Sage Journals: Discover world-class research

Abstract

Aims: The (cost-)effectiveness of a screening programme may be strongly influenced by the participation rate. The objective of this study was to compare participants’ and non-participants’ motives for the attendance decision as well as their overall preferences for participation in cardiovascular disease screening. Methods: This study sampled 1053 participants and 1006 non-participants from a screening trial and randomly allocated the participants to receive different levels of additional information about the screening programme. An ad hoc survey questionnaire about doubt and arguments in relation to the participation decision was given to participants and non-participants along with a contingent valuation task. Results: Among participants, 5% had doubt about participation and the most frequent argument was that they did not want the test result. Among non-participants, 40% would reconsider their non-participation decision after having received additional information while the remainder 60% stood by their decision and provided explicit arguments for it. After having received additional information the participants still valued the programme significantly higher than non-participants, but the difference was relatively small. Conclusions: Participants and non-participants in cardiovascular screening programmes seem to have different strengths of preferences, which signals that their behavioural choice is founded in rational thinking. Furthermore, it appears that additional information and a second reflection about the participation decision may affect a substantial proportion of non-participants to reverse their decision, a finding that should receive policy interest.

Keywords

Cardiovascular disease contingent valuation decision making information patient preferences randomised controlled trial screening willingness to pay

Get full access to this article

View all access options for this article.

References

Koopmanschap

van Oortmarssen

van Agt

. Cervical-cancer screening: attendance and cost-effectiveness. Int J Cancer 1990;45:410–5.

Stirbu

Kunst

Mielck

. Educational inequalities in utilization of preventive services among elderly in Europe. Tackling health inequalities europe: an integrated approach – EUROTHINE. Rotterdam: Erasmus MC, 2007. pp.483–99.

Aas

. Pecuniary compensation increases participation in screening for colorectal cancer. Health Econ 2009;18:337–54.

Senore

Armaroli

Silvani

. Comparing different strategies for colorectal cancer screening in Italy: predictors of patients’ participation. Am J Gastroenterol 2010;105:188–98.

van Rijn

van Rossum

Deutekom

. Low priority main reason not to participate in a colorectal cancer screening program with a faecal occult blood test. J Public Health 2008;30:461–5.

Bryan

Buxton

McKenna

. Private costs associated with abdominal aortic aneurysm screening: the importance of private travel and time costs. J Med Screen 1995;2:62–6.

Neumann

Morgenstern

. Theory of games and economic behavior. Princeton: Princeton University Press, 1944.

Sassi

McDaid

Ricciardi

. Conjoint analysis of preferences for cardiac risk assessment in primary care. Int J Technol Assess Health Care 2005;21:211–18.

Donaldson

Shackley

Abdalla

. Willingness to pay for antenatal carrier screening for cystic fibrosis. Health Econ 1995;4:439–52.

10.

Jonas

Russell

Chou

. Willingness-to-pay to avoid the time spent and discomfort associated with screening colonoscopy. Health Econ 2010;19:1193–211.

11.

Pedersen

Gyrd-Hansen

Kjaer

. The influence of information and private versus public provision on preferences for screening for prostate cancer: a willingness-to-pay study. Health Policy 2011;101:277–89.

12.

Grondal

Sogaard

Henneberg

. The Viborg Vascular (VIVA) screening trial of 65–74 year old men in the central region of Denmark: study protocol. Trials 2010;11:67.

13.

Sassi

Hurst

. The prevention of lifestyle-related chronic diseases: an economic framework. Paris: Directorate for employment, labour and social affairs, OECD, 2008.

14.

Osterlie

Solbjor

Skolbekken

. Challenges of informed choice in organised screening. J Med Ethics 2008;34:e5.

15.

Jorgensen

Brodersen

Hartling

. Informed choice requires information about both benefits and harms. J Med Ethics 2009;35:268–9.

16.

Camerer

Issacharoff

Loewenstein

. Regulation for conservatives: behavioral economics and the case for ‘asymmetric paternalism’. University of Pennsylvania Law Review 2003;151:1211–1254.

17.

Glaeser

. Paternalism and psychology. Cambridge: National Bureau of Economic Research, 2005.

Supplementary Material

Please find the following supplemental material available below.

For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.

For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.

0.00 MB

0.03 MB

Individual decision making in relation to participation in cardiovascular screening: A study of revealed and stated preferences

Abstract

Keywords

Get full access to this article

References

Supplementary Material