Intervensjonsstudien i Finnmark : evaluering av lokalsamfunnsbasert hjerte- og kar forebygging i kystkommunene Båtsfjord og Nordkapp

Abstract

Due to high cardiovascular mortality in Finnmark, Norway’s northernmost county, the aim of the Finnmark Intervention Study was to improve health and reduce cardiovascular risk factors in the intervention communities. Those with the poorer health condition should experience the main improvements. The intervention projects should be based upon empowerment and participation.<br>

The study bad a quasi-experimental design with community-based intervention in the communities of Båtsfjord and North Cape, which was independently compared to three control communities from the same costal area. The intervention started in 1988. It ended in 1991 in BåtsFJord and in 1998 in North Cape. <br>

Data were used from the Finnmark surveys in 1974/75, 1987/88,1990,1993, and 1996. The effects of the interventions were analysed in the three first papers. Changes in the cohort which met both in 1987 and 1993, were analysed. The changes in the intervention communities were compared to the changes in the control communities using analyses of covariance. The last paper studies the intervention in a longtime perspective. Cross-sectional analyses were done on cardiovascular risk factors among 40-42 year olds who took part in the Finnmark surveys in 1974/75, 1987/88, 1993 and 1996.<br>

Changes in cardiovascular risk factors analysed in paper 1 and 2, gave these main findings: Compared to the control communities changes in blood pressure were more positive in Båtsfjord, while changes in BMI and cholesterol were more positive in North Cape. There was also seen a larger change from boiled coffee to filtered coffee, and larger change from high-fat to low-fat milk in both intervention communities when compared to control communities. Finally, the males in Båtsfiord increased their physical activity, and the females in North Cape reduced their proportion of daily smokers. Paper 3 found no negative side effects of the Båtsfjord intervention when using information from questionnaires on seif-rated health and well-being. The long time perspective of the intervention in paper 4, showed that the Finnmark Intervention Study started when secular trends in cardiovascular risk factors had been reduced substantially from 1974 to 1987. After a decline in blood pressure in Båtsfjord during the intervention period, risk factor levels merged to similar levels in 1996.<br>

The changes we found were a result of a low-cost intervention study with broad involvement of voluntary organisations, public administration and private enterprise. The study showed it was possible to use these organisations together with health personnel to promote health and reduce cardiovascular risk factors in two fishing-villages in Finnmark.