Communicating Test Results from a General Health Check: Preferences from a Discrete Choice Experiment Survey

Abstract

Background: Health checks can detect risk factors and initiate prevention of cardiovascular diseases but there is no consensus on how to communicate the results. The aim of this study was to investigate the preferences of the general population for communicating health check results.

Methods: A randomly selected sample of the Swedish population aged 40-70 years completed a discrete choice experiment survey that included questions on sociodemographics, lifestyle and health and 15 choice questions consisting of six attributes (written results, notification method, consultation time, waiting time, lifestyle recommendation and cost). Data were analyzed with a latent class analysis (LCA). Relative importance of the attributes and predicted uptake for several scenarios were estimated.

Results: In the analysis, 432 individuals were included (response rate 29.6%). A three-class LCA model best fit the data. Cost was the most important attribute in all classes. Preferences heterogeneity was found for the other attributes; in Class 1, receiving consultation time and the written results were important, respondents in Class 2 dominated on costs and respondents in Class 3 found consultation time, waiting time and lifestyle recommendations to be important. Health literate respondents were more likely to belong to Class 3. The predicted uptake rates ranged from 7 to 88% for different health checks with large differences across the classes.

Conclusion: Cost was most important when deciding whether to participate in a health check. Although cost was the most important factor, it is not sufficient to offer health checks free-of-charge if other requirements regarding how the test results are communicated are not in place; participants need to be able to understand their results.

Figure 1

Example of a choice task. Note: this is a translation. The survey was administered in Swedish

Fig. 2

Relative importance scores of the attributes in all three classes

Fig. 3

Effect on ‘realistic scenario’ with one attribute level change*. *Change in predicted uptake if the ‘realistic scenario’ (average predicted uptake 66%) changed in one attribute level (written result in numerical and everyday words, notification through electronic health record and letter, 2 weeks waiting time, lifestyle recommendations included, 30-min consultation time, 300 SEK out-of-pocket cost)