Abstract
Beginning in 1979, the Centers for Disease Control (CDC) awarded risk reduction grants to health education units in state health departments. One of CDC's main policy objectives was to use the risk reduction grants to strengthen those state-level health education units. The present study had two purposes: 1) investigate the impact of the risk reduction grants on the organization, structure, and function of state health education units; and 2) identify factors associated with program success and failure. Twelve state health education units were selected and interviews were conducted with the risk reduction program coordinators in each. Results indicated that in some states the risk reduction grants helped health education units adopt a health promotion philosophy and provided a framework for a more distinct health education program identity and purpose. The most important factor associated with risk reduction program success was support of the philosophy of health promotion by high-level health department administrators. In some states the risk reduction program was placed in a chronic disease unit rather than the health education unit. Program guidance from CDC was inconsistent and led to confusion among program coordinators and wide variations in implementation.
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