Predictors and barriers to timely medical follow-up after cardiovascular disease risk factor screening according to race/ethnicity

BACKGROUND: The purpose of this study was to assess followup practices among individuals found to have elevated cardiovascular disease (CVD) risk factors in a screening and educational outreach. METHODS: Participants in the National Heart, Lung and Blood Institute Family Intervention Trial for Heart Health (FIT Heart) who were found to have hypertension, prehypertension, suboptimal lipids and/or abnormal blood glucose were included in this study (N = 214, mean age 49 +/- 13, 64% female, 33% nonwhite). Contact was made at two weeks, six weeks and three months to determine if medical follow-up was initiated. Barriers to nonadherence were assessed. RESULTS: After two weeks, significantly more whites had medical follow up compared to nonwhites (34% vs. 20%, p = 0.04). Racial/ethnic minorities were more likely to report that not having a doctor was a barrier (30% vs. 11%, p = 0.02). Non-whites were more likely to return to the study staff for followup rather than an outside physician (32% vs. 15%, p = 0.001). CONCLUSION: Racial/ethnic minorities with elevated CVD risk factors may have delayed medical follow-up compared to whites, and this may be attributable to lack of access to a doctor. These data suggest that improving access to care may reduce racial/ethnic disparities in risk factor management and CVD outcomes.