Patients' knowledge about fats and cholesterol in the Community Cholesterol Survey Project
R. B. Kelly, J. A. Hazey and S. H. McMahon
Department of Family Medicine, State University of New York at Stony Brook.
OBJECTIVE: The Community Cholesterol Survey Project assessed attitudes,
knowledge, and behaviors relating to cholesterol. DESIGN: Survey. SETTING:
Six outpatient primary care practice sites (two urban, two suburban, and
two rural) in northeast Ohio. PARTICIPANTS: Four hundred seventy-seven
site-, age-, and gender-stratified adult patients were enrolled from a
total of 604 approached (79% recruitment). INTERVENTIONS: 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. RESULTS: 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.
CONCLUSIONS: 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.
