![]() ![]() ![]() The results of these trials were disappointing. These interventions used mass media, population screening, and community organizations to convey messages encouraging healthy behavior. Several community-level interventions were implemented in the 1980s, again focusing on cardiovascular disease. This led to a second type of intervention-the community intervention, designed to change behaviors by modifying the environment that supports them. Individuals are products of their environment, the theory went, and thus one cannot change the individual without changing the community in which he or she lives. The relative failure of individual interventions was interpreted by many as evidence of the importance of environmental factors in health. Furthermore, mortality outcomes for the treatment group improved only slightly more than did outcomes for the control group. Risk factors changed more in the treatment group than in the control group, but the impact was less than was hypothesized. But the trial was only partly successful. The men received counseling and help with behavior modification. MRFIT enrolled more than 12,000 men at high risk for heart disease in a program to lower their blood pressure and cholesterol and to stop smoking. The most important individual intervention trial is the Multiple Risk Factor Intervention Trial (MRFIT) conducted in the 1970s. In both cases, though, the actions taken are controlled by the individual. These steps involve lifestyle changes (eating well and exercising) and medical changes (regular testing of blood pressure and cholesterol). Examples are programs to encourage smokers to quit, hypertensives to take medications, or diabetics to exercise. These interventions encourage people who are at high risk for a particular disease to do something about it. This chapter reviews what is known about the success and failure of behavioral interventions and speculates about why some interventions are more successful than others.īehavioral interventions can be implemented at three levels. ![]() In considering issues such as the high rate of preventable illness ( McGinness and Foege, 1993) or racial disparities in health, behavioral interventions are key. With behavioral interventions, in contrast, patient behavior is the key and the goal is to change it. Variation in patient behavior is generally shunned a strong emphasis is placed on making sure that patients do exactly what is expected from them. In the trial, doctors provide different services to different people, and then evaluate the outcomes. The typical medical intervention is a clinical trial of a particular drug, surgery, or device. Behavioral interventions are interventions designed to affect the actions that individuals take with regard to their health. ![]()
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