Department of Clinical Sciences, Danderyd University Hospital, Karolinska Institutet, Stockholm, Sweden.
Department of Research and Development, Region Halland, Halmstad, Sweden.
J Med Screen. 2021 Mar;28(1):3-9. doi: 10.1177/0969141320908316. Epub 2020 Mar 30.
In the first STROKESTOP atrial fibrillation screening study, participation was influenced by socio-demographic and geographic factors. To improve uptake in the second study, two screening sites were added, closer to low-income neighbourhoods which had very low participation in the first study. This paper aims to analyse the geographic and socio-demographic disparities in uptake in the second trial and compare the results with the first trial.
Inhabitants of the Stockholm region born in 1940 and 1941 were randomised 1:1 to be invited to screening or serve as controls. Medical history, blood samples and single-lead-ECG were collected. Invitee's residential parish was used for geo-mapping analysis of the geographical disparities in participation, using hierarchical Bayes methods. Individual data for participants and non-participants were obtained for the socioeconomic variables: educational level, disposable income, immigrant and marital status.
Higher participation was observed in those with higher education, high income, among non-immigrants and married individuals. Participation between the first and second studies improved significantly, where additional screening sites were introduced. These improvements were generally significant, in each population group according to socio-demographic characteristics.
Decentralisation of screening sites in an atrial fibrillation screening program yielded a significantly positive impact on screening uptake. Adding local screening sites in areas with low uptake had beneficial impact on participation across a wide spectrum of socio-demographic groups. Decentralised screening substantially increased the screening uptake in deprived areas.
在首个 STROKESTOP 心房颤动筛查研究中，参与情况受到社会人口和地理因素的影响。为了在第二项研究中提高参与率，增加了两个更接近低收入社区的筛查点，这些社区在第一项研究中的参与率非常低。本文旨在分析第二项试验中参与率的地理和社会人口差异，并将结果与第一项试验进行比较。
斯德哥尔摩地区 1940 年和 1941 年出生的居民被随机分为 1:1 组，邀请他们参加筛查或作为对照组。收集了病史、血液样本和单导联心电图。利用分层贝叶斯方法，根据居住的教区对参与情况的地理差异进行地理映射分析。对于参与者和非参与者的社会经济变量，获得了个人数据：教育水平、可支配收入、移民和婚姻状况。
在受教育程度较高、收入较高、非移民和已婚人群中，参与率较高。引入额外的筛查点后，第一和第二项研究之间的参与率显著提高。这些改进在根据社会人口特征划分的每个人群组中通常都是显著的。
心房颤动筛查计划中的筛查点分散化对筛查参与率产生了显著的积极影响。在参与率较低的地区增加当地的筛查点对广泛的社会人口群体的参与率产生了有益的影响。分散化筛查大大增加了贫困地区的筛查参与率。
