Non-participation in a targeted prevention program aimed at lifestyle-related diseases: a questionnaire-based assessment of patient-reported reasons

Abstract

Background Having an unhealthy lifestyle is associated with a higher risk of developing lifestyle-related diseases. Current evidence suggests that interventions targeting health-risk behaviors can help people improve their lifestyles and prevent lifestyle-related diseases. However, preventive programs are often challenged by low participation rates. Reasons for non-participation include lack of time and/or interest, and/or no perceived need for lifestyle intervention. This study explores causes for non-participation in a sample of people who chose not to take up a targeted preventive program (TOF pilot2 study). Patient-reported reasons as well as sociodemographic characteristics and lifestyle factors are in focus. Methods A total of 4633 patients from four Danish GP clinics received an invitation to take part in the TOF pilot2 study. Patients who chose not to participate in the TOF pilot2 study were asked to fill in a questionnaire concerning reasons for non-participation, lifestyle, BMI and self-rated health. Descriptive analyses were used to summarize the results. Results A total of 2462 patients (53.1%) chose not to participate in the TOF pilot2 study. Among these, 84 (3.4%) answered the full questionnaire on reasons for not participating, lifestyle, BMI and self-rated health. The most common reasons for non-participation were lack of time, having an already healthy lifestyle, and feeling healthy. Based on their self-reported lifestyle 45 (53.6%) of the non-participants had one or more health-risk behaviors including smoking, unhealthy diet, BMI ≥ 35 and/or sedentary lifestyle and were therefore eligible to receive the targeted intervention at the GP or the MHC in the original TOF pilot2 study. Conclusion When planning future preventive programs it is important to know the main reasons for patients to not participate. This study provides rare insight into why people opt out of health interventions and advances the evidence base in this area. Our results may inform efforts to better involve these patients in preventive health programs. Trial registration Trial registration number: NCT02797392.

Patients’ perspectives on adherence to cardiovascular screening consultation and lifestyle changes

“…Previous studies on non-participation in lifestyle related-interventions or prevention programs have found that a reason for non-participation is lack of time [ 22 – 25 ]. This may be due to a busy schedule, where work and the extensiveness of the program may be a barrier [ 25 ]. After participating in this study, a few participants declined further follow-up.…”

“…There is limited knowledge on non-participation in lifestyle intervention and preventive programs, especially in patients with RA. Previous studies on non-participation in lifestyle related-interventions or prevention programs have found that a reason for non-participation is lack of time [22][23][24][25]. This may be due to a busy schedule, where work and the extensiveness of the program may be a barrier [25].…”

An online, two-day educational seminar had no impact on disease-specific knowledge in patients with systemic sclerosis

“…Several observations can be derived from these studies: Firstly, while focus groups on the conception of these interventions regularly stated a high level of informational need, an increase in disease-specific knowledge was seldom evaluated 12 , 13 , 15 . Secondly, simply providing information material is not sufficient to get participants involved with the topic 14 , 16 , while in comprehensive in-person programs, time investment and travel distance are reasons for non-participation for many potential participants 15 , 17 , 18 . Lastly, observational study designs were used, presumably due to small cohort sizes, and randomized controlled studies evaluating patient education in SSc are lacking.…”