Social Dimensions of Health Institute, 11 Airlie Place, University of Dundee, Dundee, UK.
BMC Public Health. 2012 Aug 31;12:723. doi: 10.1186/1471-2458-12-723.
General and preventive health checks are a key feature of contemporary policies of anticipatory care. Ensuring high and equitable uptake of such general health checks is essential to ensuring health gain and preventing health inequalities. This literature review explores the socio-demographic, clinical and social cognitive characteristics of those who do and do not engage with general health checks or preventive health checks for cardiovascular disease.
An exploratory scoping study approach was employed. Databases searched included the British Nursing Index and Archive, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Database of Systematic Reviews (CDSR) and Database of Abstracts of Reviews of Effects (DARE), EMBASE, MEDLINE, PsycINFO and the Social Sciences Citation Index (SSCI). Titles and abstracts of 17463 papers were screened; 1171 papers were then independently assessed by two researchers. A review of full text was carried out by two of the authors resulting in 39 being included in the final review.
Those least likely to attend health checks were men on low incomes, low socio-economic status, unemployed or less well educated. In general, attenders were older than non-attenders. An individual's marital status was found to affect attendance rates with non-attenders more likely to be single. In general, white individuals were more likely to engage with services than individuals from other ethnic backgrounds. Non-attenders had a greater proportion of cardiovascular risk factors than attenders, and smokers were less likely to attend than non-smokers. The relationship between health beliefs and health behaviours appeared complex. Non-attenders were shown to value health less strongly, have low self-efficacy, feel less in control of their health and be less likely to believe in the efficacy of health checks.
Routine health check-ups appear to be taken up inequitably, with gender, age, socio-demographic status and ethnicity all associated with differential service use. Furthermore, non-attenders appeared to have greater clinical need or risk factors suggesting that differential uptake may lead to sub-optimal health gain and contribute to inequalities via the inverse care law. Appropriate service redesign and interventions to encourage increased uptake among these groups is required.
一般和预防保健检查是当代预期保健政策的一个关键特征。确保高比例和公平地接受此类一般健康检查对于确保健康收益和预防健康不平等至关重要。本文献综述探讨了那些参与和不参与一般健康检查或心血管疾病预防保健检查的人的社会人口学、临床和社会认知特征。
采用探索性范围研究方法。搜索的数据库包括英国护理索引和档案、护理和相关健康文献累积索引 (CINAHL)、 Cochrane 系统评价数据库 (CDSR) 和效应摘要数据库 (DARE)、EMBASE、MEDLINE、PsycINFO 和社会科学引文索引 (SSCI)。筛选了 17463 篇论文的标题和摘要；然后由两名研究人员独立评估了 1171 篇论文。两名作者对全文进行了审查，最终有 39 篇论文被纳入最终审查。
最不可能参加健康检查的人是收入低、社会经济地位低、失业或受教育程度低的男性。一般来说，参加者比不参加者年龄更大。一个人的婚姻状况被发现会影响出勤率，不参加者更有可能单身。一般来说，白人比其他族裔背景的人更有可能使用服务。不参加者比参加者有更多的心血管危险因素，吸烟者比不吸烟者更不可能参加。健康信念和健康行为之间的关系似乎很复杂。不参加者被认为对健康的重视程度较低，自我效能感较低，对健康的控制感较低，并且不太相信健康检查的效果。
常规健康检查的参与似乎不公平，性别、年龄、社会人口统计学地位和种族都与服务使用的差异有关。此外，不参加者似乎有更大的临床需求或风险因素，这表明差异参与可能导致健康收益不佳，并通过逆向医疗保健法导致不平等。需要对这些群体进行适当的服务重新设计和干预，以鼓励更多的参与。
