Community Intervention to Lower Blood Cholesterol: The "Know Your Cholesterol" Campaign in Pawtucket, Rhode Island

Abstract

Sufficient data exist to support approaches to lowering cardiovascular disease risk which target population-wide reductions in elevated blood cholesterol levels. Within the context of a multifactorial cardiovascular disease prevention program, a 2-month cholesterol education campaign was launched to encourage citizens to "Know Your Cholesterol" by attending screening, counseling, and referral events (SCOREs) held throughout the community. These events featured assessment of dietary fat and cholesterol, rapid blood cholesterol analyses with a fingerstick procedure and the Kodak Ektachem DT60, and immediate dietary counseling by trained volunteers. A total of 1439 persons attended 39 SCOREs: nearly 60% were found to have blood cholesterol levels that exceeded recommended goal levels. At a 2-month follow-up of 1040 of these same individuals, 600 had lowered their blood cholesterol level by an average of 29.1 mg/dl. This experience suggests that similarly modeled campaigns may have a significant impact on the distribution of blood cholesterol levels in the entire U.S. population.

The Pawtucket Heart Health Program: community changes in cardiovascular risk factors and projected disease risk.

“…Males and less well educated individuals showed insignificantly greater declines in systolic blood pressure in Pawtucket than in the comparison city. The previously described city differential in body mass index occurred predominantly in males, in those under the age of 35 years, and in those with less education.…”

“…Further, a number of short-term formative studies conducted simultaneously within the overall project demonstrate the efficacy of cholesterol change, weight control, nutrition, and exercise efforts. [35][36][37][38] Probably the nutrition and weight-control programs were the most effective, judging from the body mass index data. In addition, the possibility that the survey data are themselves inaccurate must be considered.…”

“…In the case of cardiovascular disease risk estimates, which were restricted to ages 35 through 64, the age covariate was dichotomized at 50 years, an approximate median. This standard population was modified to consist of 50% in the younger age group (35-49 years old) and 50% in the older age group (50-64 years old) and 54% in the more educated group (12 years or more of school) and 46% in the less educated group, reflecting the actual distribution in the sample population aged 35 and over. For the disease risk estimates, ratios with 95% confidence intervals (CIs) of city-specific rates (Pawtucket/comparison city) are presented by sex, age, and educational strata.…”

The impact of screening on future health-promoting behaviours and health beliefs: a systematic review

“…[45][46][47][48]59,61,64,69,73,76,77,80,81,86,[88][89][90][91][92][93][94] Nineteen of these studies reported a cholesterol reduction. Two of the studies reported no change in cholesterol level following screening.…”

“…Screening can falsely reassure people who receive a normal result and therefore no behavioural changes or detrimental behavioural changes are made. 91 This is often referred to as the 'certificate of health' effect.…”