-specifications for participating teachers and peer leaders. Twelve schools with 955 students m Bergen, Norway, participated in the study. Four schools were randomly assigned to each of the three conditions, and the programme was implemented during 10 class periods over 2 months in Spring, 1992. Pre- and post-test surveys were conducted, assessing alcohol use, as welt as cognitive variables related to alcohol use in a specific context (intentions, attitudes, norms and self-efficacy expectations). Results showed that the highly role-specified (HRS) version had a higher degree of student involvement than the less role-specified (LRS) version, indicating that the HRS programme was more successful in engaging students in alcohol prevention activities. A significant difference in programme effectiveness was found, as measured by an overall programme effect across all dependent variables. This effect was explained by significantly more positive outcomes in the HRS version compared to both the LRS and the non-treated conditions, while the LRS version did not differ significantly from the non-created condition.