Fitzgerald S T, Gibbens S, Agnew J
Division of Occupational Health, Johns Hopkins School of Hygiene and Public Health, Baltimore, Maryland 21205.
Am J Prev Med. 1991 Nov-Dec;7(6):335-40.
We designed a randomized clinical trial to examine effectiveness of a follow-up educational mailing to improve referral completion following a workplace cholesterol screening program. Of 836 employees who participated in a cholesterol screening program at Blue Cross and Blue Shield of Maryland, 313 (37%) had a total cholesterol greater than or equal to 200 mg/dL and were referred to their physician for remeasurement and evaluation. Individuals with elevated cholesterol who agreed to a telephone interview two months after screening (n = 272) were randomized to a control or intervention group. The intervention consisted of a booster mailing two weeks after screening designed to encourage further physician follow-up and to increase knowledge about cholesterol and its dietary control and about risk factors for coronary heart disease (CHD). No statistically significant differences appeared between the control and intervention groups in rate of referral completion. However, a blood cholesterol level of greater than or equal to 240 mg/dL at the time of screening was the most significant predictor of referral completion (P less than .0001). Of those randomized, the association between the number of other additional risk factors for CHD and referral completion was not statistically significant. There was, however, a trend toward reported changes in lifestyle behavior as a result of screening, particularly in diet modification.
我们设计了一项随机临床试验，以检验在工作场所胆固醇筛查项目后进行后续教育邮件对提高转诊完成率的有效性。在马里兰州蓝十字蓝盾公司参加胆固醇筛查项目的836名员工中，313人（37%）总胆固醇大于或等于200mg/dL，并被转介给他们的医生进行重新测量和评估。胆固醇升高且在筛查后两个月同意接受电话访谈的个体（n = 272）被随机分为对照组或干预组。干预措施包括在筛查两周后发送强化邮件，旨在鼓励进一步的医生随访，并增加有关胆固醇及其饮食控制以及冠心病（CHD）危险因素的知识。对照组和干预组在转诊完成率方面没有出现统计学上的显著差异。然而，筛查时血液胆固醇水平大于或等于240mg/dL是转诊完成的最显著预测因素（P小于0.0001）。在随机分组的人群中，冠心病其他额外危险因素的数量与转诊完成之间的关联没有统计学意义。然而，由于筛查，特别是在饮食调整方面，有报告显示生活方式行为出现变化的趋势。
