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Chapter 4: School-Based Research on Health Behavior Change: The Stanford Adolescent Heart Health Program as a Model for Cardiovascular Disease Risk Reduction

Schools provide an attractive setting for health behavior change instruction. The mandatory presence of students in schools offers an excellent opportunity for longitudinal research. School interventions are potentially cost-effective. Treatment programs can be integrated into the general educational curriculum so that large numbers of individuals may be influenced without heavy investments of professional resources. Maintenance of behavior change may be enhanced because school-based programs allow greater environmental support to foster and sustain behavior change. However, the transfer of health behavior change curricula from the laboratory or clinic to the school setting has proven to be a difficult task. A principal goal of this chapter is to discuss the conceptual framework, design, implementation, and evaluation of a successful school-based health behavior change intervention. We begin by presenting a conceptual model of the health behavior change process to illustrate linkages between behavior change theory and intervention practice. Next, we discuss program development, taking for our text our own school-based investigations with a multiple-factor cardiovascular disease risk reduction curriculum. We will summarize results of this work as an introduction to a discussion of design and evaluation problems of particular con