The Community Cholesterol Survey Project assessed attitudes, knowledge, and behaviors relating to cholesterol.
Six outpatient primary care practice sites (two urban, two suburban, and two rural) in northeast Ohio.
Four hundred seventy-seven site-, age-, and gender-stratified adult patients were enrolled from a total of 604 approached (79% recruitment).
Self-administered questionnaire and structured dietitian interview.
Main Outcome Measures
A knowledge score derived from responses to multiple-choice questions and a knowledge rating given by the study dietitian. Motivation and dietary health were similarly measured.
Subjects did worse than random guessing for seven of 12 knowledge questions regarding label reading, fats, and cholesterol. In particular, the meaning of "hydrogenated" and the relative energy content of fats was poorly understood. Knowledge scores and ratings were significantly correlated (r=.52). Knowledge ratings were higher in those who were receiving a cholesterol-lowering diet or who had received other advice or treatment from their physician for high cholesterol level. By analysis of variance, knowledge measures were found to have significant independent positive associations with higher social status (P<.001) and living in a suburban area (P<.05). Motivation and dietary health demonstrated similar relationships to social status.
To make use of patients' motivation for change, it will be essential to provide education at an effective level. Instruction in label reading or creation of more meaningful food labels may have the greatest impact. A particular challenge is the education of less advantaged patients to promote healthy nutrition practices.