Faculty of Medicine and Health, Institute for Musculoskeletal Health, Sydney School of Public Health, The University of Sydney and Sydney Local Health District, Sydney, NSW, Australia.
Wiser Healthcare, Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia.
Health Expect. 2021 Apr;24(2):648-658. doi: 10.1111/hex.13211. Epub 2021 Feb 18.
Community awareness of the harms of overdiagnosis remains low.
To evaluate community responses to a public health campaign designed for health service waiting rooms that focuses on the harms of unnecessary diagnostic imaging for low back pain.
We conducted two focus groups of 19 community members with or without low back pain in Sydney, Australia. This study formed the fourth and final stage of the development process of a public health campaign: (a) initial design, (b) expert review and revision, (c) online experiment and (d) community views & revision. We evaluated reactions to components of the campaign that included digital posters and an information leaflet using strong imagery and messaging about the risk of overdiagnosis. We conducted a qualitative thematic analysis to identify main themes.
Community members reacted with surprise, initial mistrust, and occasionally anger towards imagery and messaging that suggested diagnostic imaging tests could be unnecessary and harmful. With further reflection and discussion, and after reading longer format information about overdiagnosis, the participants found some of the messages informative and useful. Participants appeared to gain a better understanding of the concept of overdiagnosis and the importance of not rushing to imaging.
Public health campaigns including posters and leaflets displayed in waiting rooms could raise awareness about overuse of diagnostic imaging and the harms of overdiagnosis more broadly. However, negative reactions are possible and must be managed carefully.
We involved a community participation manager who provided advice on the focus group discussion guide, participant recruitment and manuscript presentation.
社区对过度诊断危害的认识仍然较低。
评估社区对一项公共卫生运动的反应，该运动针对的是卫生服务等候室，重点是不必要的诊断成像对腰痛的危害。
我们在澳大利亚悉尼进行了两组焦点小组讨论，每组 19 人，包括有或没有腰痛的人。这是一项公共卫生运动发展过程的第四和最后阶段：(a)初步设计，(b)专家审查和修订，(c)在线实验，(d)社区意见和修订。我们评估了对运动组成部分的反应，包括数字海报和信息传单，这些海报和传单使用了关于过度诊断风险的强烈图像和信息。我们进行了定性主题分析以确定主要主题。
社区成员对暗示诊断成像测试可能不必要和有害的图像和信息感到惊讶、最初的不信任，有时甚至愤怒。经过进一步的思考和讨论，并阅读了更多关于过度诊断的信息后，参与者发现其中一些信息很有启发性和有用。参与者似乎对过度诊断的概念和不急于进行成像的重要性有了更好的理解。
在候诊室中展示包括海报和传单在内的公共卫生运动可以提高人们对过度使用诊断成像和更广泛的过度诊断危害的认识。然而，可能会出现负面反应，必须谨慎处理。
我们邀请了一位社区参与经理，他就焦点小组讨论指南、参与者招募和论文陈述提供了建议。
