Predictors and barriers to timely medical follow-up after cardiovascular disease risk factor screening according to race/ethnicity.
BACKGROUND
The purpose of this study was to assess followup practices among individuals found to have elevated cardiovascular disease (CVD) risk factors in a screening and educational outreach.


METHODS
Participants in the National Heart, Lung and Blood Institute Family Intervention Trial for Heart Health (FIT Heart) who were found to have hypertension, prehypertension, suboptimal lipids and/or abnormal blood glucose were included in this study (N = 214, mean age 49 +/- 13, 64% female, 33% nonwhite). Contact was made at two weeks, six weeks and three months to determine if medical follow-up was initiated. Barriers to nonadherence were assessed.


RESULTS
After two weeks, significantly more whites had medical follow up compared to nonwhites (34% vs. 20%, p = 0.04). Racial/ethnic minorities were more likely to report that not having a doctor was a barrier (30% vs. 11%, p = 0.02). Non-whites were more likely to return to the study staff for followup rather than an outside physician (32% vs. 15%, p = 0.001).


CONCLUSIONS
Racial/ethnic minorities with elevated CVD risk factors may have delayed medical follow-up compared to whites, and this may be attributable to lack of access to a doctor. These data suggest that improving access to care may reduce racial/ethnic disparities in risk factor management and CVD outcomes.
Edelman
Dana J
DJ
Columbia University, New York, NY, USA.
Gao
Qian
Q
Mosca
Lori
L
D000328:Adult; D002318:Cardiovascular Diseases / Q000175:diagnosis* / Q000517:prevention & control / Q000628:therapy; D003710:Demography; D005006:Ethnicity; D005260:Female; D006297:Health Services Accessibility; D006306:Health Surveys; D006801:Humans; D008055:Lipids / Q000097:blood; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D011446:Prospective Studies; D044469:Racial Groups; D018570:Risk Assessment; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013997:Time Factors
D008055:Lipids