Community programs for obesity prevention: the Minnesota Heart Health Program

Community intervention strategies for obesity that were developed and evaluated in the Minnesota Heart Health Program (MHHP) are described. The MHHP was a 13-year research and demonstration project involving 6 communities that was designed to evaluate whether a sustained multicomponent education campaign could reduce population-wide risk factors for cardiovascular disease. MHHP weight control activities included adult education classes for weight control, exercise, and cholesterol reduction, a worksite weight control program, a home correspondence course for weight loss and a weight gain prevention program. In separate component evaluation studies each of the programs was shown to facilitate favorable changes in weight among individuals choosing to participate in them. Compared to more intensive interventions, weight changes produced by these methods were modest in magnitude, but the number of individuals participating in some of them was quite large. The overall effects of the MHHP program on population levels of obesity were disappointing. Over 7 years of intervention there was a strong upward trend in weight in all communities, independent of age, demographics, smoking habits, or other potential confounding variables. This trend was not different in communities receiving education than in comparison communities. Possible reasons for these results are discussed.