Effect of community health education on physical activity knowledge, attitudes, and behavior. The Stanford Five-City Project

Am J Epidemiol. 1996 Aug 1;144(3):264-74. doi: 10.1093/oxfordjournals.aje.a008921.


The authors studied the effectiveness of community-wide health education on physical activity knowledge, attitudes, self-efficacy, and behavior. Random samples of residents aged 18-74 years who lived in four central California cities (baseline, n = 1,056 men and 1,183 women) were evaluated in 1979-1980 and approximately every 2 years thereafter to obtain four independent samples. Moreover, every subject in the initial independent samples was asked to return for follow-up every 2 years thereafter; subjects who completed all four examinations constituted the cohort sample (n = 408 men and 499 women). Two medium-sized cities received health education and two similarly sized cities served as controls. Results indicated little consistent evidence of a treatment effect on physical activity knowledge, attitudes, or self-efficacy in either men or women. Among physical activity measures, there was an indication of a positive treatment effect for men in the independent samples for estimated daily energy expenditure and percent participation in vigorous activities (p < 0.01), and for women in the independent (p = 0.014) and cohort (p < 0.01) samples for engagement in the number of moderate activities. These results underscore the need for development of more effective interventions to change physical activity than is provided by a broad-based, community-wide health education program and for more sensitive and reliable measures of knowledge, attitudes, and behavior with regard to physical activity.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Attitude to Health
  • California
  • Child
  • Cross-Sectional Studies
  • Female
  • Health Education* / statistics & numerical data
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Linear Models
  • Male
  • Middle Aged
  • Physical Exertion*
  • Random Allocation
  • Urban Population* / statistics & numerical data