Why do general practitioners not refer patients to behaviour-change programmes after preventive health checks? A...

Area of Science:

• Public Health
• General Practice
• Health Behavior Research

Background:

• The Check-In trial evaluated preventive health checks for individuals with low socioeconomic status.
• Despite successful recruitment, the intervention showed no effect, possibly due to low referral rates to behavior-change programs.
• This study aimed to investigate general practitioners' referral patterns and identify barriers to referring patients to these programs.

Purpose of the Study:

• To examine general practitioners' referral patterns for behavior-change programs.
• To identify barriers influencing patient referrals to municipal behavior-change programs.
• To understand factors affecting the delivery dose of preventive interventions in primary care.

Main Methods:

• Mixed-method design combining patient questionnaires, health check recording sheets, and semi-structured interviews with general practitioners.
• Quantitative analysis using logistic regressions to determine odds ratios for eligibility and referral.
• Thematic analysis of qualitative data from general practitioner interviews to identify referral barriers.

Main Results:

• 45% of eligible patients (165/364) were referred to behavior-change programs (55% of eligible).
• Daily smoking, high-risk alcohol consumption, obesity, and poor lung function were associated with eligibility but not referral.
• Four key barriers emerged: practitioner responsibility, information management, timing of behavior change, and attitudes towards programs.

Conclusions:

• General practitioner-related barriers significantly influenced referral rates and intervention delivery in the Check-In trial.
• Enhanced collaboration between general practices and municipal preventive services is recommended.
• Addressing these barriers is essential for improving the effectiveness of preventive health interventions.