Development of a questionnaire to evaluate patients’ awareness of cardiovascular disease risk in England’s National Health Service Health Check preventive cardiovascular programme

BackgroundThe National Health Service (NHS) Health Check is a cardiovascular disease (CVD) risk assessment and management programme in England aiming to increase CVD risk awareness among people at increased risk of CVD. There is no tool to assess the effectiveness of the programme in communicating CVD risk to patients.AimsThe aim of this paper was to develop a questionnaire examining patients’ CVD risk awareness for use in health service research evaluations of the NHS Health Check programme.MethodsWe developed an 85-item questionnaire to determine patients’ views of their risk of CVD. The questionnaire was based on a review of the relevant literature. After review by an expert panel and focus group discussion, 22 items were dropped and 2 new items were added. The resulting 65-item questionnaire with satisfactory content validity (content validity indices≥0.80) and face validity was tested on 110 NHS Health Check attendees in primary care in a cross-sectional study between 21 May 2014 and 28 July 2014.ResultsFollowing analyses of data, we reduced the questionnaire from 65 to 26 items. The 26-item questionnaire constitutes four scales: Knowledge of CVD Risk and Prevention, Perceived Risk of Heart Attack/Stroke, Perceived Benefits and Intention to Change Behaviour and Healthy Eating Intentions. Perceived Risk (Cronbach’s α=0.85) and Perceived Benefits and Intention to Change Behaviour (Cronbach’s α=0.82) have satisfactory reliability (Cronbach’s α≥0.70). Healthy Eating Intentions (Cronbach’s α=0.56) is below minimum threshold for reliability but acceptable for a three-item scale.ConclusionsThe resulting questionnaire, with satisfactory reliability and validity, may be used in assessing patients’ awareness of CVD risk among NHS Health Check attendees.

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Cardiovascular disease risk communication in NHS health checks: video-stimulated recall interviews with practitioners

BJGP Open ◽

10.3399/bjgpo.2021.0049 ◽

2021 ◽

pp. BJGPO.2021.0049

Author(s):

Christopher J. Gidlow ◽

Naomi Jane Ellis ◽

Victoria Riley ◽

Lisa Cowap ◽

Diane Crone ◽

...

Keyword(s):

Cardiovascular Disease ◽

Risk Communication ◽

Disease Risk ◽

Health Check ◽

Risk Calculator ◽

Cvd Risk ◽

Stimulated Recall ◽

Practitioner Training ◽

Nhs Health Check ◽

Heart Age

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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Understanding the influence of NHS Health Check Cardiovascular Disease (CVD) Risk Assessment Tools

http://isrctn.com/ ◽

10.1186/isrctn10443908 ◽

2017 ◽

Author(s):

Christopher Gidlow

Keyword(s):

Cardiovascular Disease ◽

Risk Assessment ◽

Health Check ◽

Assessment Tools ◽

Cvd Risk ◽

Risk Assessment Tools ◽

Nhs Health Check

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Comparison of Cardiovascular Disease Risks of Actual and Perceptions of Men’s that 40-65 Years Old

European Journal of Public Health ◽

10.1093/eurpub/ckz187.066 ◽

2019 ◽

Vol 29 (Supplement_4) ◽

Author(s):

İbrahim Topuz ◽

Sebahat Gozum

Keyword(s):

Blood Pressure ◽

Cardiovascular Disease ◽

High Risk ◽

Perceived Risk ◽

Risk Perceptions ◽

Smoking Status ◽

Cvd Risk ◽

Related Factors ◽

Risk Reducing ◽

Very High

Abstract Background Turkey is among the top countries in Europe in coronary mortality in the 45-74 age range. The highest death due to disorders of the circulatory system (50.8%) that is Amasya province. Objective Determine related factors and to compare with actual and perceived cardiovascular disease (CVD) risks of men aged 40-65 living in Amasya. Methods The sample size of cross-sectional and analytical study consisted of 400 people who met the inclusion criteria. Actual CVD risks of men were calculated using HeartScore. Age, systolic blood pressure, total cholesterol measured by blood taken from the capillary and smoking status were used to calculate CVD risk. Actual CVD risk in next decade has been calculated as low, medium, high or very high. Perceived CVD risk in next decade were identified by participants as low, medium, high and very high responses. They also questioned why evaluation of perceived risk. Results It was determined whereas 8.3% of the males had high, 52.5% had a very high level of CVD risk. The main variables affecting actual CVD risk; diastolic blood pressure, BMI and physical activity. 13.3% of males perceived CVD risks at high and 8% at very high. The main variables affecting perceived CVD risk; age and DM. It was found that 48% and 23.8% of males perceived CVD risks lower and higher than actual CVD risk while 28.2% were accurate. Those who perceived CVD risk at a moderate, high and very high think that this is caused by diseases that increase the risk of CVD and smoking. Conclusions Approximately 1/2 men has very high risk of CVD. It was determined that 1/2 men perceived risks are lower with false optimism and couldn’t accurately identify risks of people older and with diabetes. Key messages It can be ensured that develop risk reducing behaviors and individuals with high risk of CVD can raise their awareness. The risk perceptions of males in the very high-risk group from the past to the present are important because they affect their actual risks and risk-reducing behaviors.

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Primary care use and cardiovascular disease risk in Russian 40–69 year olds: a cross-sectional study

Journal of Epidemiology & Community Health ◽

10.1136/jech-2019-213549 ◽

2020 ◽

pp. jech-2019-213549

Author(s):

Jakob Petersen ◽

Anna Kontsevaya ◽

Martin McKee ◽

Erica Richardson ◽

Sarah Cook ◽

...

Keyword(s):

Cardiovascular Disease ◽

Primary Care ◽

Chest Pain ◽

Russian Federation ◽

General Health ◽

Cross Sectional Study ◽

Health Check ◽

Sectional Study ◽

Cvd Risk ◽

Cross Sectional

BackgroundThe Russian Federation has very high cardiovascular disease (CVD) mortality rates compared with countries of similar economic development. This cross-sectional study compares the characteristics of CVD-free participants with and without recent primary care contact to ascertain their CVD risk and health status.MethodsA total of 2774 participants aged 40–69 years with no self-reported CVD history were selected from a population-based study conducted in Arkhangelsk and Novosibirsk, Russian Federation, 2015–2018. A range of co-variates related to socio-demographics, health and health behaviours were included. Recent primary care contact was defined as seeing primary care doctor in the past year or having attended a general health check under the 2013 Dispansarisation programme.ResultsThe proportion with no recent primary care contact was 32.3% (95% CI 29.7% to 35.0%) in males, 16.3% (95% CI 14.6% to 18.2%) in females, and 23.1% (95% CI 21.6% to 24.7%) overall. In gender-specific age-adjusted analyses, no recent contact was also associated with low education, smoking, very good to excellent self-rated health, no chest pain, CVD 10-year SCORE risk 5+%, absence of hypertension control, absence of hypertension awareness and absence of care-intensive conditions. Among those with no contact: 37% current smokers, 34% with 5+% 10-year CVD risk, 32% untreated hypertension, 20% non-anginal chest pain, 18% problem drinkers, 14% uncontrolled hypertension and 9% Grade 1–2 angina. The proportion without general health check attendance was 54.6%.ConclusionPrimary care and community interventions would be required to proactively reach sections of 40–69 year olds currently not in contact with primary care services to reduce their CVD risk through diagnosis, treatment, lifestyle recommendations and active follow-up.

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Impact of the National Health Service Health Check on cardiovascular disease risk: a difference-in-differences matching analysis

Primary Health Care ◽

10.7748/phc.26.8.13.s13 ◽

2016 ◽

Vol 26 (8) ◽

pp. 13-13

Author(s):

Kat Millward

Keyword(s):

Cardiovascular Disease ◽

National Health Service ◽

Health Service ◽

National Health ◽

Disease Risk ◽

Cardiovascular Disease Risk ◽

Health Check ◽

Difference In Differences

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A qualitative exploration of two risk calculators using video-recorded NHS health check consultations

BMC Family Practice ◽

10.1186/s12875-020-01315-6 ◽

2020 ◽

Vol 21 (1) ◽

Author(s):

Victoria Riley ◽

Naomi J. Ellis ◽

Lisa Cowap ◽

Sarah Grogan ◽

Elizabeth Cottrell ◽

...

Keyword(s):

Risk Communication ◽

Health Check ◽

Risk Calculator ◽

Cvd Risk ◽

Missed Opportunities ◽

Coping Responses ◽

Practitioner Training ◽

The Uk ◽

And Coping ◽

Nhs Health Check

Abstract Background The aim of the study was to explore practitioner-patient interactions and patient responses when using QRISK®2 or JBS3 cardiovascular disease (CVD) risk calculators. Data were from video-recorded NHS Health Check (NHSHC) consultations captured as part of the UK RIsk COmmunication (RICO) study; a qualitative study of video-recorded NHSHC consultations from 12 general practices in the West Midlands, UK. Participants were those eligible for NHSHC based on national criteria (40–74 years old, no existing diagnoses for cardiovascular-related conditions, not on statins), and practitioners, who delivered the NHSHC. Method NHSHCs were video-recorded. One hundred twenty-eight consultations were transcribed and analysed using deductive thematic analysis and coded using a template based around Protection Motivation Theory. Results Key themes used to frame the analysis were Cognitive Appraisal (Threat Appraisal, and Coping Appraisal), and Coping Modes (Adaptive, and Maladaptive). Analysis showed little evidence of CVD risk communication, particularly in consultations using QRISK®2. Practitioners often missed opportunities to check patient understanding and encourage risk- reducing behaviour, regardless of the risk calculator used resulting in practitioner verbal dominance. JBS3 appeared to better promote opportunities to initiate risk-factor discussion, and Heart Age and visual representation of risk were more easily understood and impactful than 10-year percentage risk. However, a lack of effective CVD risk discussion in both risk calculator groups increased the likelihood of a maladaptive coping response. Conclusions The analysis demonstrates the importance of effective, shared practitioner-patient discussion to enable adaptive coping responses to CVD risk information, and highlights a need for effective and evidence-based practitioner training. Trial registration ISRCTN ISRCTN10443908. Registered 7th February 2017.

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Understanding primary prevention of cardiovascular disease

Journal of Prescribing Practice ◽

10.12968/jprp.2021.3.8.326 ◽

2021 ◽

Vol 3 (8) ◽

pp. 326-331

Author(s):

Beverley Bostock

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

General Practice ◽

Cvd Risk ◽

Pharmacological Management ◽

Health Checks ◽

Reduction Strategies ◽

Potential Benefits ◽

Risk Reduction Strategies ◽

Nhs Health Check

Nurses working in general practice play an important role in identifying those at risk of developing cardiovascular disease (CVD) and implementing person-focused risk reduction strategies. The NHS Health Check programme was designed to identify people between the age of 40 and 74 years with risk factors for CVD. Nurses in general practice have a key role to play in encouraging people to attend Health Checks and helping people to understand the potential benefits of CVD risk assessment and reduction strategies. Lifestyle interventions and pharmacological management allow modifiable risk factors to be managed in an evidence-based and person-focused way.

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