Jenkinson Caroline E, Asprey Anthea, Clark Christopher E, Richards Suzanne H
Primary Care Research Group, University of Exeter Medical School, Smeall Building, St Luke's Campus, Exeter, EX1 2 LU, UK.
BMC Fam Pract. 2015 Mar 8;16:33. doi: 10.1186/s12875-015-0244-7.
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.
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.
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.
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.
英国国民医疗服务体系心血管健康检查（NHSHC）项目于2009年在英格兰推出，旨在降低所有40至74岁患者的心血管疾病死亡率和发病率。该项目的成本效益基于75%的假定参与率，但目前基层医疗中参与率的估计不到50%。本研究的目的是确定影响患者参加NHSHC意愿的因素。对于已参加者，探讨了他们的观点、经历以及未来参与该项目的意愿。
对最近收到英格兰托贝四个全科诊所来信邀请参加NHSHC的患者进行电话或面对面访谈。患者按性别、年龄、参与状态进行有目的抽样。访谈进行录音，逐字转录并进行主题分析。
访谈了17名参加者和10名未参加者。参加NHSHC的患者认为该检查是值得的。对自身健康的积极态度、在出现症状前预防疾病的愿望以及接受筛查和健康检查邀请的意愿促使许多人参加。未参加者表示未将NHSHC视为优先事项，或者认为它与已接受的其他疾病常规监测不同，这是他们不参加的障碍。一些未参加者在感觉良好时会主动避开全科诊所，而另一些人则不想浪费医护人员的时间。对NHSHC内容的误解以及对可能结果的负面看法很常见。
虽然少数未参加者只是做出了明智的选择不参加NHSHC，但提高邀请材料的清晰度和简洁性、加强宣传以及发送提醒信等简单行政干预措施，有很大潜力提高NHSHC的参与率。
