TY - JOUR T1 - Patients’ Perceptions of Cholesterol, Cardiovascular Disease Risk, and Risk Communication Strategies JF - The Annals of Family Medicine JO - Ann Fam Med SP - 205 LP - 212 DO - 10.1370/afm.534 VL - 4 IS - 3 AU - Roberta E. Goldman AU - Donna R. Parker AU - Charles B. Eaton AU - Jeffrey M. Borkan AU - Robert Gramling AU - Rebecca T. Cover AU - David K. Ahern Y1 - 2006/05/01 UR - http://www.annfammed.org/content/4/3/205.abstract N2 - PURPOSE Despite some recent improvement in knowledge about cholesterol in the United States, patient adherence to cholesterol treatment recommendations remains suboptimal. We undertook a qualitative study that explored patients’ perceptions of cholesterol and cardiovascular disease (CVD) risk and their reactions to 3 strategies for communicating CVD risk. METHODS We conducted 7 focus groups in New England using open-ended questions and visual risk communication prompts. The multidisciplinary study team performed qualitative content analysis through immersion/crystallization processes and analyzing coded reports using NVivo qualitative coding software. RESULTS All participants were aware that “high cholesterol” levels adversely affect health. Many had, however, inadequate knowledge about hypercholesterolemia and CVD risk, and few knew their cholesterol numbers. Many assumed they had been tested and their cholesterol concentrations were healthy, even if their physicians had not mentioned it. Standard visual representations showing statistical probabilities of risk were assessed as confusing and uninspiring. A strategy that provides a cardiovascular risk-adjusted age was evaluated as clear, memorable, relevant, and potentially capable of motivating people to make healthful changes. A few participants in each focus group were concerned that a cardiovascular risk-adjusted age that was greater than chronological age would frighten patients. CONCLUSIONS Complex explanations about cholesterol and CVD risk appear to be insufficient for motivating behavior change. A cardiovascular risk-adjusted age calculator is one strategy that may engage patients in recognizing their CVD risk and, when accompanied by information about risk reduction, may be helpful in communicating risk to patients. Annals Journal Club selection—see inside back cover. ER -