title: Adolescent Perceptions of Cholesterol Screening Results: "Young Invincibles" or Developing Adults?
abstract: Guidelines recommend cholesterol screening for all adolescents and young adults (AYAs) ages 17-21 years. Little is known about how screening results impact perceptions of AYA health.
  
  
  
  We recruited 37 AYAs and 35 parents of AYAs with differing risk for abnormal cholesterol results: (1) familial hypercholesterolemia; (2) obesity; and (3) generally healthy. Participants completed quantitative health status ratings using visual analog scales (VASs) and semistructured interviews regarding three hypothetical cholesterol screening scenarios: (1) high likelihood of cardiovascular disease (CVD) before age 40 years ("high risk"); (2) some risk of CVD before age 70 years ("moderate risk"); and (3) low risk for CVD despite a strong family history of CVD ("low risk"). We analyzed VAS data with logistic regression and qualitative data with a priori and emergent coding using multiple coders.
  
  
  
  Each group perceived all three cholesterol screening scenarios as comparatively less than perfect health; the high-risk result fell furthest from perfect health. Although there was no significant difference between AYAs and parents in VAS ratings, qualitative analyses revealed AYAs were more likely than parents to discount the impact of moderate-risk results because of longer length of time before predicted CVD.
  
  
  
  AYAs' and parents' perceptions of the impact of cholesterol screening results on AYA health varied by presented scenario, ranging from mild to significant decreases in perceptions of AYA health. As universal cholesterol screening continues to be adopted in this age group, further studies of the real-life impact on AYA risk perceptions and subsequent behavior are warranted.
authors.affiliation: Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts. Electronic address: holly.gooding@childrens.harvard.edu.
authors.forename: Holly C
authors.initials: HC
authors.lastname: Gooding
authors.affiliation: Department of Pediatrics, Tufts Medical Center, Boston, Massachusetts.
authors.forename: R Christopher
authors.initials: RC
authors.lastname: Sheldrick
authors.affiliation: Department of Medicine, Tufts Medical Center, Boston, Massachusetts.
authors.forename: Laurel K
authors.initials: LK
authors.lastname: Leslie
authors.affiliation: Department of Medicine, Tufts Medical Center, Boston, Massachusetts.
authors.forename: Supriya
authors.initials: S
authors.lastname: Shah
authors.affiliation: Department of Cardiology, Boston Children's Hospital, Boston, Massachusetts.
authors.forename: Sarah D
authors.initials: SD
authors.lastname: de Ferranti
authors.affiliation: Department of Health Systems and Policy, School of Public Health-Rutgers, The State University of New Jersey, New Brunswick, New Jersey.
authors.forename: Thomas I
authors.initials: TI
authors.lastname: Mackie
mesh_terms: D000293:Adolescent; D000067697:Adolescent Health / Q000706:statistics & numerical data*; D000328:Adult; D001294:Attitude to Health; D002784:Cholesterol / Q000097:blood*; D005260:Female; D006304:Health Status; D006801:Humans; D006937:Hypercholesterolemia / Q000175:diagnosis / Q000523:psychology*; D008297:Male; D008403:Mass Screening / Q000523:psychology* / Q000706:statistics & numerical data; D008875:Middle Aged; D009765:Obesity / Q000150:complications; D010290:Parents / Q000523:psychology; D036301:Qualitative Research; D012307:Risk Factors; D064232:Visual Analog Scale; D055815:Young Adult
chemical_list: D002784:Cholesterol
keywords: Adolescent; Cholesterol; Decision-making; Mixed methods