Improving referral compliance after public cholesterol screening.
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.
Maiman
L A
LA
University of Rochester School of Medicine and Dentistry, NY.
Hildreth
N G
NG
Cox
C
C
Greenland
P
P
D000328:Adult; D000359:Aftercare / Q000592:standards; D000368:Aged; D003376:Counseling / Q000379:methods / Q000592:standards*; D005260:Female; D006302:Health Services Research; D006801:Humans; D006937:Hypercholesterolemia / Q000453:epidemiology / Q000517:prevention & control* / Q000523:psychology; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D009518:New York / Q000453:epidemiology; D017063:Outcome Assessment, Health Care; D010349:Patient Compliance; D015397:Program Evaluation; D012017:Referral and Consultation / Q000592:standards*; D011795:Surveys and Questionnaires