Larsen Lars Bruun, Sondergaard Jens, Thomsen Janus Laust, Halling Anders, Sønderlund Anders Larrabee, Christensen Jeanette Reffstrup, Thilsing Trine
Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense, Denmark.
Research Unit for General Practice, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
J Med Internet Res. 2019 Jan 21;21(1):e11658. doi: 10.2196/11658.
During recent years, stepwise approaches to health checks have been advanced as an alternative to general health checks. In 2013, we set up the Early Detection and Prevention project (Tidlig Opsporing og Forebyggelse, TOF) to develop a stepwise approach aimed at patients at high or moderate risk of a chronic disease. A novel feature was the use of a personal digital mailbox for recruiting participants. A personal digital mailbox is a secure digital mailbox provided by the Danish public authorities. Apart from being both safe and secure, it is a low-cost, quick, and easy way to reach Danish residents.
In this study we analyze the association between the rates of acceptance of 2 digital invitations sent to a personal digital mailbox and the sociodemographic determinants, medical treatment, and health care usage in a stepwise primary care model for the prevention of chronic diseases.
We conducted a cross-sectional analysis of the rates of acceptance of 2 digital invitations sent to randomly selected residents born between 1957 and 1986 and residing in 2 Danish municipalities. The outcome was acceptance of the 2 digital invitations. Statistical associations were determined by Poisson regression. Data-driven chi-square automatic interaction detection method was used to generate a decision tree analysis, predicting acceptance of the digital invitations.
A total of 8814 patients received an invitation in their digital mailbox from 47 general practitioners. A total of 40.22% (3545/8814) accepted the first digital invitation, and 30.19 % (2661/8814) accepted both digital invitations. The rates of acceptance of both digital invitations were higher among women, older patients, patients of higher socioeconomic status, and patients not diagnosed with or being treated for diabetes mellitus, chronic obstructive pulmonary disease, or cardiovascular disease.
To our knowledge, this is the first study to report on the rates of acceptance of digital invitations to participate in a stepwise model for prevention of chronic diseases. More studies of digital invitations are needed to determine if the acceptance rates seen in this study should be expected from future studies as well. Similarly, more research is needed to determine whether a multimodal recruitment approach, including digital invitations to personal digital mailboxes will reach hard-to-reach subpopulations more effectively than digital invitations only.
近年来，逐步健康检查方法已被提出作为一般健康检查的替代方案。2013年，我们设立了早期检测与预防项目（Tidlig Opsporing og Forebyggelse，TOF），以开发一种针对慢性病高风险或中度风险患者的逐步检查方法。一个新颖的特点是使用个人数字邮箱来招募参与者。个人数字邮箱是丹麦公共当局提供的安全数字邮箱。除了安全可靠外，它还是一种低成本、快速且简便的联系丹麦居民的方式。
在本研究中，我们分析了发送到个人数字邮箱的两份数字邀请的接受率与社会人口学决定因素、医疗治疗以及慢性病预防逐步初级保健模式中的医疗保健使用情况之间的关联。
我们对随机选择的1957年至1986年出生且居住在丹麦两个自治市的居民发送的两份数字邀请的接受率进行了横断面分析。结果是对两份数字邀请的接受情况。通过泊松回归确定统计关联。使用数据驱动的卡方自动交互检测方法生成决策树分析，预测数字邀请的接受情况。
共有8814名患者从47名全科医生处收到了数字邮箱中的邀请。共有40.22%（3545/8814）的患者接受了第一份数字邀请，30.19%（2661/8814）的患者接受了两份数字邀请。在女性、老年患者、社会经济地位较高的患者以及未被诊断患有或正在接受糖尿病、慢性阻塞性肺疾病或心血管疾病治疗的患者中，两份数字邀请的接受率更高。
据我们所知，这是第一项报告参与慢性病预防逐步模式的数字邀请接受率的研究。需要更多关于数字邀请的研究来确定本研究中看到的接受率是否也会出现在未来的研究中。同样，需要更多研究来确定包括向个人数字邮箱发送数字邀请在内的多模式招募方法是否比仅使用数字邀请更有效地覆盖难以接触到的亚人群。
