6. QUALITY CONTROL
6.1 Overview
Quality assurance/quality control procedures for the Cardiovascular Fitness componentincludes development of standard procedures for the treadmill test, and intensive training and certification
of technologists prior to the start of the study. After study start-up, technologist adherence to procedures
is monitored regularly through observational visits and specific data analysis for evaluation of
technologist performance. The validity and reliability of specific data is also monitored routinely in
addition to regular equipment calibration and maintenance procedures.
6.2 Training
A 5-day training period for the Cardiovascular Fitness component is conducted at thebeginning of the study with a 2-day annual retraining. Consultants from the Cooper Institute of Aerobic
Research and Westat development staff supervise training for the treadmill test, data entry, and
integration issues with the biomedical equipment and the computer system.
6.2.1 Initial Training
The initial training period includes a discussion of the importance of collecting data on thecardiovascular fitness level of the Nation, followed by a brief overview of exercise physiology focusing
on normal and abnormal responses to a graded exercise test. Methods for excluding participants from this
component (medical history, medications, heart rate and blood pressure criteria, and safety exclusion
questions) are reviewed. Technologists are taught how to explain and demonstrate the treadmill test to a
participant and how to monitor a participant’s comfort level and to observe signs of distress that would
require stopping the test early. Operation, maintenance, and calibration procedures for the treadmill,
programmable controller, and automatic blood pressure monitor are reviewed and practiced. Procedures
for a normal treadmill test are taught in addition to special procedures for changing the exercise protocol,
interrupting the test to go to the recovery stage early, or to stop the test immediately if the condition of the