Franks P, Gold M R, Bell B P, Naumburg E H, Engerman J
Department of Family Medicine, University of Rochester, NY 14620.
J Fam Pract. 1991 Jun;32(6):614-8.
The purpose of this study was to investigate the factors that determine whether residents in a rural community have their cholesterol tested.
A population-based survey was conducted in 1987 as part of a community-oriented primary care project that sought to define and address the causes of and burden caused by increased cardiovascular disease in an economically depressed agricultural region of New York. All of the residents living in two towns in the region who were over 16 years of age and who lived in their homes year-round were surveyed. Demographic information was obtained from the participants, as well as information about previous cholesterol testing and their cardiovascular-risk knowledge and behaviors. The serum cholesterol of each participant was measured.
Of the 557 households contacted, 508 (91%) households participated. A total of 1063 persons over 16 years of age were surveyed, and 973 (92%) were screened for cholesterol. Overall, 24% reported prior cholesterol testing. Logistic regression analysis identified several independent factors that were associated with a reduced likelihood of ever having had a cholesterol test. These factors included: (1) age under 45 years, (2) having less than 12 years of education, (3) having an income of less than $10,000, (4) not having health insurance, (5) not having visited a physician within the previous year, and (6) practicing three or more high-risk cardiovascular behaviors. The participants' cardiovascular knowledge made no independent contribution to having had their cholesterol levels tested.
Many of the factors that prevent cholesterol testing are socially determined. The results of this study suggest that financial and social barriers are two of the major obstacles to residents of rural communities having their cholesterol levels tested.
本研究旨在调查决定农村社区居民是否进行胆固醇检测的因素。
1987年开展了一项基于人群的调查，作为社区导向型初级保健项目的一部分，该项目旨在确定并解决纽约一个经济萧条农业地区心血管疾病增加的原因及负担。对该地区两个城镇中所有16岁以上且常年居住在家中的居民进行了调查。从参与者那里获取了人口统计学信息，以及有关既往胆固醇检测及其心血管疾病风险知识和行为的信息。测量了每位参与者的血清胆固醇。
在联系的557户家庭中，508户（91%）参与了调查。共对1063名16岁以上的人进行了调查，其中973人（92%）接受了胆固醇筛查。总体而言，24%的人报告曾进行过胆固醇检测。逻辑回归分析确定了几个与胆固醇检测可能性降低相关的独立因素。这些因素包括：（1）45岁以下；（2）受教育年限不足12年；（3）收入低于10,000美元；（4）没有医疗保险；（5）前一年未看过医生；（6）有三种或更多高风险心血管行为。参与者的心血管疾病知识对其胆固醇水平检测没有独立影响。
许多阻碍胆固醇检测的因素是由社会因素决定的。本研究结果表明，经济和社会障碍是农村社区居民进行胆固醇水平检测的两大主要障碍。
