John William Farquhar | Stanford University (original) (raw)
Papers by John William Farquhar
Tidsskrift for den Norske lægeforening : tidsskrift for praktisk medicin, ny række, Jan 30, 1998
Preventive Medicine, 1992
American journal of epidemiology, Jan 15, 1995
In the past two decades several community intervention studies designed to lower the risk of card... more In the past two decades several community intervention studies designed to lower the risk of cardiovascular disease in populations have been completed. These trials shared the rationale that the community approach was the best way to address the large population attributable risk of mild elevations of multiple risk factors, the interrelation of several health behaviors, and the potential efficiency of large-scale interventions not limited to the medical care system. These trials also shared several threats to internal validity, especially the small number of intervention units (usually cities) that could be studied. The purpose of this paper is to reflect on the lessons learned in one of the studies, the Stanford Five-City Project, which began in 1978. The anticipated advantages were observed, including the generalizability of the intervention components, the potential for amplification of interventions through diffusion in the community, and the efficiency of the mass media and oth...
Current atherosclerosis reports, 2003
There are hundreds of foods, nutrients, herbs, and botanicals that have "bioactive" con... more There are hundreds of foods, nutrients, herbs, and botanicals that have "bioactive" constituents with potential human health benefits. Three of these are discussed in this review: soy, garlic, and ginkgo biloba. Each of these three choices involves an ingestible item composed of a complex mixture of bioactive agents. For each of these three, there is a large and growing body of research suggesting potential cardiovascular health benefits. And for each there is at least some level of disagreement or controversy. The focus of this review is on results from recent human clinical trials.
Communication Research, 1993
This study examines the process of media supplementation in the Stanford Five-City Multifactor Ri... more This study examines the process of media supplementation in the Stanford Five-City Multifactor Risk Reduction Project, a long-term trial of communitywide cardiovascular disease risk reduction conducted by Farquhar and associates. The data indicate that accessible awareness media disseminated early in the education campaign promoted use of information-rich depth media later on, demonstrating that supplementation occurred. Moreover, analyses suggest that awareness
Teaching and Learning in Medicine, 1992
The Stanford Faculty Development Program, designed to improve the instructional skills of clinica... more The Stanford Faculty Development Program, designed to improve the instructional skills of clinical teachers, uses a dissemination model to provide faculty development activities for medical schools across the country. Selected clinical faculty attend a month‐long training program at Stanford University Medical Center and then return to their home institutions to conduct seminars for their fellow faculty and for residents in
New Directions for Program Evaluation, 1989
... Evaluating Community-Level Health Promotion and Disease Preuen tion Interventions Christine J... more ... Evaluating Community-Level Health Promotion and Disease Preuen tion Interventions Christine Jackson, David G. Altman, Beth Howard-Pitney, John W. Farquhar ... program. New Directions for Progmn Evaluation, no. 43. San Francisco: Jossey-Babs, Fall 1989. 19 Page 2. ...
Journal of Clinical Investigation, 1965
Journal of Clinical Investigation, 1974
Considerable controversy exists over the purported role of obesity in causing hyperglycemia, hype... more Considerable controversy exists over the purported role of obesity in causing hyperglycemia, hyperlipemia, hyperinsulinemia, and insulin resistance; and the potential beneficial effects of weight reduction remain incompletely defined. Hypertriglyceridemia is one of the metabolic abnormalities proposed to accompany obesity, and in order to help explain the mechanisms leading to this abnormality we have proposed the following sequential hypothesis: insulin resistance --> hyperinsulinemia --> accelerated hepatic triglyceride(TG) production --> elevated plasma TG concentrations. To test this hypothesis and to gain insight into both the possible role of obesity in causing the above metabolic abnormalities and the potential benefit of weight reduction we studied the effects of weight loss on various aspects of carbohydrate and lipid metabolism in a group of 36 normal and hyperlipoproteinemic subjects. Only weak to absent correlations (r = 0.03 - 0.46) were noted between obesity and the metabolic variables measured. This points out that in our study group obesity cannot be the sole, or even the major, cause of these abnormalities in the first place. Further, we have observed marked decreases after weight reduction in fasting plasma TG (mean value: pre-weight reduction, 319 mg/100 ml; post-weight reduction, 180 mg/100 ml) and cholesterol (mean values: pre-weight reduction, 282 mg/100 ml; post-weight reduction, 223 mg/100 ml) levels, with a direct relationship between the magnitude of the fall in plasma lipid values and the height of the initial plasma TG level. We have also noted significant decreases after weight reduction in the insulin and glucose responses during the oral glucose tolerance test (37% decrease and 12% decrease, respectively). Insulin and glucose responses to liquid food before and after weight reduction were also measured and the overall post-weight reduction decrease in insulin response was 48% while the glucose response was relatively unchanged. In a subgroup of patients we studied both the degree of cellular insulin resistance and the rate of hepatic very low density (VLDL) TG production before and after weight reduction. These subjects demonstrated significant decreases after weight reduction in both degree of insulin resistance (33% decrease) and VLDL-TG production rates (40% decrease). Thus, weight reduction has lowered each of the antecedent variables (insulin resistance, hyperinsulinemia, and VLDL-TG production) that according to the above hypothesis lead to hypertriglyceridemia, and we believe the overall scheme is greatly strengthened. Furthermore, the consistent decreases in plasma TG and cholesterol levels seen in all subjects lead us to conclude that weight reduction is an important therapeutic modality for patients with endogenous hypertriglyceridemia.
International Journal of Behavioral Medicine, 2000
Czech cardiovascular disease (CVD) morbidity and mortality rates are among the highest in the wor... more Czech cardiovascular disease (CVD) morbidity and mortality rates are among the highest in the world. A 2-year community-based project was designed to increase CVD awareness and knowledge and behavior change skills, thus stimulating change in CVD-related behaviors. Dubec, a Czech town located just outside Prague, was the study community. Risk-factor surveys were conducted before and after the intervention (1992 and 1994). The intervention combined communitywide health education and intensive medical treatment of individuals at high risk for CVD.
Annals of the New York Academy of Sciences, 1991
Not Available Bibtex entry for this abstract Preferred format for this abstract (see Preferences)... more Not Available Bibtex entry for this abstract Preferred format for this abstract (see Preferences) Find Similar Abstracts: Use: Authors Title Return: Query Results Return items starting with number Query Form Database: Astronomy Physics arXiv e-prints
Annals of Epidemiology, 1997
ABSTRACT PURPOSE: Lessons from three decades of community prevention trials are discussed to prov... more ABSTRACT PURPOSE: Lessons from three decades of community prevention trials are discussed to provide directions for the future of community health promotion efforts. METHODS: The rationale for and characteristics of community prevention trials for cardiovascular disease (CVD) risk reduction are presented. Published articles regarding the main effects and component studies of community prevention trials regarding CVD were reviewed. RESULTS: All early and most recent community prevention trials carried out in diverse populations demonstrated population-wide effects on CVD risk factors, particularly blood pressure levels and smoking prevalence. Moreover, subgroup component studies (e.g., schools, worksites, events) demonstrate the efficacy of many risk reduction strategies. These results support a dose-response relationship by evidence of stronger effects where adequate exposure to the intervention was achieved. CONCLUSIONS: Although much remains untested in theory and practice, data indicate that community-based efforts to reduce the risk of CVD can influence behavior. Additional research is needed to increase understanding of the optimal mix and sequencing of components of these programs. In addition, this review indicates the importance of incorporating strategies to influence environmental change. Recommendations for the future include research regarding evaluation methods and the interaction of environmental and educational strategies, as well as dissemination research and concurrent international technology transfer of the vast number of lessons learned and the many widely accepted practice principles of community-based interventions.
The American Journal of Medicine, 1974
... Reappraisal of the Role of Insulin in Hypertriglyceridemia JERROLD M. OLEFSKY, MD-JOHN W. FAR... more ... Reappraisal of the Role of Insulin in Hypertriglyceridemia JERROLD M. OLEFSKY, MD-JOHN W. FARQUHAR, MD GERALD M. REAVEN, MD ... jOOOOOCTOaOOOOOOOOQOOOQOOC-) 5 OJ;^.<\JOQOOLn^^tri^T^r0^mmc\JC^^O^OJ0010r--4<3'LriOOOi.C3 ^-ft TOu^CTiLno^ui^o ...
American Journal of Health Promotion, 1998
Addictive Behaviors, 1982
the editorial offices in La Jolla, Calif.
Metabolism, 1976
Stimulated by increasing evidence of an inverse relationship between plasma highdensity lipoprote... more Stimulated by increasing evidence of an inverse relationship between plasma highdensity lipoprotein cholesterol level and frequency of coronary heart disease, we determined concentrations of fasting plasma cholesterol, triglyceride, and lipoproteins in 41 very active men (running > 15 miles/wk for the previous year) 35-59 years of age (mean age, 47) and in a comparison group of men of similar age, randomly selected from three northern California communities. The runners had significantly (p < 0.05) decreased mean plasma triglyceride (70 versus 146 mg/ 100 ml), total plasma cholesterol (200 versus 210 mg/lO0 ml), and low-density lipoprotein (LDL) cholesterol (125 versus 139 mg/lO0 ml) concentrations, and a higher mean level of high-density lipoprotein (HDL) cholesterol (64 versus 43 mg/ 100 ml) than the comparison group (n = 147 for HDL and LDL; n = 743 for total cholesterol and triglycerides).
Behavioral Epidemiology and Disease Prevention, 1985
Tidsskrift for den Norske lægeforening : tidsskrift for praktisk medicin, ny række, Jan 30, 1998
Preventive Medicine, 1992
American journal of epidemiology, Jan 15, 1995
In the past two decades several community intervention studies designed to lower the risk of card... more In the past two decades several community intervention studies designed to lower the risk of cardiovascular disease in populations have been completed. These trials shared the rationale that the community approach was the best way to address the large population attributable risk of mild elevations of multiple risk factors, the interrelation of several health behaviors, and the potential efficiency of large-scale interventions not limited to the medical care system. These trials also shared several threats to internal validity, especially the small number of intervention units (usually cities) that could be studied. The purpose of this paper is to reflect on the lessons learned in one of the studies, the Stanford Five-City Project, which began in 1978. The anticipated advantages were observed, including the generalizability of the intervention components, the potential for amplification of interventions through diffusion in the community, and the efficiency of the mass media and oth...
Current atherosclerosis reports, 2003
There are hundreds of foods, nutrients, herbs, and botanicals that have "bioactive" con... more There are hundreds of foods, nutrients, herbs, and botanicals that have "bioactive" constituents with potential human health benefits. Three of these are discussed in this review: soy, garlic, and ginkgo biloba. Each of these three choices involves an ingestible item composed of a complex mixture of bioactive agents. For each of these three, there is a large and growing body of research suggesting potential cardiovascular health benefits. And for each there is at least some level of disagreement or controversy. The focus of this review is on results from recent human clinical trials.
Communication Research, 1993
This study examines the process of media supplementation in the Stanford Five-City Multifactor Ri... more This study examines the process of media supplementation in the Stanford Five-City Multifactor Risk Reduction Project, a long-term trial of communitywide cardiovascular disease risk reduction conducted by Farquhar and associates. The data indicate that accessible awareness media disseminated early in the education campaign promoted use of information-rich depth media later on, demonstrating that supplementation occurred. Moreover, analyses suggest that awareness
Teaching and Learning in Medicine, 1992
The Stanford Faculty Development Program, designed to improve the instructional skills of clinica... more The Stanford Faculty Development Program, designed to improve the instructional skills of clinical teachers, uses a dissemination model to provide faculty development activities for medical schools across the country. Selected clinical faculty attend a month‐long training program at Stanford University Medical Center and then return to their home institutions to conduct seminars for their fellow faculty and for residents in
New Directions for Program Evaluation, 1989
... Evaluating Community-Level Health Promotion and Disease Preuen tion Interventions Christine J... more ... Evaluating Community-Level Health Promotion and Disease Preuen tion Interventions Christine Jackson, David G. Altman, Beth Howard-Pitney, John W. Farquhar ... program. New Directions for Progmn Evaluation, no. 43. San Francisco: Jossey-Babs, Fall 1989. 19 Page 2. ...
Journal of Clinical Investigation, 1965
Journal of Clinical Investigation, 1974
Considerable controversy exists over the purported role of obesity in causing hyperglycemia, hype... more Considerable controversy exists over the purported role of obesity in causing hyperglycemia, hyperlipemia, hyperinsulinemia, and insulin resistance; and the potential beneficial effects of weight reduction remain incompletely defined. Hypertriglyceridemia is one of the metabolic abnormalities proposed to accompany obesity, and in order to help explain the mechanisms leading to this abnormality we have proposed the following sequential hypothesis: insulin resistance --> hyperinsulinemia --> accelerated hepatic triglyceride(TG) production --> elevated plasma TG concentrations. To test this hypothesis and to gain insight into both the possible role of obesity in causing the above metabolic abnormalities and the potential benefit of weight reduction we studied the effects of weight loss on various aspects of carbohydrate and lipid metabolism in a group of 36 normal and hyperlipoproteinemic subjects. Only weak to absent correlations (r = 0.03 - 0.46) were noted between obesity and the metabolic variables measured. This points out that in our study group obesity cannot be the sole, or even the major, cause of these abnormalities in the first place. Further, we have observed marked decreases after weight reduction in fasting plasma TG (mean value: pre-weight reduction, 319 mg/100 ml; post-weight reduction, 180 mg/100 ml) and cholesterol (mean values: pre-weight reduction, 282 mg/100 ml; post-weight reduction, 223 mg/100 ml) levels, with a direct relationship between the magnitude of the fall in plasma lipid values and the height of the initial plasma TG level. We have also noted significant decreases after weight reduction in the insulin and glucose responses during the oral glucose tolerance test (37% decrease and 12% decrease, respectively). Insulin and glucose responses to liquid food before and after weight reduction were also measured and the overall post-weight reduction decrease in insulin response was 48% while the glucose response was relatively unchanged. In a subgroup of patients we studied both the degree of cellular insulin resistance and the rate of hepatic very low density (VLDL) TG production before and after weight reduction. These subjects demonstrated significant decreases after weight reduction in both degree of insulin resistance (33% decrease) and VLDL-TG production rates (40% decrease). Thus, weight reduction has lowered each of the antecedent variables (insulin resistance, hyperinsulinemia, and VLDL-TG production) that according to the above hypothesis lead to hypertriglyceridemia, and we believe the overall scheme is greatly strengthened. Furthermore, the consistent decreases in plasma TG and cholesterol levels seen in all subjects lead us to conclude that weight reduction is an important therapeutic modality for patients with endogenous hypertriglyceridemia.
International Journal of Behavioral Medicine, 2000
Czech cardiovascular disease (CVD) morbidity and mortality rates are among the highest in the wor... more Czech cardiovascular disease (CVD) morbidity and mortality rates are among the highest in the world. A 2-year community-based project was designed to increase CVD awareness and knowledge and behavior change skills, thus stimulating change in CVD-related behaviors. Dubec, a Czech town located just outside Prague, was the study community. Risk-factor surveys were conducted before and after the intervention (1992 and 1994). The intervention combined communitywide health education and intensive medical treatment of individuals at high risk for CVD.
Annals of the New York Academy of Sciences, 1991
Not Available Bibtex entry for this abstract Preferred format for this abstract (see Preferences)... more Not Available Bibtex entry for this abstract Preferred format for this abstract (see Preferences) Find Similar Abstracts: Use: Authors Title Return: Query Results Return items starting with number Query Form Database: Astronomy Physics arXiv e-prints
Annals of Epidemiology, 1997
ABSTRACT PURPOSE: Lessons from three decades of community prevention trials are discussed to prov... more ABSTRACT PURPOSE: Lessons from three decades of community prevention trials are discussed to provide directions for the future of community health promotion efforts. METHODS: The rationale for and characteristics of community prevention trials for cardiovascular disease (CVD) risk reduction are presented. Published articles regarding the main effects and component studies of community prevention trials regarding CVD were reviewed. RESULTS: All early and most recent community prevention trials carried out in diverse populations demonstrated population-wide effects on CVD risk factors, particularly blood pressure levels and smoking prevalence. Moreover, subgroup component studies (e.g., schools, worksites, events) demonstrate the efficacy of many risk reduction strategies. These results support a dose-response relationship by evidence of stronger effects where adequate exposure to the intervention was achieved. CONCLUSIONS: Although much remains untested in theory and practice, data indicate that community-based efforts to reduce the risk of CVD can influence behavior. Additional research is needed to increase understanding of the optimal mix and sequencing of components of these programs. In addition, this review indicates the importance of incorporating strategies to influence environmental change. Recommendations for the future include research regarding evaluation methods and the interaction of environmental and educational strategies, as well as dissemination research and concurrent international technology transfer of the vast number of lessons learned and the many widely accepted practice principles of community-based interventions.
The American Journal of Medicine, 1974
... Reappraisal of the Role of Insulin in Hypertriglyceridemia JERROLD M. OLEFSKY, MD-JOHN W. FAR... more ... Reappraisal of the Role of Insulin in Hypertriglyceridemia JERROLD M. OLEFSKY, MD-JOHN W. FARQUHAR, MD GERALD M. REAVEN, MD ... jOOOOOCTOaOOOOOOOOQOOOQOOC-) 5 OJ;^.&lt;\JOQOOLn^^tri^T^r0^mmc\JC^^O^OJ0010r--4&lt;3&#x27;LriOOOi.C3 ^-ft TOu^CTiLno^ui^o ...
American Journal of Health Promotion, 1998
Addictive Behaviors, 1982
the editorial offices in La Jolla, Calif.
Metabolism, 1976
Stimulated by increasing evidence of an inverse relationship between plasma highdensity lipoprote... more Stimulated by increasing evidence of an inverse relationship between plasma highdensity lipoprotein cholesterol level and frequency of coronary heart disease, we determined concentrations of fasting plasma cholesterol, triglyceride, and lipoproteins in 41 very active men (running > 15 miles/wk for the previous year) 35-59 years of age (mean age, 47) and in a comparison group of men of similar age, randomly selected from three northern California communities. The runners had significantly (p < 0.05) decreased mean plasma triglyceride (70 versus 146 mg/ 100 ml), total plasma cholesterol (200 versus 210 mg/lO0 ml), and low-density lipoprotein (LDL) cholesterol (125 versus 139 mg/lO0 ml) concentrations, and a higher mean level of high-density lipoprotein (HDL) cholesterol (64 versus 43 mg/ 100 ml) than the comparison group (n = 147 for HDL and LDL; n = 743 for total cholesterol and triglycerides).
Behavioral Epidemiology and Disease Prevention, 1985