Skip to main content

Development of a questionnaire to evaluate patients’ awareness of cardiovascular disease risk in England’s NHS Health Check Programme

Cardiovascular disease (CVD) is a major cause of disability and premature mortality worldwide. In England, it accounts for a third of deaths and costs the National Health Service (NHS) and the UK economy £30 billion annually.

The National Health Service (NHS) Health Check is a CVD risk assessment and management programme in England aiming to increase CVD risk awareness among people at increased risk of CVD. There was previously no tool to assess the effectiveness of the programme in communicating CVD risk to patients. In research published in the journal BMJ Open, we describe how we developed a questionnaire examining patients’ CVD risk awareness for use in health service research evaluations of the NHS Health Check programme.

We developed an 85-item questionnaire to determine patients’ views of their risk of CVD. The questionnaire was based on a review of the relevant literature. After review by an expert panel and focus group discussion, 22 items were dropped and 2 new items were added. The resulting 65-item questionnaire with satisfactory content validity (content validity indices≥0.80) and face validity was tested on 110 NHS Health Check attendees.

Following analyses of data, we reduced the questionnaire from 65 to 26 items. The 26-item questionnaire constitutes four scales: Knowledge of CVD Risk and Prevention, Perceived Risk of Heart Attack/Stroke, Perceived Benefits and Intention to Change Behaviour and Healthy Eating Intentions. Perceived Risk (Cronbach’s α=0.85) and Perceived Benefits and Intention to Change Behaviour (Cronbach’s α=0.82) have satisfactory reliability (Cronbach’s α≥0.70). Healthy Eating Intentions (Cronbach’s α=0.56) is below minimum threshold for reliability but acceptable for a three-item scale.

This is the first study that describes the development of a short, validated questionnaire with satisfactory content and face validity and reliability examining CVD risk awareness among the NHS Health Check attendees. The ABCD Risk Questionnaire may be used for evaluating the accuracy of perceived CVD risk, general knowledge of CVD and intention to change behaviour regarding diet and exercise among NHS Health Check attendees.

Agreement between perceived and predicted CVD risk suggests that the tool performs well in assessing perceived CVD risk. As the questionnaire was developed using both an expert panel and a patient focus group, it ought to be relatively easy to understand for both patients and clinicians. If NHS Health Check recommendations change over time, it may need to be updated. The resulting questionnaire, with its satisfactory reliability and validity, may be used in assessing patients’ awareness of CVD risk among NHS Health Check attendees.

DOI: http://dx.doi.org/10.1136/bmjopen-2016-014413

Comments

Popular posts from this blog

What is the difference between primordial prevention and primary prevention?

Primordial prevention and primary prevention are both crucial strategies for promoting health, but they operate at different levels. Primordial prevention aims to address the root causes of health problems and improve the wider determinants of health. It focuses on preventing the emergence of risk factors in the first place by tackling the underlying social, economic, and environmental determinants of health. This involves broad, population-wide interventions such as: Policies that promote healthy food choices: Think about initiatives like taxing sugary drinks to discourage unhealthy consumption, or providing subsidies for fruits and vegetables to make them more accessible. Urban planning that prioritises well-being: This could include creating walkable neighborhoods with safe cycling routes, ensuring access to green spaces for recreation and relaxation, and designing communities that foster social connections. Social programs that address inequality: Initiatives aimed at reducing pov...

MPH Student Presentations on the NHS Care.Data Programme

As part of a session on primary care data in the Health Informatics module on the Imperial Master of Public Health Programme, I asked students to work in two groups to present arguments for and against the NHS Care.Data programme. Care.Data is an NHS programme that will extract data from the medical records held by general practitioners (GPs) in England. The Care.Data programme takes advantage of the very high level of use of electronic medical records by GPs in England. After extraction, data will be uploaded to the NHS Health and Social Care Information Centre (HSCIC). The data will then be used for functions such as health care planning, monitoring disease patterns and research. The programme has been controversial with proponents arguing that the programme will bring many benefits for the NHS and the population of England; and opponents arguing it is a major breach of privacy. You can view the two presentations to help inform you further about these arguments: Arguments fo...

What makes a good doctor – and who gets to decide?

What Makes a Good Doctor? This is the question that Waseem Jerjes and I explore in the Journal of the Royal Society of Medicine . It is a key question that underpins the architecture of medical education, clinical practice, regulation, and professional identity. It cannot be answered by regulators, educators, or employers in isolation. It must be answered together – by doctors and patients – revisited throughout a career, and adapted as society and the profession change. Without that shared reflection, the danger is not simply disillusionment, but the erosion of the moral foundations of clinical work. As we enter an era when diagnosis will increasingly involve artificial intelligence and when performance metrics reward volume over value, reclaiming this question as a professional one is imperative. The integrity of our institutions – and of the practitioners within them – depends on reimagining excellence in inclusive, relational terms. A good doctor is not a flawless technician or a f...