Unwillingness to participate in health checks for cardiometabolic diseases: A survey among primary health care patients in five European countries

Abstract

Background and aims: Since cardiometabolic diseases (CMD) are a frequent cause of death worldwide, preventive strategies are needed. Recruiting adults for a health check could facilitate the identification of individuals at risk for CMD. For successful results, participation is crucial. We aimed to identify factors related to unwillingness to participate in CMD health checks.

Methods: We performed a cross-sectional study in the Czech Republic, Denmark, Greece, the Netherlands, and Sweden. A questionnaire was distributed among persons without known CMD consulting general practice between January and July 2017 within the framework of the SPIMEU study.

Results: In total, 1354 persons responded. Nine percent was unwilling to participate in a CMD health check. Male gender, smoking, higher self-rated health, never been invited before, and not willing to pay were related to unwillingness to participate. The most mentioned reason for unwillingness to participate was "I think that I am healthy" (57%). Among the respondents who were willing to participate, 94% preferred an invitation by the general practitioner and 66% was willing to pay.

Conclusion: A minority of the respondents was unwilling to participate in a CMD health check with consistent results within the five countries. This provides a promising starting point to increase participation in CMD health checks in primary care.

Keywords: cardiometabolic disease; cardiovascular disease; health check; prevention; willingness to participate.

FIGURE 1

Odds ratios of factors associated with unwillingness to participate in a cardiometabolic health check. Age 55 and younger, reference group: 56 and older. Male, reference group: female. Low, middle education. Reference group: high education. Low: No education, primary school, middle: Secondary school/high‐school, high: Vocational training, University. Not (self) employed, reference group: self‐employed. Not (self) employed includes looking for work, not working because of poor health, fulltime house person, being retired, or being a student or other. Living alone, reference group: Living together: living with partner, children, and/or parents. BMI: Body mass index 25 and higher. Reference group: BMI below 25. Currently smoking at least one cigarette per day Reference group: smoking in the past or not smoking. High physical activity: ≥5 days/week ≥30 min. Reference group: low physical activity, <5 days/week. No family history of CVD/DMII, Reference group: family history of CVD/diabetes CVD: cardiovascular disease, onset before the age of 60, DM II: type 2 diabetes mellitus. Good self‐rated health: >7. Reference group: self‐rated health below median ≤ 7. Scale from 1 to 10, 1 very bad health 10 very good health