General Practice & Primary Care Research Unit, University of Cambridge, Institute of Public Health, Forvie Site, Robinson Way, Cambridge CB2 2SR, UK.
Public Health. 2011 Sep;125(9):645-52. doi: 10.1016/j.puhe.2011.05.010. Epub 2011 Jul 20.
To test whether information about benefits and harms of screening for type 2 diabetes increases intentions to make lifestyle changes amongst attenders, predominantly among the socially advantaged and those with a strong future time orientation.
Planned subgroup analysis of attenders for screening participating in a randomized controlled trial of an informed choice invitation vs a standard invitation to attend for type 2 diabetes screening.
Potentially eligible participants were identified from practice registers using routine data which were used to calculate risk scores for diabetes for all aged 40-69 years without known type 2 diabetes and area deprivation based on post code. In total, 1272 individuals in the top 25% risk category were randomized to receive one of two invitations to attend their practices for screening: an informed choice invitation or a standard invitation. The subsequent attenders completed self-report measures of future time orientation and deprivation immediately before undergoing a screening test.
Individual-level deprivation demonstrated a significant moderator effect [F (4,635) = 4.32, P = 0.002]: individuals who were high in deprivation had lower intentions to engage in lifestyle change following receipt of the informed choice invitation. However, intentions were not patterned by deprivation when it was assessed at the area-level using the Index of Multiple Deprivation 2007. The hypothesized moderating effect of future time orientation on invitation type was also supported [F(14,613) = 2.46, P = 0.002): individuals low in future time orientation had markedly lower intentions to engage in lifestyle change following receipt of an informed choice invitation compared with a standard invitation for screening.
Efforts to enhance informed choice where the implications of diagnosis are a requirement for lifestyle change may require that the immediate benefits are communicated, and efforts to address the apparent barriers to diabetes self-care are made, if the potential for inequity is to be avoided.
检验有关 2 型糖尿病筛查的获益和危害的信息是否会增加参与者改变生活方式的意愿，尤其是在社会地位较高和未来时间取向较强的人群中。
对参加一项关于知情选择邀请与标准邀请参加 2 型糖尿病筛查的随机对照试验的参与者进行计划的亚组分析。
使用常规数据从实践登记处确定潜在的合格参与者，这些数据用于计算所有年龄在 40-69 岁之间、无已知 2 型糖尿病且基于邮政编码的地区贫困程度的糖尿病风险评分。共有 1272 名处于最高 25%风险类别的个体被随机分配接受两种参加实践筛查的邀请之一：知情选择邀请或标准邀请。随后的参与者在接受筛查测试之前立即完成关于未来时间取向和贫困程度的自我报告测量。
个体层面的贫困程度显示出显著的调节作用[F(4,635) = 4.32, P = 0.002]：处于贫困程度较高的个体在收到知情选择邀请后改变生活方式的意愿较低。然而，当使用 2007 年多因素剥夺指数在区域层面评估贫困程度时，其意愿并没有表现出模式。未来时间取向对邀请类型的假设调节作用也得到了支持[F(14,613) = 2.46, P = 0.002]：未来时间取向较低的个体在收到知情选择邀请后改变生活方式的意愿明显低于收到标准筛查邀请。
如果要避免不平等的潜在风险，那么在需要改变生活方式才能确诊的情况下，增强知情选择的努力可能需要传达即时的益处，并努力解决糖尿病自我护理的明显障碍。
