Epidemiological measures of participation in community health promotion projects.

ABSTRACT

PIP: The paper is concerned with the use of epidemiological methods to measure the rates at which different strata of a defined population participate in community health promotion projects. The specific aim was to estimate the incidence rates of participation in projects sponsored by the Western Australian Health Promotion Foundation (Healthway), separately for sociodemographic and health-related behavioral subgroups. Data were drawn from Healthway sponsorship projects in 1992. Each sport, arts, and racing project was associated with promotion of a health message and creation of a health promoting environment. The study used a 2-stage sampling design. 13 of 57 large sponsorship projects and 30 of 129 small projects were selected. In the second stage, respondents were randomly surveyed from among project participants. A total of 4060 respondents at least 10 years old was sampled from the 43 selected projects. Population-based incident participation were estimated and were related to person-years at risk. The total participation rate was 4.01 per person-year in people or= 10 years old. The rate was very high at ages 10-14 years and thereafter declined with increasing age. Compared with the least socially disadvantaged 25% of the population, the participation rate fell by around 1/3 in the medium and high disadvantaged groups, but exceeded the baseline by a ratio of 1.85 (95% confidence interval: 1.57-2.18) in the most disadvantaged 10% of the population. The comparatively high rate of participation in the most disadvantaged group occurred only at ages 50 years and the effect was most pronounced at ages 10-19 years. Compared with the least disadvantaged 25%, the rate ratio in the most disadvantaged 10% of the population was 2.50 in the metropolitan area and 1.25 in the country regions of western Australia. Participation was higher in those who smoked, drank alcohol unsafely, reported sunburn, and reported low consumption of fruit and vegetables. Epidemiological methods can be used to evaluate the distribution of participation of a population in community health promotion projects.