The purpose of this study was to assess parental knowledge, attitudes, and behavior concerning lead reduction counseling. Of 108 children with confirmed venous lead levels > or = 20 microg/dL, 75 (69%) of the parents were interviewed by telephone 6-9 months later. The majority of parents recalled being given specific lead reduction strategies. Knowledge of cleaning interventions was associated with parents who could state the lead level, who perceived a benefit from knowing it was elevated, and whose children were referred to a specialty lead clinic. Recall of nutritional interventions was associated with parents who could state the lead level and whose children were referred to a specialty lead clinic. Although 79% of parents thought that it was beneficial to know their child's lead level was elevated, only 65% reported implementing lead reduction strategies. The majority of parents recalled receiving lead reduction counseling but reported low compliance with lead reduction strategies. Further research is needed to determine the causes of the discrepancy between knowledge and making the behavior changes necessary to comply with lead reduction interventions.