Department of Public Health, The Research Unit for General Practice and Section of General Practice, University of Copenhagen, Copenhagen, Denmark.
The Primary Health Care Research Unit, Zealand Region, Sorø, Denmark.
Eur J Public Health. 2023 Jun 1;33(3):509-514. doi: 10.1093/eurpub/ckad067.
Invitations to screening programmes may include influences that are intending to increase the participation rates. This study had two objectives: (i) to assess if different categories of influences had a significant effect on the intention to participate in a screening programme for a fictitious disease and (ii) whether participants were aware of the influences, and if the intention to participate was associated to this awareness.
A seven-armed randomized controlled trial. Six hundred passers-by were randomly allocated to receive one of seven pamphlets inviting to a fictitious screening programme (neutral, relative risk reductions, misrepresentation of harms, pre-booked appointment, recommendation of participation, fear appeals, all combined). Participants were surveyed to assess (i) intention to participate (ITP) in the screening programme and (ii) awareness of an exerted influence. Chi-squared test was used to calculate the effect of the influences on ITP and the association of ITP with indicating awareness of an exerted influence and correctly locating an influence.
Five hundred and eighty-nine participants were included for analysis. ITP was significantly increased (P < 0.05) in three pamphlets (misrepresentation of harms, fear appeals, all combined) [adjusted odds ratio (OR) 4.84, 95% confidence interval (CI): 2.54-9.23; OR 2.45, 95% CI: 1.31-4.59; OR 9.02, 95% CI: 4.44-18.34]. A percentage of 60.0-78.3 participants did not indicate awareness. Awareness was associated with a decreased ITP for those who could locate the influence (OR 0.39, 95% CI: 0.21-0.72) and those who failed to locate the influence (OR 0.47, 95% CI: 0.30-0.74).
The application of influences should be carefully considered for interventions where an informed choice is desired.
邀请参加筛查项目可能包括旨在提高参与率的各种影响因素。本研究有两个目的：（i）评估不同类别的影响因素是否对参加虚构疾病筛查项目的意愿产生显著影响；（ii）参与者是否意识到这些影响因素，以及参与意愿是否与这种意识相关。
采用七臂随机对照试验。将 600 名过路人随机分配到七份邀请参加虚构筛查项目的小册子中（中性、相对风险降低、危害的错误陈述、预约、参与推荐、恐惧诉求、全部组合）。通过问卷调查评估（i）对筛查项目的参与意向（ITP）和（ii）对施加影响的意识。卡方检验用于计算影响因素对 ITP 的影响，以及 ITP 与表明对施加影响的意识和正确定位影响之间的关联。
589 名参与者被纳入分析。三种小册子（危害的错误陈述、恐惧诉求、全部组合）的 ITP 显著增加（P<0.05）[调整后的优势比（OR）4.84，95%置信区间（CI）：2.54-9.23；OR 2.45，95% CI：1.31-4.59；OR 9.02，95% CI：4.44-18.34]。60.0%-78.3%的参与者未表明意识到影响因素。对于那些能够定位影响因素的人（OR 0.39，95% CI：0.21-0.72）和那些未能定位影响因素的人（OR 0.47，95% CI：0.30-0.74），意识与降低的 ITP 相关。
在期望做出知情选择的干预措施中，应谨慎考虑应用影响因素。
