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Factors Influencing Non-Participation in Cardiometabolic Risk Assessment and Treatment Program

This study explores the reasons why individuals do not participate in a cardiometabolic risk assessment and treatment program in general practice. It examines the relationship between non-participation and risk factors. The findings suggest that patients at high risk are more likely to feel unhealthy, expect high risk, and be afraid of test results. However, overall, a majority of individuals are willing to adjust their lifestyle for better health. Alternative methods of invitation will be tested in future studies.

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Factors Influencing Non-Participation in Cardiometabolic Risk Assessment and Treatment Program

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  1. Reasons for persons not to participate in a cardiometabolic risk assessment and treatment program in general practice M Nielen A Drijkoningen M Hollander I Badenbroek D Stol Prof. N de Wit Prof. F Schellevis WONCA 2016

  2. Increasing number cardio-metabolic diseases • Overlapping lifestyle-related risk factors: • Overweight • Unhealthy diet • Physical inactivity • Smoking • Population-based prevention strategies needed to prevent future problems! Background

  3. Low risk Lifestyle advice Questionnaire: - Smoking - Family history CVD - Age - Gender - Waist circumference - BMI ‘Healthy population’ 45-70 years old Tailor-made Lifestyle advice + local prevention programs Intermediate risk High risk PREVENTIVE CONSULTATION 1 • Check questionnaire + talk about risk • Measure risk factors • Referral to lab PREVENTION CONSULTATION 2 • Make up risk profile • Assess lifestyle • Risk communication, advice Treatment in primary care + local programs according to: • Guideline and disease management programs on CVD, Diabetes and Chronic Kidney Diseases • Smoking cessation; Physical exercise; Healthy nutrition Prevention Consultation CMD

  4. Effectiveness determined by participation rates! • Objective: • To study factors that are related to non-response for this prevention program • Used methods • 15 out of 38 participating INTEGRATE practices • Non-response questionnaire after two invitations • Reasons for non-participation & risk factors Aim & Methods

  5. Response

  6. Reasons for not participating

  7. Risk factors: response vs non-response P=0.06 P<0.05

  8. High risk individuals: • Feel less often healthy (OR=0.2) • Expect more often to have a high risk (OR=6.4) • More often afraid for results of test (OR=7.5) • In general: • 75% is ‘willing to adjust lifestyle if that is necessary for my health’ •  Other methods to approach participants? Statements

  9. Participation with other invitation methods?

  10. Participation in the CMD risk assessment and treatment program can be increased • Patients with risk factors realise that they have an elevated risk and are willing to participate • Inviting patients at risk during the consultation is probably a good alternative • Alternative methods of invitation will be tested in the INTEGRATE project Conclusions

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