Results of a multifactor cardiovascular risk reduction program in the czech republic: The healthy dubec project

Czech cardiovascular disease (CVD) morbidity and mortality rates are among the highest in the world. A 2-year community-based project was designed to increase CVD awareness and knowledge and behavior change skills, thus stimulating change in CVD-related behaviors. Dubec, a Czech town located just outside Prague, was the study community. Risk-factor surveys were conducted before and after the intervention (1992 and 1994). The intervention combined communitywide health education and intensive medical treatment of individuals at high risk for CVD. At baseline, 55% of the eligible population (n = 1,119) participated in the survey; however, the dropout rate in 1994 was high (46%). After taking those factors associated with dropout into consideration, regression analyses revealed significant increases in CVD knowledge, reductions in blood pressure, non-high-density lipoprotein cholesterol (non-HDL-C), and dietary intake of fat in both the high-risk CVD group and the community sample. In addition, the community sample had significant reductions in total cholesterol and a positive shift in their attitudes about changing CVD risk. There were no significant changes in percentage of smokers, body mass index (BMI), or dietary intake of high-fiber foods. This study demonstrates the feasibility of addressing CVD risk-related behaviors in Central Europe and supports additional efforts to address this significant public health problem. This program was supported by the U.S. Agency for International Development (US AID) under the Partnerships in Health Care Program (EUR 00037-G-00-2026-00). The authors wish to acknowledge the considerable support of Julia Terry, US AID program officer for the Central and Eastern European Partnerships.