Coronary artery disease risk screening response by high-risk groups: Implications for social work strategies in disease prevention

Virginia Jeanne Swartz, University of Pennsylvania


Studies show lower socio-economic groups, and African Americans have the highest incidence of morbidity and mortality from coronary artery disease (CAD). These groups are least likely to be screened for CAD risks. This study replicates findings on correlates of preventive health behavior but for a southeastern, African American and poor white population who suffer high rates of morbidity and mortality from CAD and explores accessibility to screenings. Method. Invitations (15,000) to CAD risk screening were sent to residents of the neighborhood surrounding an urban family practice center. Participants completed questionnaires on health status, knowledge and beliefs, locus of control, values, demographic and insurance questions, their blood pressure, cholesterol and weights were recorded, they were given CAD risk factor instruction and invited by letter, to return for follow up screening four months later. Results. 283 (expected response rate was 1-2%) attended the initial screening, for a response rate of 1.9%, 39% of participants followed up. Low income, older, white women, high school graduates were over represented in the sample; when controlled for age, significant differences were that younger participants were less likely to have high school education, older black participants followed up at higher rates, the younger black participants were less likely to return, as were the highest income group. Health locus of control and health value measures replicated results of previous studies: internal HLC and high health value predicted, participation and return, reported behavior change, awareness of CAD risk factors, the external HLC types, although under represented, had the highest mean improvement in blood pressure, cholesterol and weight. The majority of participants returning for follow up made improvements in CAD risk factors. Blacks, non-graduates, seniors and those returning for follow up rated the importance of practical accessibility higher than did the others, while white, older, high school graduates and those who did not return rated sociocultural accessibility higher. Implications for social work practice and questions for further research are presented.

Subject Area

Social work|Public health|Ethnic studies

Recommended Citation

Swartz, Virginia Jeanne, "Coronary artery disease risk screening response by high-risk groups: Implications for social work strategies in disease prevention" (1994). Dissertations available from ProQuest. AAI9421435.