Improving referral compliance after public cholesterol screening

L.A. Maiman, N.G. Hildreth, C. Cox and P. Greenland

American Journal of Public Health, 1992, vol. 82, issue 6, 804-809

Abstract: Background. Noncompliance with referral to a physician for retesting and diagnosis is a concern in public cholesterol screening. Methods. Participants (n = 2109) were referred by a health professional or lay communicator and randomly assigned to a coupon offer, referral reminder letter, or control group. A questionnaire was completed at screening, and a telephone interview was conducted 5 months later. Results. Physician visit rates showed no professional or lay differences. For 'no history' subjects, the behavioral interventions were effective compared with controls (coupon = 60.7% and reminder = 57.7% vs control = 46.1%). With professional counseling, only the coupon was effective; for lay counseling, both coupon and reminder yielded higher visit rates. Adjusted for sociodemographics, heart disease risk factors, and health perceptions, the intervention effects remained (professional-coupon offer: odds ratio [OR] = 1.94, 95% confidence interval [CI] = 1.21, 3.09; professional-reminder letter: OR = 1.04, 95% CI = 0.67, 1.63; lay-coupon offer: OR = 2.52, 95% CI = 1.52, 4.18; and lay-reminder letter: OR = 3.10, 95% CI = 1.83, 5.22). Conclusions. For unaware participants, lay counselors and referral follow-up efforts tailored to specific cholesterol risk groups are indicated.

Date: 1992
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