What affects response rates in primary healthcare-based programmes? An analysis of individual and unit-related factors associated with increased odds of non-response based on HCV screening in the general population in Poland

Abstract

ObjectivesResponse rate in public health programmes may be a limiting factor. It is important to first consider their delivery and acceptability for the target. This study aimed at determining individual and unit-related factors associated with increased odds of non-response based on hepatitis C virus screening in primary healthcare.DesignPrimary healthcare units (PHCUs) were extracted from the Register of Health Care Centres. Each of the PHCUs was to enrol adult patients selected on a random basis. Data on the recruitment of PHCUs and patients were analysed. Multilevel modelling was applied to investigate individual and unit-related factors associated with non-response. Multilevel logistic model was developed with fixed effects and only a random intercept for the unit. Preliminary analysis included a random effect for unit and each of the individual or PHCU covariates separately. For each of the PHCU covariates, we applied a two-level model with individual covariates, unit random effect and a single fixed effect of this unit covariate.SettingThis study was conducted in primary care units in selected provinces in Poland.ParticipantsA total of 242 PHCUs and 24 480 adults were invited. Of them, 44 PHCUs and 20 939 patients agreed to participate. Both PHCUs and patients were randomly selected.ResultsData on 44 PHCUs and 24 480 patients were analysed. PHCU-level factors and recruitment strategies were important predictors of non-response. Unit random effect was significant in all models. Larger and private units reported higher non-response rates, while for those with a history of running public health programmes the odds of non-response was lower. Proactive recruitment, more working hours devoted to the project and patient resulted in higher acceptance of the project. Higher number of personnel had no such effect.ConclusionsPrior to the implementation of public health programme, several factors that could hinder its execution should be addressed.

A population-based screening for hepatitis C antibodies and active infection using a point-of-care test in a low prevalence area

“…In line with our results, another study in Barcelona, Spain, based on invitation for a blood HCV test by ordinary mail, showed an even lower response rate (4.11%: 238 participants out of 5,793 letters sent) [18]. Successful recruitment in this type of population studies probably requires different approaches and better communication strategies, including the use of the media and social networks, especially in younger populations and in urban areas [19].…”

Missed opportunities for diagnosing viral hepatitis C in Poland. Results from routine HCV testing at the Emergency Department in the Hospital for Infectious Diseases in Warsaw

“…Currently, the tests for the detection of anti-HCV antibodies are not routinely performed, which may result in the development of late disease consequences such as cirrhosis or liver cancer (hepatocellular carcinoma). Lack of systemic solutions leads to lower rates of HCV detection in the general population [5]. It is well known that late diagnosis is associated with increased morbidity and mortality, poorer response to treatment, increased healthcare costs and obviously with increased transmission rates [6].…”

Factors associated with hepatitis C prevalence differ by the stage of liver fibrosis: A cross-sectional study in the general population in Poland, 2012-2016

“…Patients were contacted by phone, post or face-to-face. Detailed information of the sampling and recruitment procedure was specified in [ 15 ].…”