Iris Groenenberg1, Mathilde R Crone2, Sandra van Dijk3, Winnifred A Gebhardt4, Jamila Ben Meftah5, Barend J C Middelkoop6, Anne M Stiggelbout7, Willem J J Assendelft8. 1. Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands. Electronic address: i.groenenberg@lumc.nl. 2. Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands. Electronic address: m.r.crone@lumc.nl. 3. Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands. Electronic address: s.van_dijk@lumc.nl. 4. Department of Health, Medical, and Neuropsychology, Leiden University, Leiden, The Netherlands. Electronic address: gebhardt@fsw.leidenuniv.nl. 5. Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands. Electronic address: j.ben_meftah@lumc.nl. 6. Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands. Electronic address: b.j.c.middelkoop@lumc.nl. 7. Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands. Electronic address: a.m.stiggelbout@lumc.nl. 8. Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands; Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, The Netherlands. Electronic address: w.assendelft@elg.umcn.nl.
Abstract
OBJECTIVE: Exploring determinants influencing vulnerable groups regarding (non-) participation in the Dutch two-stage cardiometabolic health check, comprising a health risk assessment (HRA) and prevention consultations (PCs) for high-risk individuals. METHODS: Qualitative study comprising 21 focus groups with non-Western (Surinamese, Turkish, Moroccan) immigrants aged 45-70, adult children from one of these descents, native Dutch with a lower socioeconomic status, and healthcare professionals working with these groups. RESULTS: Reasons for not completing the HRA included (flawed) risk perceptions, health negligence, (health) illiteracy, and language barriers. A face-to-face invitation from a reliable source and community outreach to raise awareness were perceived as facilitating participation. Reasons for not attending the PCs overlapped with completing the HRA but additionally included risk denial, fear about the outcome, its potential consequences (lifestyle changes and medication prescription), and disease-related stigma. CONCLUSION: Reasons for not completing the HRA were mainly cognitive, whereas reasons for not attending the PCs were also affective. PRACTICE IMPLICATIONS: When designing a two-stage health check, choice of invitation method seems important, as does training healthcare professionals in techniques to effectively handle patients' (flawed) risk perceptions and attitudinal ambivalence. Focus should be on promoting informed choices by providing accurate information.
OBJECTIVE: Exploring determinants influencing vulnerable groups regarding (non-) participation in the Dutch two-stage cardiometabolic health check, comprising a health risk assessment (HRA) and prevention consultations (PCs) for high-risk individuals. METHODS: Qualitative study comprising 21 focus groups with non-Western (Surinamese, Turkish, Moroccan) immigrants aged 45-70, adult children from one of these descents, native Dutch with a lower socioeconomic status, and healthcare professionals working with these groups. RESULTS: Reasons for not completing the HRA included (flawed) risk perceptions, health negligence, (health) illiteracy, and language barriers. A face-to-face invitation from a reliable source and community outreach to raise awareness were perceived as facilitating participation. Reasons for not attending the PCs overlapped with completing the HRA but additionally included risk denial, fear about the outcome, its potential consequences (lifestyle changes and medication prescription), and disease-related stigma. CONCLUSION: Reasons for not completing the HRA were mainly cognitive, whereas reasons for not attending the PCs were also affective. PRACTICE IMPLICATIONS: When designing a two-stage health check, choice of invitation method seems important, as does training healthcare professionals in techniques to effectively handle patients' (flawed) risk perceptions and attitudinal ambivalence. Focus should be on promoting informed choices by providing accurate information.
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