Participation in community health screenings: a qualitative evaluation

Community health screenings and education programs have been widely used to identify individual health risks and promote early diagnosis and treatment of disease. Participation in these community activities is dependent on the initial health-seeking behaviors of the individual. Focus group interviews1 were conducted with both attendees and nonattendees of a program offering health education and screenings in various settings in a semirural area. The purpose of these group interviews was to better understand issues associated with participation. A domain analysis of the qualitative data revealed that multiple aspects of self-care orientations as well as interpersonal and environmental factors influenced participation. A paradoxical facilitator-inhibitor effect was apparent. The companionship and support inherent in a community setting was an incentive for participation, but also presented concerns about confidentiality. However, concern about getting knowledge about self-care and the fear and anxiety of learning the results of screening tests creates a push-pull dilemma that is a challenge for health care providers. Factors that influence participation in semirural community health screenings are varied and complex and suggest multidimensional approaches be used in designing programs.