Compliance with childhood cholesterol screening among members of a prepaid health plan

Article Abstract:

Parental compliance with a childhood cholesterol screening program appears to be low even among members of a prepaid health plan in which testing is free. Of 1,160 children aged two to 18 whose parents completed a questionnaire on family medical history, 529 had a family history of high blood cholesterol, heart disease or stroke. Of the 529 children who were then advised to have a random cholesterol test, 70% complied. Of the 93 children with total cholesterol levels over 4.8 millimoles per liter (mmol/L) who were asked to return for a fasting blood test, 62% complied. Of the 58 who complied, 25 (43%) had levels of low-density lipoproteins of 3.25 mmol/L or greater and were offered a three-to-six week nutrition training program. Only nine children (36%) enrolled in the nutrition program. These findings suggest that universal childhood cholesterol screening is ineffective.

Care and treatment

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Screening for familial hypercholesterolemia in childhood

Article Abstract:

Selective screening for familial hypercholesterolemia (FH) may be effective, but universal screening of children for high cholesterol would be wasteful and ineffective in reducing overall rates of heart disease. Screening for FH may be warranted because it is an identifiable and significant cause of premature heart disease. It is a serious disease, and generally those affected develop heart lesions in their 20s or 30s. Current cholesterol screening techniques could reliably detect FH. Selective screening for FH based on a family history of premature heart disease or high blood cholesterol would identify most children at risk without falsely labelling too many children. Furthermore, unlike the therapy for other causes of heart disease, initiating treatment for FH in childhood appears to be more effective than waiting until adulthood.

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Compliance with voluntary prenatal HIV testing in a large health maintenance organization (HMO)

Article Abstract:

Using a trained and personally designated counselor appears to increase the likelihood of voluntary HIV testing in pregnant women. A representative from each of 31 Kaiser Permanente of Northern California sites was interviewed about their procedures for counseling pregnant women about HIV screening tests. Policies associated with high testing rates included easily available tests, an identified HIV educator for each patient, and the inclusion of a registered nurse in the counseling process. Voluntary HIV testing rates increased from 50% to 63% after sharing the survey results with the participating sites.

Methods, Services, Testing, Surveys, HIV infections, Patient compliance, Pregnant women, Pregnancy, HIV testing, HIV tests, HIV infection in pregnancy

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