A sample of 1570 men and women aged 20-45 years registered with an inner-city Cardiff practice were offered the opportunity by their general practitioner to have a health check at the surgery. The demographic characteristics, attitudes, beliefs and preventive health behaviour and past contact with the practice were compared for a sample of 259 non-attenders and 216 attenders. The results showed that attenders were generally better educated, better motivated to look after their health, had fewer ties and commitments, performed more healthapproved practices, had had more recent contact with their own practice and accepted the legitimacy of a general practitioner's interest in his patients' lifestyle. Offering cohorts of patients additional screening services is unlikely to be efficient or effective since it is the low-risk people already known to the doctor who are most likely to attend. The onus lies on primary health care to provide services in a way which permits appropriate screening of the high-risk groups as they attend for other reasons.

Adult↗

PubMed1988

Invitation to attend a health check in a general practice setting: the views of a cohort of non-attenders.

Two hundred and fifty-nine men and women aged 20-45 years who did not respond to an offer from their general practitioner for a health check were interviewed at home to explore the reasons for non-response. There was no support for the view that the invitation aroused anxiety or that the administrative arrangements had been a barrier to acceptance. Many subjects were not really interested (44%) or just forgot to attend (24%). Crises at work or home (26%) and current attendance at a doctor (16%) were other reasons offered, while 11% felt screening to be in appropriate. There is little that can be done to change these rates except by a shift of public opinion to more consumer demand for health checks or by more opportunistic health checks when people attend their doctors for other reasons. The dangers of marketing health checks to increase consumer demand are discussed in the light of these findings and other work.

Adult↗

PubMedDate not supplied

The effectiveness of one-to-one risk communication interventions in health care: a systematic review.

OBJECTIVES: To assess whether risk-communication interventions are associated with changes in patient knowledge, attitudes, and behaviors, and to identify aspects of these interventions that modify these effects. DESIGN: Systematic review. DATA SOURCES: 96 studies from the period 1985-1996 retrieved by electronic searching of eight databases, hand searching of four journals, contacting key authors, and reference list searching. MAIN OUTCOME MEASURES: The effect size of the principal outcome was identified from each study. Outcomes measuring behavioral change were preferred; if these were not available, knowledge, anxiety, or risk perceptions were used, according to the focus of the study. Data were available to calculate the principal effect sizes for 82 of the studies. ANALYSIS: Meta-regression. RESULTS: The methodologic qualities of the studies varied. Nevertheless, risk-communication interventions generally had positive (beneficial) effects. Interventions addressing treatment choices were associated with larger effects than were those in other contexts, such as prevention or screening. Interventions using individual risk estimates were associated with larger effects than were those using more general risk information. Two design variables were identified as effect modifiers: randomized controlled trials were associated with smaller effects than other designs, and dichotomous outcomes were associated with larger effects than continuous outcomes. CONCLUSIONS: Risk communication interventions may be most productive if they include individual risk estimates in the discussion between professional and patient. Patient decisions about treatment appear more amenable to change by these interventions than attendance for screening or modification of risky behavior.

Communication↗