Standard and Tailored Conditions

Standard CARDIAC

• CARDIAC Introductions
  
  
  • The Teaching Poster provided pictures of the events that occurred for children during the CARDIAC Screening and provided an image of an artery showing how cholesterol builds up.
    
    
  • The Talking Points provide the descriptions to use with the Teaching Poster. These are designed to give children the necessary information to discuss the program with their parents and decide if they would like to participate.
    
    
• Fixed Incentives
  
  
  • Emphasis was not placed on incentives, but they had long been included in CARDIAC so they were continued in the Standard procedure.
    
    
  • A standard amount for a gift certificate or prize of $75 was offered to a single child in each county. The child’s name was drawn from among all of the children who participated in the CARDIAC screening. In addition, a “party” involving healthy food (Subway® sandwiches) was offered to the classroom that had the highest return rate* for consent/assent forms. *Return of the forms was the criteria, regardless of whether children chose to participate in the screening.
    
    
• Reminders to children to return the consent/assent forms
  
  
  • The research project required only 1 verbal reminder about the screening be given to students 1-2 days before the screening. This was established to reduce differences in recruitment across the counties.

The Tailored Approach, detailed below, addressed the health belief barriers identified during Studies 1 and 2.

Tailored CARDIAC

• A letter mailed to parents from the school nurse with county-specific pictures and general information on county-specific heart disease/ cholesterol data (Sample version of one county available).
  
  
  • Letters were mailed to the parents of all eligible 5th grade students prior to the introduction of CARDIAC in the classroom. The letters conveyed the school nurse’s support for the CARDIAC project and an enclosed flyer showcased the county and provided generic information on the number of participants and the health problems identified. A CARDIAC Magnet was included to put on the refrigerator to remind parents about the upcoming screening.
    
    
• Child and Parent Brochures
  
  
  • Brochures were created to give parents and children added information about the upcoming screening event. These brochures supplemented the CARDIAC Consent Form and provided lay language about the Screening and heart disease. The information in the brochures was based on data from the interviews and focus groups, and followed the framework set forth by the Theory of Planned Behavior. Information addressed the importance of screening children for heart disease and diabetes risk factors at an early age.
    
    
• CARDIAC Health Report
  
  
  • The CARDIAC Health Report is a tailored redesign of the original Report Card that was given to children following the screening. These reports provided the child’s screening results for cholesterol, AN, blood pressure, height, weight, and Body Mass Index (BMI). The Health Report addressed parents’ requests for additional information and provided explanations of each result along with information on healthy eating and activity. The Health Report also indicated whether the child was recommended for a Fasting Lipid Profile to confirm the cholesterol screening results.
    
    
• Follow-up Blood Test Brochure (and voucher)
  
  
  • The FLP Brochure was given to children who had an abnormal fingerstick reading during CARDIAC Screening. The information in the brochure explained why the child was referred for an additional blood test, how to discuss the blood test with the child, and what to expect about the test.
    
    
• Reminder postcard
  
  
  • The reminder postcard was mailed to each family. During interviews, parents indicated “important information comes in the mail”, and previous research has found mailed reminders increase the likelihood an appointment will be kept. The reminder listed locations and times for the free FLP blood draw.

**The Tailored materials were pilot tested in focus groups with children and parents.