Alfred L. McAlister

Pilot study of smoking, alcohol and drug abuse prevention.

A longitudinal pilot study gathered data on the onset and prevention of smoking, alcohol, and drug abuse among 526 students from two junior-high-schools in California. Over two school years, students who were trained to resist social pressures toward tobacco, alcohol, and drug use began smoking at less than one-half the rate of those who did not receive special training. Frequent alcohol and marijuana use was also less prevalent among the students who received such training.

Theory and action for health promotion illustrations from the North Karelia Project.

The North Karelia Project in Finland illustrates the fundamental goals of health promotion. Specific activities of the project serve as examples of how concepts from the social and behavioral sciences can be applied to achieve estimated reductions in predicted risk of disease. The results in North Karelia are not conclusive, but they are encouraging, and the investigations conducted there is an essential reference for future research in health promotion and disease prevention.

Long-term follow-up of a pilot project on smoking prevention with adolescents

Seventh graders (N=355)in one junior high school received an experimental smoking prevention program aimed at teaching students to resist the social pressures to smoke cigarettes. Seventh graders (N=217)in another school served as controls. Teams of high-school students trained in basic behavior change skills led seven classroom sessions of instruction in counter-arguing during the school year. Significant differences were found between groups in reported smoking at a 9-month posttest. Results were maintained at 21- and 33-month follow-ups.

The North Karelia youth project: Evaluation of two years of intervention on health behavior and CVD risk factors among 13- to 15-year old children☆

A school and community based intervention to influence health behavior and cardiovascular disease (CVD) risk factors in 13- to 15-year-old children was carried out in North Karelia, Finland. The intervention was carried out on two levels: (a) an intensive intervention (II) in two schools and (b) a county-wide intervention (CI) in the rest of North Karelia. For the evaluation three matched pairs of schools were chosen: the two schools of the II, two schools to represent the CI and two schools from a reference county (R). 851 children, their parents, and their teachers were studied at the outset in 1978 and after the intervention in 1980. During the program the proportion of boys reporting to smoke at least 1–2 times per month increased 12.6% in II, 8.2% in CI and 29.7% in the R schools (P < 0.001 between II and R) and in girls 9.0%, 18.0% and 20.0%, respectively, (P < 0.05 between II and R). The mean serum total cholesterol was 5.1 mmol/liter in 1978 and it decreased among boys 0.5 mmol/liter in all three school groups. Among girls, the decrease was 0.43 mmol/liter (II), 0.35 mmol/liter (CI), and 0.21 mmol/liter (R) (P < 0.01 between II and R). The mean amount of fat from milk and butter changed among boys −8 g (II), 0 g (CI), and +3 g (R) and among girls −16 g, −2 g, and −5 g, respectively (both P < 0.01 between II and R). The intervention had no effect on blood pressure although there was some reported reduction in the salt consumption in the intervention schools. A relative decrease according to the intervention level was observed among North Karelian children in occurrence of psychosomatic symptoms. The effects were not related to increases in health knowledge or changes in attitudes and did not lead, on an average, to any harmful emotional consequences.

The role of lay workers in community health education: experiences of the North Karelia Project.

The role of natural community leaders in serving as lay health workers in a comprehensive community health programme has been explored. In rural Finland, nearly 300 persons were trained to detect cardiovascular risk factors (smoking, high-cholesterol diet, high blood pressure) in their communities, and to advise community members of the desirability of lowering these risk factors. Initial data from studies of the lay health workers and their intervention work support the concept that carefully select community health workers who are to varying degrees representative of their local populations, can well act as intermediaries in preventive health care strategies.

Social and Environmental Influences on Health Behavior

Health education has often been sadly neglected in the public schools. When I attended high school, we were required to complete a four month health course taught by an athletics instructor who perceived his assignment as a disagreeable chore. Everyone could easily pass the course by memorizing a few simple facts and words. We students were beginning to make decisions that could influence our health, but most of us failed to see the relevance of the information that was presented in health education classes. We were eager to communicate frankly with one another, and many erroneous notions concerning drugs and sexual conduct

Media and Community Organization for Prevention Programs

Mass media are believed by many to hold great promise as educators and agents of positive social influence. The seeming simplicity of an extensive mass media campaign and the larger number of persons reached make it an attractive alternative for cost-effective intervention in social problems arising out of individual behaviors (e.g., eating habits, tobacco and alcohol abuse, failure to use safety restraints in automobiles). However, most research on public service media makes them appear to be ineffective.