Community cholesterol screening. Impact of labeling on participant behavior

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Abstract
To investigate the effect of screening for an elevated cholesterol level and compliance with follow-up recommendations, we surveyed 375 participants in a free screening program at a shopping mall walk-in clinic. One hundred thirty-nine participants (37%) had desirable (5.17 mmol/L[6.18 mmol/L [>239 mg/dL]) cholesterol levels. Persons in the borderline and high categories were instructed to see their physicians within 2 months to confirmation of their levels. Of the 338 (90%) who responded to a follow-up questionnaire at 3 months, 8 (7%) in the desirable, 23 (22%) in the borderline, and 44 (50%) in the high group has been to see physicians concerning their cholesterol levels since the screening. In multiple logistic regression analyses only cholesterol catergory at time of screening, current use of antihypertensive drugs, history of coronary heart disease, and history of a high cholesterol level were associated with physician follow-up. Our results suggest that labeling persons as being at high rather than borderline risk results in greater physician follow-up.