To Check or Not to Check? A Qualitative Study on How the Public Decides on Health Checks for Cardiovascular Disease Prevention

Abstract

BackgroundMore than half of the general population does not attend screening for cardiovascular diseases (CVD) hence they are unaware of their risks. The objective of this study was to explore the views and experiences of the public in deciding to undergo health checks for CVD prevention.MethodsThis was a qualitative study utilising the constructivist grounded theory approach. A total of 31 individuals aged 30 years and above from the community were sampled purposively. Eight interviews and six focus groups were involved, using a semi-structured topic guide.ResultsA conceptual framework was developed to explain the public’s decision-making process on health check participation for CVD prevention. The intention to participate in health checks was influenced by the interplay between perceived relevance and the individual’s readiness to face the outcome of health checks. Health checks were deemed relevant if people perceived themselves to be at risk of CVD and there was an advantage in knowing their cardiovascular status. People were ready to face the outcome of health checks if they wanted to know the results and were prepared to deal with the subsequent management. The decision to participate in health checks was also influenced by external factors such as the views of significant others, and the accessibility and availability of resources including time and finances.ConclusionsThe intention to screen for CVD is motivated by two internal factors: the perceived relevance of the disease and readiness to face screening outcomes. Strategies targeting the internal decision-making process may prove to be key in improving the uptake of screening.

Australian Community Pharmacists’ Experience of Implementing a Chronic Kidney Disease Risk Assessment Service

“…However, a systematic review examining customer attitudes found that they were more receptive to the availability of medi-cine-related services than health promotion or screening services, but those who experienced these pharmacy services were highly satisfied with them (12). In a recent Australian atrial fibrillation screening study, pharmacists perceived combining screening with other established services, such as medication reviews, as an alternative approach to improve service uptake (29). Similarly, in this qualitative study, pharmacists observed an improvement in the customers' response to the CKD service when it was integrated with other professional services.…”

“…Previous studies have found that, to improve customer awareness and participation in pharmacy services, pharmacists need to reassess their daily practice and ensure that they are not just dispensing prescriptions (27,29). Instead, pharmacists should play an active role by directly approaching customers and explaining available services, and by using prominent flyers (29). Similarly, pharmacists in this study found investing more time in explaining the service to customers, and the use of additional flyers or newsletters, improved the service implementation process.…”

Women’s reasons for declining cardiovascular screening – a qualitative study

“…As such, nonattendees tended to think 'it may happen to others, but not to me', despite being aware of increased risk due to cardiovascular risk factors (20,21). According to Cheong et al (22), patients' motivation for accepting screening is related to their preparedness to deal with the test results, including a diagnosis and need for interventions (both medical and lifestyle modi cations). In addition, Dahl et al (21) found that nonattendance was related to preferring unclarity and wanting not to disturb the feeling of being healthy or running the risk of discovering health problems.…”

Determinants for cardiovascular disease health check questionnaire: A validation study

“…To improve participation rates of health checks for prevention of CVD, it is crucial to understand factors that influence individuals’ intention to go for such checks. We addressed this by first exploring factors that influenced individuals’ decision-making to undergo health checks for CVD prevention in a previous qualitative study [ 7 ]. Following this, a questionnaire was developed to identify the factors that influenced individuals’ intention to undergo health checks for CVD prevention using a quantitative study on a population.…”

“…A number of questionnaires have been used in previous studies to examine factors influencing individuals’ intention to participate in health checks using the health belief model [ 9 – 12 ] or the theory of planned behaviour [ 13 , 14 ]. However, the items used were not grounded to local context and the concepts measured did not include all determinants found in our qualitative study [ 7 ]. Thus, we aimed to develop and validate a questionnaire that assessed all determinants that could influence individuals’ intention to undergo CVD health-checks.…”