Involving people with type 2 diabetes in facilitating participation in a cardiovascular screening programme

Abstract

Background Knowledge is lacking about how to increase uptake among people with type 2 diabetes (T2D) invited to preventive initiatives like cardiovascular screening. Aim To explore how to improve participation of people with T2D in cardiovascular screening using patient and public involvement (PPI). Methods Patient and public involvement was included in a qualitative research design. From April to October 2019, we invited 40‐ to 60‐year‐old people with T2D (n = 17) to individual consultative meetings, using an interviewing approach. Before the interviews, participants were asked to read a proposed invitation letter to be used in a cardiovascular screening programme. Inductive content analysis was undertaken. Results Participants considered cardiovascular screening important and beneficial from both a personal and social perspective. We found that the relational interaction between the person with T2D and the health‐care professional was key to participation and that nudging captured through the design of the screening programme and the wording of the invitation letter was requested. Conclusion In preventive initiatives perceived as meaningful by the invitee, a focus on recruitment is crucial to facilitate participation. This study contributed with knowledge about how to promote participation by involving health‐care professionals in recruitment initiatives and through nudging. This knowledge may assist researchers, policymakers and ethicists' understanding and assessment of the ethical appropriateness and public acceptability of nudging in cardiovascular screening. Patient or public contribution By consulting 17 people with T2D, we are now in a position to suggest how a screening initiative should be altered because tools to improve uptake have been identified.

Arabic‐speaking male immigrants' perceptions of preventive initiatives: An interview study

“…At the structural level, we suggest that prevention initiatives be designed by involving representatives from vulnerable groups. Public involvement is an acknowledged approach to improving the quality and relevance of healthcare alongside improving information readability and facilitating participation 32–34 . At the health professional level, we recommend formal training to facilitate person‐centred care that is sensitive to health literacy, including basic assumptions.…”

“…Public involvement is an acknowledged approach to improving the quality and relevance of healthcare alongside improving information readability and facilitating participation. 32 , 33 , 34 At the health professional level, we recommend formal training to facilitate person‐centred care that is sensitive to health literacy, including basic assumptions. At an individual level, health literacy also includes the ability to critically appraise health information; an ability we find likely to be inadequate amongst older immigrants.…”

Understanding Nonattendance among Women Invited to a Cardiovascular Preventive Initiative

“…People in Denmark are assigned a GP, who may appear to be a natural person to speak with. Furthermore, patients with diabetes have stated that receiving personal support from a trusted care provider may help them begin cardiovascular screening [28]. Ethically, GPs may play an important role in assisting invitees in making decisions based on facts rather than their personal feelings, and they should ensure that the conclusion they make is in line with what the person wants.…”

Understanding Nonattendance among Women Invited to a Cardiovascular Preventive Initiative - A Supplementary Analysis of Nonattendees’ Perspectives

“…In Denmark, citizens are registered with a specific GP, who may be an obvious person to involve. Moreover, people with diabetes have suggested that accepting cardiovascular screening may be facilitated by personal encouragement from a trusted treatment provider [28]. Ethically, GPs may also be vital in supporting invitees to make a decision based on an informed choice rather than inner logics and in ensuring that the decision is in accordance with the individual's preferences.…”

“…Ethically, GPs may also be vital in supporting invitees to make a decision based on an informed choice rather than inner logics and in ensuring that the decision is in accordance with the individual's preferences. Moreover, involving the invitees in designing the screening invitation may be beneficial in terms of improving the readability and communicating its relevance [28]. As such public involvement may be a way to make screening emotionally and cognitively meaningful and thereby facilitate screening acceptability and encourage participation.…”