Labeling of Participants in High Blood Pressure Screening Programs

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Abstract
• Screening programs have expanded to identify the many persons who are unaware of their high blood cholesterol level and thus are at an increased risk for coronary heart disease. These programs bring both potential benefits and potential risks to the participant. One potential risk is that of iatrogenic effects of learning one's risk status, often referred to as the "labeling phenomenon." Research that has addressed the labeling phenomenon in blood pressure screening programs has important implications for blood cholesterol screenings. Detrimental effects on screening participants are possible, but they can be attenuated by careful attention to characteristics of the debriefing and counseling that should be included in screening protocols. (Arch Intern Med 1988;148:1993-1997)