Early Detection of and Intervention Towards Chronic Diseases Among Individuals Without Formal Education
Condition: Smoking; Health Behavior; Chronic Disease
MeSH terms: Chronic Disease
Study type: Interventional

Summary: 
      In this randomized controlled study it is investigated if a proactive action by the general
      practitioner offering individuals without formal education a preventive health check will
      lead to a larger number of diagnoses in form of chronic obstructive pulmonary disease,
      cardiovascular diseases, and diabetes among participants in the intervention group compared
      to the control group. Furthermore it will be investigated if the proactive action by the
      general practitioner will be associated with a higher smoking cessation rate at 12 month
      follow-up.
    

Detailed description: 
      The study will be conducted at Vesterbro and Amager in Copenhagen, Denmark, and general
      practitioners with a medical practice in this area will be invited to enter the study. From
      the patient lists of the participating general practitioners all persons aged 45-64 years
      will be identified and baseline questionnaires will be mailed to these persons.

      The questionnaire information will be entered electronically into the general practitioners
      electronic chart system using the Danish Quality Unit of General Practice (DAK-E) system.
      Thus, the questionnaire information will provide the general practitioners with information
      in the electronic form on health behavior, symptoms and socioeconomic information on all his
      patients in this age group that would not normally have access to in a systematic way.

      Persons who answer the baseline questionnaire and who do not have any formal education will
      randomly be divided into two groups - one intervention group and one control group.

      All persons allocated to the intervention group will receive a personal invitation to an
      appointed health check from their general practitioner. The health check at the general
      practitioner includes measurement of weight, height, hip and waist circumference, blood
      pressure, lung function, blood sugar, total cholesterol, and thyroidal status.

      Participants with abnormal screens at the health check will, depending of the severity,
      either receive the offer of the referral to the municipality health center for a lifestyle
      change program and/or follow the procedures for diagnostics and treatment. For individuals
      with abnormal screens or health behavior amenable to intervention at the first health check
      an additional health check will be scheduled six months after the first health check.

      Persons allocated to the control group will receive a baseline questionnaire and other than
      that follow normal procedure in general practice.

      At 12 month follow-up questionnaires will be send out to all participants at the intervention
      group as well as the control group.
    

Intervention name(s): Proactive action by the general practitioner
Intervention type(s): Behavioral
Intervention description(s): Individuals allocated to the intervention group will receive a personal invitation to an appointed health check from their general practitioner. Three days before the appointment participants will be reminded by phone about the appointment.
At the health check a follow-up consultation will be scheduled. At the follow-up consultation the results of the health check will be reviewed. All participants with abnormal screens at the health check will, depending of the severity, either receive the offer of a referral to the municipality health center for a lifestyle change program and/or follow the procedures for diagnostics and treatment. This will follow the usual medical standards in general practice. For individuals with abnormal screens or health behavior amenable to intervention at the first health check an additional health check will be scheduled six months after the first health check with a follow-up consultation for review of the results.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Prevention
Keywords: Health behavior; Chronic disease; Proactive action; General practitioner; Preventive health check; Social inequality in health; Randomised controlled trial