Impact of an informed choice invitation on uptake of screening for diabetes in primary care (DICISION): randomised trial

نویسندگان

  • Theresa M Marteau
  • Eleanor Mann
  • A Toby Prevost
  • Joana C Vasconcelos
  • Ian Kellar
  • Simon Sanderson
  • Michael Parker
  • Simon Griffin
  • Stephen Sutton
  • Ann Louise Kinmonth
چکیده

OBJECTIVE To compare the effect of an invitation promoting informed choice for screening with a standard invitation on attendance and motivation to engage in preventive action. DESIGN Randomised controlled trial. SETTING Four English general practices. PARTICIPANTS 1272 people aged 40-69 years, at risk for diabetes, identified from practice registers using a validated risk score and invited to attend for screening. INTERVENTION Intervention was a previously validated invitation to inform the decision to attend screening, presenting diabetes as a serious potential problem, and providing details of possible costs and benefits of screening and treatment in text and pie charts. This was compared with a brief, standard invitation simply describing diabetes as a serious potential problem. MAIN OUTCOME MEASURES The primary end point was attendance for screening. The secondary outcome measures were intention to make changes to lifestyle and satisfaction with decisions made among attenders. RESULTS The primary end point was analysed for all 1272 participants. 55.8% (353/633) of those in the informed choice group attended for screening, compared with 57.6% (368/639) in the standard invitation group (mean difference -1.8%, 95% confidence interval -7.3% to 3.6%; P=0.51). Attendance was lower among the more deprived group (most deprived third 47.5% v least deprived third 64.3%; P<0.001). Interaction between deprivation and effect of invitation type on attendance was not significant. Among attenders, intention to change behaviour was strong and unaffected by invitation type. CONCLUSIONS Providing information to support choice did not adversely affect attendance for screening for diabetes. Those from more socially deprived groups were, however, less likely to attend, regardless of the type of invitation received. Further attention to invitation content alone is unlikely to achieve equity in uptake of preventive services. TRIAL REGISTRATION Current Controlled Trials ISRCTN 73125647.

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Impact of an informed choice invitation on uptake of screening for diabetes in primary care (DICISION): trial protocol

BACKGROUND Screening invitations have traditionally been brief, providing information only about population benefits. Presenting information about the limited individual benefits and potential harms of screening to inform choice may reduce attendance, particularly in the more socially deprived. At the same time, amongst those who attend, it might increase motivation to change behavior to reduce...

متن کامل

Impact of informed-choice invitations on diabetes screening knowledge, attitude and intentions: an analogue study

BACKGROUND Despite concerns that facilitating informed choice would decrease diabetes screening uptake, 'informed choice' invitations that increased knowledge did not affect attendance (the DICISION trial). We explored possible reasons using data from an experimental analogue study undertaken to develop the invitations. We tested a model of the impact on knowledge, attitude and intentions of a ...

متن کامل

Does a decision aid improve informed choice in mammography screening? Results from a randomised controlled trial

BACKGROUND Decision aids can support informed choice in mammography screening, but for the German mammography screening programme no systematically evaluated decision aid exists to date. We developed a decision aid for women invited to this programme for the first time based on the criteria of the International Patient Decision Aids Standards Collaboration. OBJECTIVE To determine whether a de...

متن کامل

Evaluation of an informed choice invitation for type 2 diabetes screening.

OBJECTIVE To evaluate an innovative invitation designed to facilitate informed choices for undergoing screening for type 2 diabetes. METHODS Four hundred and seventeen people aged 40-69 years (sex: F 53%/M 47%), without known diabetes, recruited from street locations. Participants were randomised to receive one of two hypothetical invitations for screening for type 2 diabetes; one based on Ge...

متن کامل

Impact on informed choice of offering antenatal sickle cell and thalassaemia screening in primary care: a randomized trial

OBJECTIVES Offering antenatal sickle cell and thalassaemia (SCT) screening early in pregnancy can maximize the range of post-screening choices available, however these benefits should not be obtained at the expense of informed choice.  This study examined whether offering this screening in primary care at the time of pregnancy confirmation compromises women making informed choices. Design Parti...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

عنوان ژورنال:

دوره 340  شماره 

صفحات  -

تاریخ انتشار 2010