Engagement with advice to reduce cardiovascular risk following a health check programme: A qualitative study

• Main Authors: Samah Alageel, Martin C. Gulliford, Alison Wright, Bernadette Khoshaba, Caroline Burgess
• Format: Article
• Language: English
• Published: Wiley 2020-02-01
• Series: Health Expectations
• Subjects: cardiovascular disease; cardiovascular prevention; NHS Health Check; qualitative research
• Online Access: https://doi.org/10.1111/hex.12991
• ISSN: 1369-6513; 1369-7625

Abstract Background The success of a cardiovascular health check programme depends not only on the identification of individuals at high risk of cardiovascular disease (CVD) but also on reducing CVD risk. We examined factors that might influence engagement and adherence to lifestyle change interventions and medication amongst people recently assessed at medium or high risk of CVD (>10% in the next 10 years). Method Qualitative study using individual semi‐structured interviews. Data were analysed using the Framework method. Results Twenty‐two participants (12 men, 10 women) were included in the study. Four broad themes are described: (a) the meaning of ‘risk’, (b) experiences with medication, (c) attempts at lifestyle change, and (d) perceived enablers to longer‐term change. The experience of having a health check was mostly positive and reassuring. Although participants may not have understood precisely what their CVD risk meant, many reported efforts to make lifestyle changes and take medications to reduce their risk. Individual’s experience with medications was influenced by family, friends and the media. Lifestyle change services and family and friends support facilitated longer‐term behaviour change. Conclusions People generally appear to respond positively to having a CVD health check and report being motivated towards behaviour change. Some individuals at higher risk may need clearer information about the health check and the implications of being at risk of CVD. Concerns over medication use may need to be addressed in order to improve adherence. Strategies are required to facilitate engagement and promote longer‐term maintenance with lifestyle changes amongst high‐risk individuals.