SEARCHSYSTEMATIC_REVIEWpublic health, epidemiology

systematic_review·public health, epidemiology, cardiology, endocrinology, family medicine·PMC10557298

Exploring targeted preventive health check interventions – a realist synthesis

BMC Public Health · 6 authors, 4 centres

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TL;DR

This realist synthesis of systematic reviews, meta-analyses, qualitative studies, grey literature, stakeholder interviews, and workshops developed a seven-theme program theory for targeted preventive health checks.

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A noted limitation is that contextual circumstances are rarely described in quantitative studies, limiting the linking of mechanisms to outcomes across study types. International differences in healthcare systems also constrain generalizability.

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systematic_review

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public health

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ORIGINAL PAPER

PMC10557298

Exploring targeted preventive health check interventions – a realist synthesis

BMC Public Health

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ABSTRACT

Background Preventive health checks are assumed to reduce the risk of the development of cardio-metabolic disease in the long term. Although no solid evidence of effect is shown on health checks targeting the general population, studies suggest positive effects if health checks target people or groups identified at risk of disease. The aim of this study is to explore why and how targeted preventive health checks work, for whom they work, and under which circumstances they can be expected to work. Methods The study is designed as a realist synthesis that consists of four phases, each including collection and analysis of empirical data: 1) Literature search of systematic reviews and meta-analysis, 2) Interviews with key-stakeholders, 3) Literature search of qualitative studies and grey literature, and 4) Workshops with key stakeholders and end-users. Through the iterative analysis we identified the interrelationship between contexts, mechanisms, and outcomes to develop a program theory encompassing hypotheses about targeted preventive health checks. Results Based on an iterative analysis of the data material, we developed a final program theory consisting of seven themes; Target group; Recruitment and participation; The encounter between professional and participants; Follow-up activities; Implementation and operation; Shared understanding of the intervention; and Unintended side effects. Overall, the data material showed that targeted preventive health checks need to be accessible, recognizable, and relevant for the participants’ everyday lives as well as meaningful to the professionals involved. The results showed that identifying a target group, that both benefit from attending and have the resources to participate pose a challenge for targeted preventive health check interventions. This challenge illustrates the importance of designing the recruitment and intervention activities according to the target groups particular life situation. Conclusion The results indicate that a one-size-fits-all model of targeted preventive health checks should be abandoned, and that intervention activities and implementation depend on for whom and under which circumstances the intervention is initiated. Based on the results we suggest that future initiatives conduct thorough needs assessment as the basis for decisions about where and how the preventive health checks are implemented. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-023-16861-8.

CITATION EXPORT

Nanna Bjørnbak Christoffersen, Freja Ekstrøm Nilou, Trine Thilsing et al.. Exploring targeted preventive health check interventions – a realist synthesis. BMC Public Health. (2023). https://doi.org/10.1186/s12889-023-16861-8

AUTHORS

6 · 4 CENTRES

Nanna Bjørnbak Christoffersen, Freja Ekstrøm Nilou, Trine Thilsing, Lars Bruun Larsen, Jane Nautrup Østergaard, Marie Broholm-Jørgensen

1grid.10825.3e0000 0001 0728 0170Research Program On Health and Social Conditions, National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
2grid.10825.3e0000 0001 0728 0170Research Unit of General Practice, University of Southern, Odense, Denmark
3Steno Diabetes Center Zealand, Holbæk, Denmark
4grid.154185.c0000 0004 0512 597XSteno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark