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Early Response to a Behavioral Community-Based Educational Intervention on Cardiovascular Risk Profile and Well-Being
Valentí Fuster1, Domènec Haro2, Xavier Òrrit2
1Centro Nacional de Investigaciones Cardiovasculares Carlos III, Madrid, Spain; Mount Sinai Fuster Heart Hospital, New York, New York, USA; Foundation for Science, Health, and Education (SHE), Barcelona, Spain.
Background:
Cardiovascular disease is the leading global cause of morbidity and mortality, driven largely by modifiable risk factors. Following the World Health Organization Healthy Cities framework, the Cardona Healthy Community 2030 (HC-2030) intervention was launched in 2021 in Cardona, Spain.
Objectives:
This interim analysis evaluates the 2-year dose-response effect of HC-2030 on the Fuster-BEWAT, a score that summarizes several risk factors and behaviors: blood pressure [B], exercise [E], weight [W], alimentation [A], and tobacco [T], score and other cardiovascular risk markers, compared with nonintervened participants from the control town of Sallent.
Methods:
In this quasi-experimental study, 1,857 participants aged 12 to 85 years were recruited. HC-2030 included community health-education workshops in Cardona, while Sallent received only usual care and standard prevention advice. Baseline assessments-Fuster-BEWAT score, anthropometrics, behavioral and psychosocial variables, blood pressure, lipid profile, and physical activity-were repeated after 2 years. Dose-response analyses were conducted exclusively in Cardona.
Results:
Participants attending 4 or more workshops showed the greatest improvements in physical activity, adherence to the Mediterranean diet, triglycerides, and diastolic blood pressure. While Fuster-BEWAT scores remained stable in Cardona, they declined significantly in Sallent (-0.06 [95% CI: -0.19 to 0.07] vs -0.50 [95% CI: -0.63 to -0.37] points; P < 0.001). Compared with the control town, the intervention produced 2-year reductions in waist circumference, total cholesterol, and smoking prevalence, together with increases in physical activity and well-being.
Conclusions:
The HC-2030 intervention demonstrates the preventive value of community education programs. Consistent participation-at least 4 workshops over 2 years-appears essential to achieve optimal cardiovascular benefits. Continued follow-up will clarify long-term effects.
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