Impact of receiving blood cholesterol test results on dietary change.

INTRODUCTION: The study objective was to determine the impact of receiving results of a blood cholesterol test on changes in dietary behaviors among individuals participating in a Health Risk Appraisal Program. METHODS: This randomized trial of maintenance employees at six hospitals included two groups: Group 1 received their blood cholesterol test results at the pretest; Group 2 received results only at the posttest (16-20 weeks later). The pretest interview included (1) a 24-hour dietary recall; (2) an evaluation of dietary behaviors and suggestions on how to change; (3) height, weight, and blood cholesterol measurement. Five hundred employees participated, and 429 eligible employees completed both pretest and posttest interviews. RESULTS: Blood cholesterol levels decreased by 4.8% (P < .001) and saturated fat intake decreased by 7.4% (P < .05). Regression analyses indicated that individuals more likely to have lowered saturated fat intake had higher pretest saturated fat intakes, had a family history of high blood cholesterol, and were light-maintenance employees (P < .05); no other variables were associated (receiving blood cholesterol test results, previous blood cholesterol test, pretest blood cholesterol levels, personal history of heart disease, BMI, age, gender, tobacco/alcohol use). Among subjects with normal cholesterol levels, those not receiving blood test results reduced saturated fat intake more than those receiving test results; both groups had similar saturated fat intakes (> 12%) greater than recommended intake (< 10%). CONCLUSIONS: Screening programs should include an assessment of saturated fat intake as screening for blood cholesterol may provide normocholesterolemic subjects with a false sense of security.

Impact of two cardiovascular disease reduction education programs varying in the type of nutrition information provided.

The purpose of the study was to determine the impact of two worksite cardiovascular nutrition education programs. Program 1 focused on information related to the skills needed to change dietary behaviours (1 session, 45 minutes). Program 2 focused on information related to skills as well as cardiovascular risk factors (1 session, 60 minutes). The study sample consisted of office employees at three worksites. The pretest consisted of questions pertaining to: frequency of consumption of high fat foods, knowledge related to the risk and skills components of the program, and self-report of family and personal history of cardiovascular disease. Of employees who completed the pretest, 67% (55/82) in Program 1, 88% (46/52) in Program 2, and 86% (30/35) in the control group completed the post-test (six weeks after the programs). The results of regression analysis indicated that participants of Program 1 (skills only) reduced their frequency of consumption of high fat foods (p < 0.01); no other variables were significant. Nutrition education programs for the prevention of cardiovascular disease should focus on information related to skills when limited time is available.

A supermarket cardiovascular screening program: analysis of participants' solicitation of follow-up care.

We conducted a cardiovascular screening program in 54 supermarkets in the province of Québec, Canada to determine cardiovascular risk factors, including total cholesterol, blood pressure, tobacco use, height, weight, and physical activity levels. A 10-minute debriefing counseling session followed. Of the 3,432 screening participants 18-74 years of age, 2,420 participated in a nutrition study, consisting of answering a brief questionnaire before the screening. Three months after the screening, 1,293 individuals returned the posttest nutrition questionnaire sent to them by mail. We report follow-up care activity for low-risk and high-risk individuals for respondents of the posttest nutrition questionnaire. Overall, 53% of respondents reported seeing a physician within three months after the screening to discuss their blood cholesterol or blood pressure results, and the percentage ranged from 25% for individuals with normal cholesterol (< or = 199 mg/dL) and normal blood pressure (< 140/90 mm Hg) to 83% for individuals with high cholesterol (> or = 240 mg/dL) and high blood pressure (> or = 140/90 mm Hg). Respondents who saw a physician following the screening were more likely to be (1) those on medication at the time of the screening for high blood cholesterol and high blood pressure, (2) older individuals, (3) those found to have high blood cholesterol and high blood pressure values during the screening, (4) women, and (5) individuals with a lower level of education. Seventy-nine percent identified as having high blood cholesterol during the screening reported that their blood cholesterol was remeasured. The majority of high-risk participants and their physicians took appropriate follow-up action.(ABSTRACT TRUNCATED AT 250 WORDS)

Changes in knowledge and food behaviour following a screening program held in a supermarket.

We examined the relationship between knowledge, health beliefs and dietary behaviours of participants in a supermarket cardiovascular screening program, the conceptual framework for which was the Health Belief Model. 3,432 individuals aged 18-74 participated in the screening program conducted in 54 supermarkets in Montreal and Quebec. This program identified participants' risk for cardiovascular disease by measuring total serum cholesterol, blood pressure, height, weight, level of physical activity, and tobacco use. A ten-minute debriefing counselling session interpreted risk factors and recommended follow-up. 70% (n = 2,420) also completed a nutrition questionnaire on knowledge, health beliefs, and frequency of consumption of high fat foods. Respondents increased their knowledge and reduced the frequency of consumption of high-fat foods following the screening program (p < or = 0.05), particularly individuals with higher blood cholesterol levels, high blood pressure, and women.

The relationship among learning, health beliefs, alcohol consumption, and tobacco use of primigravidas.

The purposes of this study were to identify how pregnant women learned about alcohol consumption and tobacco use, and to identify the relationship between learning, health beliefs and behaviours. Determining how pregnant women learned was based upon Tough's and Knowles' view of learning and consisted of identifying knowledge levels, resources utilized, advice given, time in learning, and initiators of learning episodes. The ex post facto research design involved one-hour interviews with 128 primigravidas at 8 hospitals in British Columbia, 75% of the sample consumed alcoholic beverages before becoming pregnant and these women reduced their intake by an average of 82%; 39% smoked cigarettes before becoming pregnant and these women reduced their cigarette smoking by an average of 52%. Drinkers were advised not to consume alcoholic beverages during pregnancy, whereas smokers were told by friends and family members that it was okay to smoke during pregnancy. Engagement in other-initiated learning episodes was found to be correlated with reduced alcohol intake (p less than or equal to .05); whereas, health beliefs were not correlated with reduced alcohol intake. Neither self-initiated nor other-initiated learning was associated with reduced cigarette smoking; however, perceived risk was associated with reduced cigarette smoking. Knowledge about smoking was associated with health beliefs, suggesting that learning may be indirectly related to smoking behaviours. This study should be replicated with a larger sample to determine the directionality of the association between learning, beliefs and behaviours.