The effects of infographics and several quantitative versus qualitative formats for cardiovascular disease risk, including heart age, on people’s risk understanding

Damman, Olga C.; Vonk, S E M; Haak, Maaike J. van den; Hooijdonk, C.M.J. van; Timmermans, Daniëlle R.M.

doi:10.1016/j.pec.2018.03.015

Cited by 38 publications

(34 citation statements)

References 36 publications

(51 reference statements)

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“…Soureti et al 26 found that the intention to change lifestyle behavior was higher in those receiving risk information as heart age compared with percent risk, and others support that heart age, compared to other risk visualization tools, positively influence risk recall and behaviors. 27 Communicating risk as heart age might however not be as effective if used in a low-risk population. 21 In line with this, we found that the average heart age barely exceeded chronological age (4.2 years), and a tendency to slightly better effect on cholesterol reduction when the disparity between heart age and chorological age increased.…”

Section: Discussionmentioning

confidence: 99%

Evaluating the use of the heart age tool in community pharmacies: a 4-week cluster-randomized controlled trial

Svendsen

Jacobs

Mørch-Reiersen³

et al. 2020

European Journal of Public Health

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Background Joint British Societies have developed a tool that utilizes information on cardiovascular disease (CVD) risk factors to estimate an individual’s ‘heart age’. We studied if using heart age as an add-on to conventional risk communication could enhance the motivation for adapting to a healthier lifestyle resulting in improved whole-blood cholesterol and omega-3 status after 4 weeks. Methods A total of 48 community pharmacies were cluster-randomized to use heart age+conventional risk communication (intervention) or only conventional risk communication (control) in 378 subjects after CVD risk-factor assessment. Dried blood spots were obtained with a 4-week interval to assay whole-blood cholesterol and omega-3 fatty acids. We also explored pharmacy-staff’s (n=27) perceived utility of the heart age tool. Results Subjects in the intervention pharmacies (n=137) had mean heart age 64 years and chorological age 60 years. In these, cholesterol decreased by median (interquartile range) −0.10 (−0.40, 0.35) mmol/l. Cholesterol decreased by −0.20 (−0.70, 0.30) mmol/l (P difference =0.24) in subjects in the control pharmacies (n=120) with mean chronological age 60 years. We observed increased concentrations of omega-3 fatty acids after 4 weeks, non-differentially between groups. Pharmacy-staff (n=27) agreed that heart age was a good way to communicate CVD risk, and most (n=25) agreed that it appeared to motivate individuals to reduce elevated CVD risk factors. Conclusions The heart age tool was considered a convenient and motivating communication tool by pharmacy-staff. Nevertheless, communicating CVD risk as heart age was not more effective than conventional risk communication alone in reducing whole-blood cholesterol levels and improving omega-3 status.

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Section: Discussionmentioning

confidence: 99%

Evaluating the use of the heart age tool in community pharmacies: a 4-week cluster-randomized controlled trial

Svendsen

Jacobs

Mørch-Reiersen³

et al. 2020

European Journal of Public Health

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“…A number of FPs expressed some difficulty in getting their patients to understand their profile and level of risk for depression. That also happens, for example, in cardiovascular risk management [30]. How risk is communicated influences prevention [31], so improving clinicians’ skills to communicate it efficiently is a challenge that needs further evaluation.…”

Section: Discussionmentioning

confidence: 99%

Family physicians’ views on participating in prevention of major depression. The predictD-EVAL qualitative study

et al. 2019

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Background The predictD intervention, a multicomponent intervention delivered by family physicians (FPs), reduced the incidence of major depression by 21% versus the control group and was cost-effective. A qualitative methodology was proposed to identify the mechanisms of action of these complex interventions. Purpose To seek the opinions of these FPs on the potential successful components of the predictD intervention for the primary prevention of depression in primary care and to identify areas for improvement. Method Qualitative study with FPs who delivered the predictD intervention at 35 urban primary care centres in seven Spanish cities. Face-to-face semi-structured interviews adopting a phenomenological approach. The data was triangulated by three investigators using thematic analysis and respondent validation was carried out. Results Sixty-seven FPs were interviewed and they indicated strategies used to perform the predictD intervention, including specific communication skills such as empathy and the activation of patient resources. They perceived barriers such as lack of time and facilitators such as prior acquaintance with patients. FPs recognized the positive consequences of the intervention for FPs, patients and the doctor-patient relationship. They also identified strategies for future versions and implementations of the predictD intervention. Conclusions The FPs who carried out the predictD intervention identified factors potentially associated with successful prevention using this program and others that could be improved. Their opinions about the predictD intervention will enable development of a more effective and acceptable version and its implementation in different primary health care settings.

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“…However, there remain questions regarding its ability to improve CVD risk factors and lifestyle change intentions (13), and some patients question the credibility of heart age (17,39,40). Similar to QRISK2®, it is possible that practitioners do not fully understand what heart age means (i.e., the estimated age of someone of the same gender and ethnicity, and annual risk of a CVD event, but with optimal risk factors), but it is intuitive that an 'old heart age' is an undesirable outcome (41). Therefore, unlike QRISK2®, a superficial understanding of heart age might be adequate for an informed discussion of CVD risk.…”

Section: Comparison With Existing Literaturementioning

confidence: 99%

Cardiovascular disease risk communication in NHS Health Checks: a qualitative video-stimulated recall interview study with practitioners

et al. 2021

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BackgroundNHS Health Check (NHSHC) is a national programme to identify and manage cardiovascular disease (CVD) risk. Practitioners delivering the programme should be competent in discussing CVD risk, but there is evidence of limited understanding of the recommended 10 year/centage CVD risk scores. Lifetime CVD risk calculators might improve understanding and communication of risk.AimTo explore practitioner understanding, perceptions and experiences of CVD risk communication in NHSHCs when using two different CVD risk calculators.Design & settingQualitative video-stimulated recall (VSR) study with NHSHC practitioners.MethodVSR interviews were conducted with practitioners who delivered NHSHCs using either the QRISK2 10-year risk calculator (n=7) or JBS3 lifetime CVD risk calculator (n=8). Data were analysed using reflexive thematic analysis.ResultsFindings from analysis of VSR interviews with 15 practitioners (9 Healthcare Assistants, 6 General Practice Nurses) are presented by risk calculator. There was limited understanding and confidence of 10-year risk, which was used to guide clinical decisions through determining low/medium/high risk thresholds, rather than as a risk communication tool. Potential benefits of some JBS functions were evident, particularly heart age, risk manipulation and visual presentation of risk.ConclusionsThere is a gap between the expectation and reality of practitioners’ understanding, competencies and training in CVD risk communication for NHS Health Check. Practitioners would welcome heart age and risk manipulation functions of JBS3 to promote patient understanding of CVD risk, but there is a more fundamental need for practitioner training in CVD risk communication.

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The effects of infographics and several quantitative versus qualitative formats for cardiovascular disease risk, including heart age, on people’s risk understanding

Cited by 38 publications

References 36 publications

Evaluating the use of the heart age tool in community pharmacies: a 4-week cluster-randomized controlled trial

Evaluating the use of the heart age tool in community pharmacies: a 4-week cluster-randomized controlled trial

Family physicians’ views on participating in prevention of major depression. The predictD-EVAL qualitative study

Cardiovascular disease risk communication in NHS Health Checks: a qualitative video-stimulated recall interview study with practitioners

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