Health Promotion in Older Adults: Effectiveness of Community-Based Screening

Background: The purpose of this study was to assess the effectiveness of annual screening for cardiovascular risk factors in low-income older adults residing in an urban community. Methods: From 2005 to 2009, screenings were conducted at senior housing sites and senior centers. Screening components included blood pressure, cholesterol and blood glucose measurement; BMI calculation; 24 hour diet recall; and medication review. Each participant received a written copy of his/her results, with individualized teaching consistent with the NHLBI recommendations. Participants agreed to telephone follow-up. Telephone contact was attempted for all participants who received recommendations for follow-up with a health care provider and/or behavioral changes. Results: More than 750 older adults have participated in the screenings to date. Approximately 30% of those screened received recommendations for follow-up with a health care provider and/or behavioral changes. Telephone contact was attempted three times for each of these participants, with a 35% success rate. Of those contacted, 70%-90% followed specific recommendations for evaluation by a health care provider and behavioral changes. Reasons for not following recommendations included not being able to obtain an appointment in a timely manner or lack of concern with screening results on the part of the health care provider. Conclusion: The low-income older adult population in this urban community faces significant barriers to care. Annual community-based screenings appear to be an effective way to identify those in need of intervention. Nearly 1/3 of those who followed the recommendation for evaluation by a health care provider reported a medication adjustment.