[Comparison of attitudes and perceptions in spontaneous and invited participants in health screenings]

In the initial phase of a community-based program aiming at cardiovascular risk factor prevention in two Swiss towns, Aarau and Nyon, a health examination was proposed, the participants of which filled a questionnaire about their knowledge, attitudes and practices in relation with health matters. The present study looks at the data obtained in respect to attitudes and perceptions, first for the whole respondent group, and then in comparing spontaneous participants with those who came only after receiving a personal invitation/appointment. As regards the whole participant population, 70-89% of the questioned persons think they are in good health (with a significant decrease intervening with age), 64-90% consider their state of health as identical to the one of persons of the same age. Interestingly, there is a statistically significant trend, when advancing in age, to believe more often that one is in better health than one's contemporaries. Asked about their motives for adopting given behaviors (regarding nutrition, tobacco use, physical exercise), two-thirds of the respondents say they have at least once done it for a health reason. One-fifth say they live "as they please", without attention to possible health consequences, while the others choose their lifestyle according to the needs of their health (the number of the "unconcerned" decreasing significantly in older age groups). 73-80% of the respondents think one can contribute much to the improvement of one's own health, thus showing, in principle, an attitude favorable to health education efforts. Comparing the responses of spontaneous participants with those of people who had to be personally requested to come, the following statistically significant differences appear: the spontaneous ones think more often that they are in good health; they have more often in the past adopted given behaviours for health reasons; they select more often their way of life on health grounds and they believe more often that it is possible to contribute much to one's health (they are thus less "fatalistic"). Finally, when comparing their health to the one of people of the same age, it is only in Aarau that these spontaneous participants say more often that they are in better health. The implications of these results for health education and the necessity to give particular attention to the needs of people who do not engage spontaneously in prevention programmes are discussed.