PUBLIC HEALTH MODEL SYSTEM--BLOOD CHOLESTEROL SCREENING

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The Massachusetts Department of Public Health proposes to implement a public health model system for cholesterol screening, education, and referral. Working in four communities with a diversity of racial, ethnic, and socioeconomic populations, it will educate physicians as to the importance and means of treating patients with moderate and high levels of serum cholesterol and establish a referral network of physicians willing to accept such patients. After conducting community analyses to establish the most appropriate sites for conducting screenings and the most effective means of recruiting volunteers to be screened, the Department will use a specially trained team to conduct its screening, education, and referral programs in each community. Approximately 11,000 individuals will be screened using a portable Reflotron analyzer. Venipuncture samples will be drawn and analyzed for one-tenth of those screened in order to verify the reliability of the Reflotron determinations. Those screened will receive education and counseling about serum cholesterol and diet by either a health professional or a trained lay person. Additional contact will be made with one-half of those referred to physicians within two weeks in order to see whether this increases the rate of successful referrals. Follow-up will be conducted on all individuals referred to physicians to determine the rate of successful referrals and what treatments have been prescribed. For a subsample of those referred, follow-up activities will be conducted at six months to ascertain changes in dietary fat consumption and whether any medications are being taken. Repeat Reflotron blood samples will be taken on this subsample to see whether serum cholesterol levels have changed since the initial screening.