Background Type 2 diabetes (T2D) is associated with a significant increased risk of cardiovascular disease (CVD). The DIAabetic CArdioVAscular Screening and intervention trial (DIACAVAS) was designed to clarify whether advanced imaging for subclinical atherosclerosis combined with medical treatment is an effective strategy to develop individualised treatment algorithms for Danish men and women with T2D aged 40–60. But in the DIACAVAS pilot study, the uptake was only 41%. Consequently, we explored how people experienced living with T2D to understand how to improve the uptake in initiatives targeting prevention of CVD. Methods We used semi-structured interviews to obtain information on how the respondents experienced having T2D. For supplementary information, we used structured interviews on e.g. socioeconomic factors. From April to October 2019, 17 participants aged 40–60 years were recruited from general practices and diabetes outpatient clinics in Denmark. Several levels of analysis were involved consistent with inductive content analysis. Results The participants’ experiences of living with T2D fell along two continuums, from an emotional to a cognitive expression and from proactive to reactive disease management. This led to identification of four archetypal characteristics: (I) powerlessness, (II) empowerment, (III) health literacy, and (IV) self-efficacy. These characteristics indicated the importance of using different approaches to facilitate participation in cardiovascular preventive initiatives. Additionally, findings inspired us to develop a model for facilitating participation in forthcoming preventive initiatives. Conclusion Encouraging people with T2D to participate in cardiovascular preventive initiatives might necessitate a tailored invitation strategy. We propose a model for an invitational process that takes into consideration invitees’ characteristics, including powerlessness, empowerment, health literacy and self-efficacy. This model may enhance participation in such initiatives. However, participation is a general concern, not only in relation to cardiovascular disease prevention. Our proposed model may be applicable in preventive services for people with T2D in general.

Background During 2011–2013, women from a municipality in Denmark who were born in 1936, 1941, 1946 or 1951 were invited to cardiovascular screening (n = 1984); of those, ten nonattendees were interviewed about their perspectives on cardiovascular screening. The interviews were re-analysed to gain a deeper understanding of their motives for viewing screening as personally irrelevant. A salutogenic perspective formed the premise for the data analysis. Methods A secondary analysis applying a deductive content analysis inspired by Elo and Kyngäs. The core components of Sense of Coherence were used as a theoretical framework. Results We found that nonattendance was rooted in the women’s social role as caregiver and their individual inner logics. Being a caregiver provided the women with a feeling of Sense of Coherence in their daily lives. The inner logics reflected a line of reasoning without critical reflections and the women acted upon these when declining screening. Inner logics were used as a strategy to uphold their social role and identity. Conclusion The women had a salutogenic orientation to life and they found screening meaningless. Inner logics, caring role and personal desire to maintain control of one’s life interact with individuals’ experiences of Sense of Coherence, and thus their identities. If women are expected to attend screening, it must be emotionally and cognitively meaningful for them. This could be facilitated by using a salutogenic approach in the screening invitation.