Doubt remains over effectiveness of community health promotionBMJ 1998; 316 doi: https://doi.org/10.1136/bmj.316.7134.0c (Published 14 March 1998) Cite this as: BMJ 1998;316:c
Heartbeat Wales was a community based, national demonstration programme to reduce modifiable risk factors for cardiovascular disease. Evaluation was based on a quasi-experimental design with before and after surveys in both Wales and a reference area (north east England). On p 818 Tudor-Smith et al report that in 1985-90 similar improvements in smoking, in dietary choices, and exercise patterns occurred in both intervention and reference areas. During the study period north east England showed a rapid uptake of Heartbeat Wales initiatives, which compromised its use as a reference area. With hindsight the quasi-experimental design was inappropriate for such a complex intervention.