The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #56745

Amiram M. Sheffet, PHD and Donald B. Louria, MD. Department of Preventive Medicine, UMDNJ - New Jersey Medical School, PO Box 1709, Newark, NJ 07101-1709, 973-972-5441, sheffeam@umdnj.edu

A representative sample of 1246 adults was surveyed regarding compliance with recommended screening tests in the New Jersey Health Wellness Promotion Act (consistent with, but not identical to, recommendations of the US Preventive Services Task Force). The effect of sociodemographic and other determinants, on compliance with screening test schedules, was assessed.

The surveyed were 47% males, 46% between the ages of 30 to 49, 18% 65+ years; 76% were whites, 12% African-American, 9% Hispanics; 48% reported household income of $50,000+, 90% had health insurance, 86% self-assessed their general health as good, but 19% had serious chronic conditions. Reported screening tests compliance (age and gender specific) was: blood pressure (BP) - 92%; cholesterol - 88%; pap smear - 79%; mammography - 66%; influenza immunization - 66%; glucose - 61%; hemoglobin - 48%; breast self-examination - 48%; sigmoidoscopy - 34%; hemoccult - 29%; bone density - 29%.

Computed Odds Ratios (ORs) (by multivariate logistic regression procedures) indicate that reminders to take specified tests improved compliance substantially for cholesterol, glucose, hemoglobin, mammogram, and pap smear (ORs 4.6, 3.1, 2.5, 5.2, and 2.5, respectively). Having health insurance was significant for compliance with sigmoidoscopy and mammography (ORs of 4.6) and for cholesterol and glucose blood tests (ORs 1.9, 1.6, respectively). A "chronic health condition" was significant for compliance with tests for blood pressure, cholesterol, hemoglobin, and glucose (ORs 5.0, 1.9, 1.5, 2.3, respectively). Self-assessed health was not associated with compliance. Except for pap test, compliance improved with age. Having health insurance and receiving reminders to take tests are crucial determinants for compliance with preventive services.

Learning Objectives:

• Recognize how far we have to go to achieve optimal prevention goals.
• Understand the importance of the New Jersey Health Wellness Promotion Act as a national legislative model to promote health and prevent disease.
• Recognize that "health insurance" and "reminders for tests" are the most important determinants of compliance with preventive practices.
• Articulate the need for health professionals to remind clients to do preventive tests.
• Identify groups that need aggressive approaches to achieve better compliance.

Keywords: Health Insurance, Prevention

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.