What factors determine whether individuals found to have hypercholesterolaemia at mass screening accept advice to visit their physician.
OBJECTIVE
This study aims to identify the determinants of compliance with the recommendation to visit a physician for advice which was given to individuals whose cholesterolemia was > 6.2 mmol/l at mass screening for risk factors of cardiovascular diseases.


METHODS
Data were collected from 1144 adults found to be hypercholesterolemic during a screening programme in 54 work sites and 29 public areas and contacted by phone two to six months later. Based on the Health Belief Model, perceived seriousness, perceived self-efficacy, and cues to action were measured. Potential determinants of compliance to the recommendation were examined using multivariate analyses.


RESULTS
Mean compliance was 58.6%. For the perceived seriousness dimension of the Health Belief Model, personal history of CVD or risk factors, and prior awareness of cholesterol levels were important determinants. Those already treated for hypercholesterolemia comply twice as much as those who were aware and untreated. Among cues to action, higher cholesterol levels and hypertension are associated with greater compliance; however, smokers were less likely to comply. The dimension of perceived self-efficacy, as measured by ease of access to health services and prior success in eating habit modification, is also associated with compliance to the recommendation. Compliance increases significantly with age. For those previously aware of their elevated cholesterol level, variables representing perceived self-efficacy were no longer determinants. For those previously unaware of their elevated cholesterol level, variables representing CVD perceived threat do not influence compliance.


CONCLUSIONS
The Health Belief Model appears to be an appropriate framework to the determinants of compliance with the recommendation to visit a doctor during mass screening.
Department of Family Medicine, McGill University, Canada.
R
R
Guibert
N
N
Leduc
P
P
Fournier
H
H
Tétreault
D000328:Adult; D001294:Attitude to Health; D002318:Cardiovascular Diseases / Q000523:psychology; D005260:Female; D006801:Humans; D006937:Hypercholesterolemia / Q000175:diagnosis / Q000523:psychology*; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D015999:Multivariate Analysis; D010349:Patient Compliance; D012017:Referral and Consultation; D012307:Risk Factors; D012907:Smoking / Q000523:psychology; D012959:Socioeconomic Factors