‘It can’t do any harm’: A qualitative exploration of accounts of participation in preventive health checks

Abstract

Assessing and managing risk are central to participation in preventive health checks, as the purpose is to identify adverse health behaviours and risk factors. Drawing on the cultural theory of risk, we explore why people without formal education participate in preventive health checks and discuss how this is related to their understandings of risk and health. With this aim, we conducted semistructured qualitative interviews with people without formal education who participated in the intervention study Check-in. Check-in evaluated the effect of an invitation of people aged 45-64 without formal education beyond lower secondary school (grades 7-9) to a prescheduled preventive health check in general practice. In this way, Check-in provided the empirical context of this study. Within our analysis we identified four participation styles representing different ways of participating in preventive health checks: 1) selective participation, 2) participation to control uncertainty, 3) feeling an obligation to participate and 4) participation to change the healthcare system. Across the participation styles, we found that participants attended the preventive health check for reasons other than getting help to change their health behaviour and that the accounts of participation were socially embedded. Participants ascribed and assessed risk and health in relation to their immediate network and everyday lives and thereby presented risk perceptions differently from the general preventive messages. From these findings we suggest that preventive health checks should be based on participants' context-dependent needs.

‘Motivational work’: a qualitative study of preventive health dialogues in general practice

“…This means that the assessment could point to healthrelated problems that patients may not have recognized as problematic. However, motivation for health behavioral change has generally been found to occur when patients experience symptoms affecting their quality of life and affected by conditions surrounding their everyday lives and to a lesser extent influenced by information about risk [10,[38][39][40][41]. Furthermore, although the TOF pilot study provided the patients with a risk profile and offered a digital health profile, which they were encouraged to look through to prepare for the health dialogue, we found that the risk profiles did not affect the health dialogues as such.…”

‘Motivational work’: a qualitative study of preventive health dialogues in general practice

“…Our ndings, however, do not support this suggestion, given that patients in the health dialogues brought up other medical health problems despite the intended focus on prevention. Qualitative studies of complex preventive interventions have shown that participants ascribe different expectations to their participation than assumed in the intervention and that these expectations are based on their everyday lives [39]. Our study already includes interviews with participating patients with the purpose of examining patients' expectations and experiences with the health dialogue.…”

‘Motivational work’: a qualitative study of preventive health dialogues in general practice

“…This means that the assessment could point to health-related problems that patients may not have recognized as problematic. However, motivation for health behavioral change has generally been found to occur when patients experience symptoms affecting their quality of life and affected by conditions surrounding their everyday lives and to a lesser extent in uenced by information about risk [10,[37][38][39][40]. Furthermore, although the TOF pilot study provided the patients with a risk pro le and offered a digital health pro le, which they were encouraged to look through to prepare for the health dialogue, we found that the risk pro les did not affect the health dialogues as such.…”

“…Qualitative studies of complex preventive interventions have shown that participants ascribe different expectations to their participation than assumed in the intervention and that these expectations are based on their everyday lives [39]. Our study already includes interviews with participating patients with the purpose of examining patients' expectations and experiences with the health dialogue.…”