A community-based cholesterol screening program in Rochester, NY, a metropolitan area of over 700,000 people, is proposed. The objective is to develop a system that will serve as a model for other urban communities interested in screening efforts as part of the National Cholesterol Education Program.
Major specific aims are: 1) to determine if the medical community can be prepared to ensure availability of follow-up for screenees whose cholesterol levels fall above the 75th percentile, a referral cut-off proposed by the 1984 NIH Consensus Conference; 2) to determine whether community screenings held in supermarkets will reach the target populations at highest risk and most likely to benefit from referral; 3) to evaluate the effectiveness of strategies, singly and cumulatively, to enhance referral complaints; 4) to assess the precision and accuracy of a new instrument, under operational conditions, capable of performing rapid total cholesterol determinations using a small volume of capillary blood. A community-based screening program will be conducted in supermarkets, reaching a projected population of 15,000. The referred population (N=3,000) will be randomly assigned to sequential interventions to enhance compliance with referral: 1) receipt of exit counseling by a lay or health professional communicator; and 2) monetary incentive, mailed reminder, or control. A 3-month post-screening questionnaire will provide assessment of referral compliance (to be validated by physician questionnaire) and referred population characteristics. A sample of the referred population (N=900) will be surveyed at 12-months post-screening to assess dietary behavior, cholesterol knowledge, medical treatment and labeling effects. A subsample (blood cholesterol 241-280 mg/dl) will have cholesterol reassessments (3-months post-screening, N=200; 12-months post-screening, N=400). Samples of the non-referred population with borderline (221-240 mg/dl) or """"""""normal"""""""" (greater than or equal to 220 mg/dl) blood cholesterols will receive reassessments at 3- and 12-months post-screening and a questionnaire at 12-months post-screening to assess effects of labeling, false reassurance, and change in cholesterol values. A survey of a sample of primary care physicians (N=375) will provide assessments of cholesterol-related education, attitudes, and assessment and management activities of physicians, following a Preliminary Physician Education Program. Following the 18-month screening and follow-up Phase, data analysis will be completed. Information from this model cholesterol screening program will be used to help guide future efforts of the National Cholesterol Education Program.

National Institute of Health (NIH)
National Heart, Lung, and Blood Institute (NHLBI)
Research Project (R01)
Project #
Application #
Study Section
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
University of Rochester
School of Medicine & Dentistry
United States
Zip Code
Greenland, P; Hildreth, N G; Maiman, L A (1992) Attendance patterns and characteristics of participants in public cholesterol screening. Am J Prev Med 8:159-64
Maiman, L A; Hildreth, N G; Cox, C et al. (1992) Improving referral compliance after public cholesterol screening. Am J Public Health 82:804-9
Greenland, P; Bowley, N L; French, C A et al. (1990) Precision and accuracy of a portable blood analyzer system during cholesterol screening. Am J Public Health 80:181-4
Greenland, P; Bowley, N L; Meiklejohn, B et al. (1990) Blood cholesterol concentration: fingerstick plasma vs venous serum sampling. Clin Chem 36:628-30