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Enhanced Invitations Using the Question-Behavior Effect and Financial Incentives to Promote Health Check Uptake in

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Low uptake of cardiovascular health checks in primary care was not improved by using the question-behavior effect (QBE) or financial incentives. Enhanced invitation methods did not significantly increase health check attendance.

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Area of Science:

  • Public Health
  • Health Services Research
  • Behavioral Science

Background:

  • Cardiovascular risk assessment uptake in primary care settings in England is lower than anticipated.
  • The question-behavior effect (QBE) presents a potential scalable intervention to improve health check attendance.

Purpose of the Study:

  • To evaluate the effectiveness of enhanced invitation strategies using the QBE, with or without financial incentives, for increasing primary care health check uptake.

Main Methods:

  • A three-arm randomized trial was conducted across 18 general practices in London.
  • Participants received either a standard invitation, a QBE questionnaire followed by a standard invitation, or a QBE questionnaire with a financial incentive to return it, followed by a standard invitation.
  • The primary outcome was the completion of a health check within six months of invitation, analyzed using intention-to-treat.

Main Results:

  • Health check uptake within six months was 14.41% for the standard invitation group.
  • The QBE questionnaire group showed 15.80% uptake, and the QBE with financial incentive group showed 15.85% uptake.
  • Neither the QBE questionnaire nor the QBE with a financial incentive significantly increased health check uptake compared to the standard invitation.

Conclusions:

  • Standard invitations for primary care health checks resulted in low uptake.
  • Enhanced invitation methods utilizing the question-behavior effect did not significantly improve health check uptake.