havioral Risk Factor Surveillance System, 1999b). Past 6-month prevalence of reported blood pressure screening was higher among women (78 percent) than men (70 percent) and increased with age, though there did not seem to be any significant differences by levels of income or educational attainment. Interestingly, African-Americans (79 percent) were most likely to have been screened for high blood pressure within the past 6 months, followed by whites (75 percent), Hispanics (69 percent), and all other ethnic groups (69 percent). Importantly, between 1986 and 1996, overall death rates from cardiovascular diseases decreased an additional 21 percent (American Heart Association, 1998); differences by ethnic group and gender are discussed in Chapter 1.

These impressive declines in high blood pressure and stroke rates closely match the timing of the National High Blood Pressure Education Program. In addition, evidence that some of the specific targets for the program (e.g., awareness and care seeking) were affected along with morbidity and mortality supports an argument that they are related to program efforts. However, the communication-specific program elements were only one component of the broad program, and the program itself operated as a complement to other changes in the environment. It is not possible to make any precise claims as to how much of the effects might have been lost absent the communication-specific elements of the program.

Back to Sleep Campaign

The Back to Sleep Campaign was launched in June 1994 to disseminate the recommendations of the American Academy of Pediatrics, advocating the back (supine) infant sleeping position to help reduce the risk of SIDS. Continuous evaluations to monitor changes in knowledge and behaviors regarding infant sleeping practices are available to the campaign through various surveys. These include the National Infant Sleep Position Study (NISP), an annual telephone survey of nighttime caregivers of infants under 8 months of age, and national surveys of the National Institute for Child Health and Development (NICHD), such as the National

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