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BMC Public Health
Published in: BMC Public Health 1/2016

Open Access 01-12-2016 | Research article

The response to receiving phenotypic and genetic coronary heart disease risk scores and lifestyle advice – a qualitative study

Authors: Guy Shefer, Barbora Silarova, Juliet Usher-Smith, Simon Griffin

Published in: BMC Public Health | Issue 1/2016

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Abstract

Background

Individuals routinely receive information about their risk of coronary heart disease (CHD) based on traditional risk factors as part of their primary care. We are also able to calculate individual’s risk of CHD based on their genetic information and at present genetic testing for common diseases is available to the public. Due to the limitations in previous studies further understanding is needed about the impact of the risk information on individual’s well-being and health-behaviour. We aimed to explore the short term response to receiving different forms of CHD risk information and lifestyle advice for risk reduction.

Methods

We conducted fourty-one face-to-face interviews and two focus groups across England with participants from the INFORM trial who received a combination of individualised phenotypic and genotypic CHD risk scores and web-based lifestyle advice. Risk scores were presented in different formats, e.g. absolute 10 year risk was presented as a thermometer and expressed as a percentage, natural frequency and ‘heart age’. Interviews and focus groups explored participants’ understanding and reaction to the risk scores and attempts to change lifestyle during the intervention. We tape-recorded and transcribed the interviews and focus groups and analysed them using thematic analysis.

Results

Three main themes were identified: limitations of risk scores to generate concern about CHD risk; the advantages of the ‘heart age’ format of risk score presentation in communicating a message of sub-optimal lifestyle; and intentions and attempts to make moderate lifestyle changes which were prompted by the web-based lifestyle advice.

Conclusions

There are a number of limitations to the use of risk scores to communicate a message about the need for a lifestyle change. Of the formats used, the ‘heart age’, if noticed, appears to convey the most powerful message about how far from optimal risk an individual person is. An interactive, user friendly, goal setting based lifestyle website can act as a trigger to initiate moderate lifestyle changes, regardless of concerns about risk scores.

Trial registration

Current Controlled Trials ISRCTN17721237. Registered 12 January 2015.
Appendix
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Metadata
Title
The response to receiving phenotypic and genetic coronary heart disease risk scores and lifestyle advice – a qualitative study
Authors
Guy Shefer
Barbora Silarova
Juliet Usher-Smith
Simon Griffin
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2016
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-016-3867-2

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