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Published in: BMC Primary Care 1/2015

Open Access 01-12-2015 | Research article

Patients’ willingness to attend the NHS cardiovascular health checks in primary care: a qualitative interview study

Authors: Caroline E Jenkinson, Anthea Asprey, Christopher E Clark, Suzanne H Richards

Published in: BMC Primary Care | Issue 1/2015

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Abstract

Background

The NHS Cardiovascular Health Check (NHSHC) programme was introduced in England in 2009 to reduce cardiovascular disease mortality and morbidity for all patients aged 40 to 74 years old. Programme cost-effectiveness was based on an assumed uptake of 75% but current estimates of uptake in primary care are less than 50%. The purpose of this study was to identify factors influencing patients’ willingness to attend an NHSHC. For those who attended, their views, experiences and their future willingness to engage in the programme were explored.

Method

Telephone or face-to-face interviews were conducted with patients who had recently been invited for an NHSHC by a letter from four general practices in Torbay, England. Patients were purposefully sampled (by gender, age, attendance status). Interviews were audio recorded, transcribed verbatim and analysed thematically.

Results

17 attendees and 10 non-attendees were interviewed. Patients who attended an NHSHC viewed it as worthwhile. Proactive attitudes towards their health, a desire to prevent disease before they developed symptoms, and a willingness to accept screening and health check invitations motivated many individuals to attend. Non-attendees cited not seeing the NHSHC as a priority, or how it differed from regular monitoring already received for other conditions as barriers to attendance. Some non-attendees actively avoided GP practices when feeling well, while others did not want to waste health professionals’ time. Misunderstandings of what the NHSHC involved and negative views of what the likely outcome might be were common.

Conclusion

While a minority of non-attendees simply had made an informed choice not to have an NHSHC, improving the clarity and brevity of invitational materials, better advertising, and simple administrative interventions such as sending reminder letters, have considerable potential to improve NHSHC uptake.
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Literature
1.
go back to reference NHS Health Check Programme. Putting prevention first – NHS health check: vascular risk assessment and management best practice guidance. London: Crown; 2009. 12-6-0014. NHS Health Check Programme. Putting prevention first – NHS health check: vascular risk assessment and management best practice guidance. London: Crown; 2009. 12-6-0014.
2.
go back to reference Department of Health. NHS health check programme. Best practice guidance. London: Crown; 2013. 25-9-2014. Department of Health. NHS health check programme. Best practice guidance. London: Crown; 2013. 25-9-2014.
3.
go back to reference Hippisley-Cox J, Coupland C, Vinogradova Y, Robson J, Minhas R, Sheikh A, et al. Predicting cardiovascular risk in England and Wales: prospective derivation and validation of QRISK2. BMJ. 2008;336:1475–82.CrossRefPubMedPubMedCentral Hippisley-Cox J, Coupland C, Vinogradova Y, Robson J, Minhas R, Sheikh A, et al. Predicting cardiovascular risk in England and Wales: prospective derivation and validation of QRISK2. BMJ. 2008;336:1475–82.CrossRefPubMedPubMedCentral
4.
go back to reference Public Health England. NHS health check information governance and data flows. London: Crown; 2014. Public Health England. NHS health check information governance and data flows. London: Crown; 2014.
6.
go back to reference Department of Health. Improving outcomes and supporting transparency part 1A: a public health outcomes framework for England, 2013-2016. London: Department of Health; 2014. 12-6-0014. Department of Health. Improving outcomes and supporting transparency part 1A: a public health outcomes framework for England, 2013-2016. London: Department of Health; 2014. 12-6-0014.
7.
go back to reference Cochrane T, Davey R, Iqbal Z, Gidlow C, Kumar J, Chambers R, et al. NHS health checks through general practice: randomised trial of population cardiovascular risk reduction. BMC Public Health. 2012;12:944.CrossRefPubMedPubMedCentral Cochrane T, Davey R, Iqbal Z, Gidlow C, Kumar J, Chambers R, et al. NHS health checks through general practice: randomised trial of population cardiovascular risk reduction. BMC Public Health. 2012;12:944.CrossRefPubMedPubMedCentral
8.
9.
go back to reference Dalton AR, Bottle A, Okoro C, Majeed A, Millett C. Uptake of the NHS health checks programme in a deprived, culturally diverse setting: cross-sectional study. J Public Health (Oxf). 2011;33:422–9.CrossRef Dalton AR, Bottle A, Okoro C, Majeed A, Millett C. Uptake of the NHS health checks programme in a deprived, culturally diverse setting: cross-sectional study. J Public Health (Oxf). 2011;33:422–9.CrossRef
10.
go back to reference Lambert AM, Burden AC, Chambers J, Marshall T. Cardiovascular screening for men at high risk in heart of Birmingham teaching primary care trust: the ‘Deadly Trio’ programme. J Public Health (Oxf). 2012;34:73–82.CrossRef Lambert AM, Burden AC, Chambers J, Marshall T. Cardiovascular screening for men at high risk in heart of Birmingham teaching primary care trust: the ‘Deadly Trio’ programme. J Public Health (Oxf). 2012;34:73–82.CrossRef
12.
go back to reference McNaughton RJ, Oswald NT, Shucksmith JS, Heywood PJ, Watson PS. Making a success of providing NHS health checks in community pharmacies across the Tees Valley: a qualitative study. BMC Health Serv Res. 2011;11:222.CrossRefPubMedPubMedCentral McNaughton RJ, Oswald NT, Shucksmith JS, Heywood PJ, Watson PS. Making a success of providing NHS health checks in community pharmacies across the Tees Valley: a qualitative study. BMC Health Serv Res. 2011;11:222.CrossRefPubMedPubMedCentral
13.
go back to reference Saukko PM, Farrimond H, Evans PH, Qureshi N. Beyond beliefs: risk assessment technologies shaping patients’ experiences of heart disease prevention. Sociol Health Illn. 2012;34:560–75.CrossRefPubMed Saukko PM, Farrimond H, Evans PH, Qureshi N. Beyond beliefs: risk assessment technologies shaping patients’ experiences of heart disease prevention. Sociol Health Illn. 2012;34:560–75.CrossRefPubMed
15.
go back to reference Fereday J, Muir-Cochrane E. Demonstrating rigor using thematic analysis: a hybrid approach of inductive and deductive coding and theme development. International Journal of Qualitative Methods. 2006;5:1–11. Fereday J, Muir-Cochrane E. Demonstrating rigor using thematic analysis: a hybrid approach of inductive and deductive coding and theme development. International Journal of Qualitative Methods. 2006;5:1–11.
16.
go back to reference Braun J, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3:77–101.CrossRef Braun J, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3:77–101.CrossRef
17.
go back to reference Ritchie J, Spencer L. Qualitative data analysis for applied policy research. In: Bryman A, Burgess R, editors. Analysing qualitative data. London: Routledge; 1994. p. 173–94.CrossRef Ritchie J, Spencer L. Qualitative data analysis for applied policy research. In: Bryman A, Burgess R, editors. Analysing qualitative data. London: Routledge; 1994. p. 173–94.CrossRef
18.
go back to reference Ritchie J. The applications of qualitative methods to social research. In: Ritchie J, Lewis J, editors. Qualitative research practice: a guide for social science students and researchers. London: Sage Publications; 2003. p. 24–46. Ritchie J. The applications of qualitative methods to social research. In: Ritchie J, Lewis J, editors. Qualitative research practice: a guide for social science students and researchers. London: Sage Publications; 2003. p. 24–46.
19.
go back to reference Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care. 2007;19:349–57.CrossRefPubMed Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care. 2007;19:349–57.CrossRefPubMed
20.
go back to reference Clark CE, Fordham J, Greenwood M, Richards S, Campbell J. Costs of hypertension detection within the NHS health check programme compared to opportunistic detection. J Hum Hypertens. 2014;28:630–1. Clark CE, Fordham J, Greenwood M, Richards S, Campbell J. Costs of hypertension detection within the NHS health check programme compared to opportunistic detection. J Hum Hypertens. 2014;28:630–1.
21.
go back to reference Farrimond H, Saukko PM, Qureshi N, Evans PH. Making sense of being at ‘high risk’ of coronary heart disease within primary prevention. Psychol Health. 2010;25:289–304.CrossRefPubMed Farrimond H, Saukko PM, Qureshi N, Evans PH. Making sense of being at ‘high risk’ of coronary heart disease within primary prevention. Psychol Health. 2010;25:289–304.CrossRefPubMed
22.
go back to reference McNaughton RJ, Shucksmith J. Reasons for (non)compliance with intervention following identification of ‘high-risk’ status in the NHS Health Check programme. J Public Health (Oxf). Published online 18th September 2014:1-8. doi:10.1093/pubmed/fdu066. McNaughton RJ, Shucksmith J. Reasons for (non)compliance with intervention following identification of ‘high-risk’ status in the NHS Health Check programme. J Public Health (Oxf). Published online 18th September 2014:1-8. doi:10.1093/pubmed/fdu066.
23.
go back to reference Perry C, Thurston M, Alford S, Cushing J, Panter L. The NHS health check programme in England: a qualitative study. Health Promot Int. Published online 29th July 2014. 1-10. doi:10.1093/heapro/dau059 Perry C, Thurston M, Alford S, Cushing J, Panter L. The NHS health check programme in England: a qualitative study. Health Promot Int. Published online 29th July 2014. 1-10. doi:10.1093/heapro/dau059
24.
go back to reference Burgess C, Wright AJ, Forster AS, Dodhia H, Miller J, Fuller F, et al.. Influences on individuals’ decisions to take up the offer of a health check: a qualitative study. Health Expect. Published online 3rd June 2014. 1-12. doi:10.1111/hex.12212. Burgess C, Wright AJ, Forster AS, Dodhia H, Miller J, Fuller F, et al.. Influences on individuals’ decisions to take up the offer of a health check: a qualitative study. Health Expect. Published online 3rd June 2014. 1-12. doi:10.1111/hex.12212.
25.
go back to reference Cuijpers P, van SA, Warmerdam L, van Rooy MJ. Recruiting participants for interventions to prevent the onset of depressive disorders: possible ways to increase participation rates. BMC Health Serv Res. 2010;10:181.CrossRefPubMedPubMedCentral Cuijpers P, van SA, Warmerdam L, van Rooy MJ. Recruiting participants for interventions to prevent the onset of depressive disorders: possible ways to increase participation rates. BMC Health Serv Res. 2010;10:181.CrossRefPubMedPubMedCentral
26.
go back to reference Soljak M, Lonergan K, Hayward J. Public health action support team project report: systematic review of methods of patient and public contact for screening programmes. London: Public Health Action Support Team (PHAST); 2009. Soljak M, Lonergan K, Hayward J. Public health action support team project report: systematic review of methods of patient and public contact for screening programmes. London: Public Health Action Support Team (PHAST); 2009.
27.
go back to reference Brouwers MC, De Vito C, Bahirathan L, Carol A, Carroll JC, Cotterchio M, et al. What implementation interventions increase cancer screening rates? A systematic review. Implement Sci. 2011;6:111.CrossRefPubMedPubMedCentral Brouwers MC, De Vito C, Bahirathan L, Carol A, Carroll JC, Cotterchio M, et al. What implementation interventions increase cancer screening rates? A systematic review. Implement Sci. 2011;6:111.CrossRefPubMedPubMedCentral
28.
go back to reference Ebrahim S, Taylor F, Ward K, Beswick A, Burke M, Davey Smith G. Multiple risk factor interventions for primary prevention of coronary heart disease (Review). Suupl 1. Art. No.: CD001561. doi:10.1002/14651858.CD001561.pub3. 2011. Wiley. Cochrane Database of Systematic Reviews 2011. 22-5-2014. Ebrahim S, Taylor F, Ward K, Beswick A, Burke M, Davey Smith G. Multiple risk factor interventions for primary prevention of coronary heart disease (Review). Suupl 1. Art. No.: CD001561. doi:10.1002/14651858.CD001561.pub3. 2011. Wiley. Cochrane Database of Systematic Reviews 2011. 22-5-2014.
29.
go back to reference Krogsboll LT, Jorgensen KJ, Gronhoj LC, Gotzsche PC. General health checks in adults for reducing morbidity and mortality from disease: Cochrane systematic review and meta-analysis. BMJ. 2012;345:e7191.CrossRefPubMedPubMedCentral Krogsboll LT, Jorgensen KJ, Gronhoj LC, Gotzsche PC. General health checks in adults for reducing morbidity and mortality from disease: Cochrane systematic review and meta-analysis. BMJ. 2012;345:e7191.CrossRefPubMedPubMedCentral
30.
go back to reference Artac M, Dalton AR, Majeed A, Car J, Millett C. Effectiveness of a national cardiovascular disease risk assessment program (NHS Health Check): results after one year. Prev Med. 2013;57:129–34.CrossRefPubMed Artac M, Dalton AR, Majeed A, Car J, Millett C. Effectiveness of a national cardiovascular disease risk assessment program (NHS Health Check): results after one year. Prev Med. 2013;57:129–34.CrossRefPubMed
32.
go back to reference Krogsboll LT, Jorgensen KJ, Gotzsche PC. Universal health checks should be abandoned. BMJ. 2013;347:f5227.CrossRefPubMed Krogsboll LT, Jorgensen KJ, Gotzsche PC. Universal health checks should be abandoned. BMJ. 2013;347:f5227.CrossRefPubMed
33.
go back to reference Goodyear-Smith F. Government’s plans for universal health checks for people aged 40-75. BMJ. 2013;347:f4788.CrossRefPubMed Goodyear-Smith F. Government’s plans for universal health checks for people aged 40-75. BMJ. 2013;347:f4788.CrossRefPubMed
34.
go back to reference Public Health England. NHS health check: our approach to the evidence. London: Public Health England; 2013. Public Health England. NHS health check: our approach to the evidence. London: Public Health England; 2013.
35.
go back to reference Krogsboll LT, Jorgensen KJ, Gronhoj LC, Gotzsche PC. General health checks in adults for reducing morbidity and mortality from disease. Cochrane Database Syst Rev. 2012;10, CD009009.PubMed Krogsboll LT, Jorgensen KJ, Gronhoj LC, Gotzsche PC. General health checks in adults for reducing morbidity and mortality from disease. Cochrane Database Syst Rev. 2012;10, CD009009.PubMed
36.
go back to reference NHS Health Check. Explore NHS health check data. Devon: Cornwall and Somerset NHS Health Check statistics 5 year cumulative data; 2014. 17-9-0014. NHS Health Check. Explore NHS health check data. Devon: Cornwall and Somerset NHS Health Check statistics 5 year cumulative data; 2014. 17-9-0014.
37.
38.
go back to reference Murray J, Craigs CL, Hill KM, Honey S, House A. A systematic review of patient reported factors associated with uptake and completion of cardiovascular lifestyle behaviour change. BMC Cardiovasc Disord. 2012;12:120.CrossRefPubMedPubMedCentral Murray J, Craigs CL, Hill KM, Honey S, House A. A systematic review of patient reported factors associated with uptake and completion of cardiovascular lifestyle behaviour change. BMC Cardiovasc Disord. 2012;12:120.CrossRefPubMedPubMedCentral
39.
go back to reference Public Health England. NHS health check programme standards: a framework for quality improvement. London: Crown; 2014. 12-6-0014. Public Health England. NHS health check programme standards: a framework for quality improvement. London: Crown; 2014. 12-6-0014.
Metadata
Title
Patients’ willingness to attend the NHS cardiovascular health checks in primary care: a qualitative interview study
Authors
Caroline E Jenkinson
Anthea Asprey
Christopher E Clark
Suzanne H Richards
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Primary Care / Issue 1/2015
Electronic ISSN: 2731-4553
DOI
https://doi.org/10.1186/s12875-015-0244-7

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