Experiences of patients and healthcare professionals of NHS cardiovascular health checks: a qualitative study

Riley, Ruth; Coghill, Nikki; Montgomery, Alan; Feder, Gene; Horwood, Jeremy

doi:10.1093/pubmed/fdv121

Cited by 34 publications

(52 citation statements)

References 25 publications

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“…Journal of Public Health. 2016;38:(3): 543–551 [ 36 ]. 28 patients and 16 HCPs Attend Deliver Patient behaviour change Interviews Riley, V.A., C. Gidlow, and N.J. Ellis, Uptake of NHS health check: issues in monitoring.…”

Section: Resultsmentioning

confidence: 99%

Influences on NHS Health Check behaviours: a systematic review

et al. 2020

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Background National Health Service Health Checks were introduced in 2009 to reduce cardiovascular disease (CVD) risks and events. Since then, national evaluations have highlighted the need to maximise the programme’s impact by improving coverage and outputs. To address these challenges it is important to understand the extent to which positive behaviours are influenced across the NHS Health Check pathway and encourage the promotion or minimisation of behavioural facilitators and barriers respectively. This study applied behavioural science frameworks to: i) identify behaviours and actors relevant to uptake, delivery and follow up of NHS Health Checks and influences on these behaviours and; ii) signpost to example intervention content. Methods A systematic review of studies reporting behaviours related to NHS Health Check-related behaviours of patients, health care professionals (HCPs) and commissioners. Influences on behaviours were coded using theory-based models: COM-B and Theoretical Domains Framework (TDF). Potential intervention types and behaviour change techniques (BCTs) were suggested to target key influences. Results We identified 37 studies reporting nine behaviours and influences for eight of these. The most frequently identified influences were physical opportunity including HCPs having space and time to deliver NHS Health Checks and patients having money to adhere to recommendations to change diet and physical activity. Other key influences were motivational, such as beliefs about consequences about the value of NHS Health Checks and behaviour change, and social, such as influences of others on behaviour change. The following techniques are suggested for websites or smartphone apps: Adding objects to the environment, e.g. provide HCPs with electronic schedules to guide timely delivery of Health Checks to target physical opportunity, Social support (unspecified), e.g. include text suggesting patients to ask a colleague to agree in advance to join them in taking the ‘healthy option’ lunch at work; Information about health consequences, e.g. quotes and/or videos from patients talking about the health benefits of changes they have made. Conclusions Through the application of behavioural science we identified key behaviours and their influences which informed recommendations for intervention content. To ascertain the extent to which this reflects existing interventions we recommend a review of relevant evidence.

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Section: Resultsmentioning

confidence: 99%

Influences on NHS Health Check behaviours: a systematic review

et al. 2020

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“…It also forms part of the routine tools used in the NHS Health Check interview in England, which is primarily undertaken by other healthcare professionals, rather than by GPs themselves. 11 One in four people say they would be more active if advised by a GP or nurse. 12 Health professional-led PA interventions are very effective, with brief advice for PA having a number needed to treat of 12, up to 10…”

Section: Introductionmentioning

confidence: 99%

GPs’ knowledge, use, and confidence in national physical activity and health guidelines and tools: a questionnaire-based survey of general practice in England

et al. 2017

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The majority of GPs in England (80%) are unfamiliar with the national PA guidelines. Awareness of the recommended tool for assessment, GPPAQ, is higher than use by GPs. This may be because it is used by other clinical staff, for example, as part of the NHS Health Check programme. Although brief advice in isolation by GPs on PA will only be a part of the behaviour change journey, it is an important prompt, especially if repeated as part of routine practice. This study highlights the need for significant improvement in knowledge, skills, and confidence to maximise the potential for PA advice in GP consultations.

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“…Welschen et al suggested that improvements in the perception of CVD risk did not influence patients’ attitudes and intentions to change their behaviour . The overall experience of attending the health check may have an impact on thinking about health and trigger behaviour change, regardless of CVD risk score . This might be explained by the population who take up the offer of a health check, where people who respond to the health check invitation might be more motivated to adopt a healthier lifestyle …”

Section: Discussionmentioning

confidence: 99%

Engagement with advice to reduce cardiovascular risk following a health check programme: A qualitative study

Alageel

Gulliford

Wright

et al. 2019

Health Expectations

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Background:The success of a cardiovascular health check programme depends not only on the identification of individuals at high risk of cardiovascular disease (CVD) but also on reducing CVD risk. We examined factors that might influence engagement and adherence to lifestyle change interventions and medication amongst people recently assessed at medium or high risk of CVD (>10% in the next 10 years).Method: Qualitative study using individual semi-structured interviews. Data were analysed using the Framework method.Results: Twenty-two participants (12 men, 10 women) were included in the study. Four broad themes are described: (a) the meaning of 'risk', (b) experiences with medication, (c) attempts at lifestyle change, and (d) perceived enablers to longer-term change. The experience of having a health check was mostly positive and reassuring.Although participants may not have understood precisely what their CVD risk meant, many reported efforts to make lifestyle changes and take medications to reduce their risk. Individual's experience with medications was influenced by family, friends and the media. Lifestyle change services and family and friends support facilitated longerterm behaviour change.Conclusions: People generally appear to respond positively to having a CVD health check and report being motivated towards behaviour change. Some individuals at higher risk may need clearer information about the health check and the implications of being at risk of CVD. Concerns over medication use may need to be addressed in order to improve adherence. Strategies are required to facilitate engagement and promote longer-term maintenance with lifestyle changes amongst high-risk individuals. K E Y W O R D Scardiovascular disease, cardiovascular prevention, NHS Health Check, qualitative research | INTRODUC TI ONCardiovascular disease (CVD) is a major cause of death globally 1 and accounts for around 160 000 deaths annually in the United Kingdom (UK). 2 A large proportion of CVD might be preventable through modification of behavioural risk factors (smoking, lack of physical activity) and taking preventive medication. There is evidence that multiple risk factor interventions for people without CVD, with or 194 | ALAGEEL Et AL.without pharmacological treatments, appear to have little impact on CVD risk and CVD risk factors 3,4 or on the risk of coronary heart disease mortality or morbidity. 5Evidence suggests that communicating information about disease risk to people is challenging and complex. 6 Risk information on its own is not effective and needs to be coupled with other intervention elements to promote healthy behaviour. 7 A systematic review of the literature of providing coronary risk information to adults suggested that whilst global risk information seems to improve the accuracy of risk perception, there is no evidence that risk perception translated into lifestyle changes. 7 Providing risk information to health-care providers appeared to increase medication prescribing, 7 but the evidence is unclear of the efficacy o...

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Experiences of patients and healthcare professionals of NHS cardiovascular health checks: a qualitative study

Cited by 34 publications

References 25 publications

Influences on NHS Health Check behaviours: a systematic review

Influences on NHS Health Check behaviours: a systematic review

GPs’ knowledge, use, and confidence in national physical activity and health guidelines and tools: a questionnaire-based survey of general practice in England

Engagement with advice to reduce cardiovascular risk following a health check programme: A qualitative study

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