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Improving cardiovascular disease risk communication in NHS Health Checks: a qualitative study
  1. Meredith K D Hawking1,
  2. Adam Timmis2,
  3. Fae Wilkins1,
  4. Jessica L Potter1,
  5. John Robson1
  1. 1 Centre for Primary Care and Public Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
  2. 2 NIHR Cardiovascular Biomedical Research Unit, Barts Heart Centre, London, UK
  1. Correspondence to Dr John Robson; j.robson{at}


Objective The NHS Health Check programme is a public screening and prevention initiative in England to detect early signs of cardiovascular ill health among healthy adults. We aimed to explore patient perspectives and experiences of a personalised Risk Report designed to improve cardiovascular risk communication in the NHS Health Check.

Design and setting This is a qualitative study with NHS Health Check attendees in three general practices in the London Borough of Newham.

Intervention and participants A personalised Risk Report for the NHS Health Check was developed to improve communication of results and advice. The Risk Report was embedded in the electronic health record, printed with auto-filled results and used as a discussion aid during the NHS Health Check, and was a take-home record of information and advice on risk reduction for the attendees. 18 purposively sampled socially diverse participants took part in semistructured interviews, which were analysed thematically.

Results For most participants, the NHS Health Check was an opportunity for reassurance and assessment, and the Risk Report was an enduring record that supported risk understanding, with impact beyond the individual. For a minority, ambivalence towards the Risk Report occurred in the context of attending for other reasons, and risk and lifestyle advice were not internalised or acted on.

Conclusion Our findings demonstrate the potential of a personalised Risk Report as a useful intervention in NHS Health Checks for enhancing patient understanding of cardiovascular risk and strategies for risk reduction. Also highlighted are the challenges that must be overcome to ensure transferability of these benefits to diverse patient groups.

Trial registration number NCT02486913.

  • public health
  • preventive medicine
  • primary care
  • information technology
  • communication

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  • Contributors MKDH led the design of the Risk Report, and with AT and JR designed the qualitative study. FW organised the recruitment of practices, IT components, staff training and participant attendance. MKDH carried out the interviews and analysed the transcripts with JLP. All authors contributed to the manuscript.

  • Funding This study was funded by The Guttmann Academic Partnership hosted by UCLPartners. MKDH was in part supported by the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care North Thames at Barts Health NHS Trust (NIHR CLAHRC North Thames). The views expressed in this article are those of the author(s) and not necessarily those of the NHS, the NIHR, or the Department of Health and Social Care.

  • Competing interests JR has a non-pecuniary interest as a coauthor of QRISK2 and is also a member of a national NHS Health Check advisory group.

  • Patient consent for publication Not required.

  • Ethics approval The study received final approval from the National Research Ethics Service Committee North West (Preston) on 7 August 2015. The research ethics committee reference was 15/NW/0635 (protocol number MCPH1C8R).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement No data are available.

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