1 Note: Please consider that this survey was originally in Swedish. This is a translated version.
The translation was made for review purpose and were not made professionally. Therefore, it is possible that not all phrases are entirely correctly translated. The layout and design of the originally survey are not reflected in this version.
Receiving test results from a health examination
A questionnaire study about what matters to the public
If you were invited to a health examination, what would be important to you regarding how the test results were returned? That is what we want to study by this survey.
Cardiovascular diseases are the number one cause of death in Sweden. The disease often progresses in
“silence” without symptoms. By conducting health examinations risk factors such as high blood pressure, high cholesterol and unhealthy life style can be detected in an early stage and disease be prevented. However, we know from experience that people have difficulties understanding and using the results from health examinations. Therefore, this study is important to find out how the public prefer to have test results from a health examination communicated to them.
By logging in and answer the survey you give your consent to participate in the study. You also confirm that:
• You have read the information about the study that was sent to your home address.
• You understand that participation is voluntary and can be ended at any time.
USERNAME:
Log in
2
Welcome!
The survey is divided in three parts.
1. Questions about you. We want to compare what different population groups think.
Therefore, we ask questions about your background, for example your age, sex and your financial situation. We anonymize your answers before we make our analyzers. Results will be reported at group level. We will never report exactly what you have answered. More information about personal data management and anonymization of survey responses can be found in the information sheet and on the website:www.crb.uu.se/svara.
2. Choice scenarios. In the choice scenarios, you get to choose between different health examinations. When we compile the answers from everyone who responded to the survey it will give us an idea of what is important for different population groups.
3. Questions about your health. We ask questions about your health and your view of illness and risks in order to be able to investigate whether health and views of illness and disease risks can influence which health examination a person prefer.
Please answer the questions as thorough as possible. Keep in mind that there are no right or right answers; we are interested in what YOU think. Your answers are saved automatically even if you do not finish answering the survey.
Part 1: Bakground questions
Part 2:
choice scenarios
Part 3:
Questions
about health
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Part 1. Questions about you
Variable Question Response alternatives
Age How old are you?
Sex Are you: Male
Female, Other
Cant/don’t want to answer Country of birth Are you born in Sweden Yes
No
- If no, how many years have you lived in Sweden Cant/don’t want to answer Education What is your highest completed
education?
Compulsory school High school, University
Cant/don’t want to answer Medical training Do you hold a degree in
medicine/care?
Yes No
Cant/don’t want to answer Occupation What is you main occupation at the
moment?
Multiple answers possible
Employed/Self-employed Student
Retired
Long term sick leave Unemployed
Other
Cant/don’t want to answer Marital status What is your marital status? Married/cohabiting
Living apart from partner Single
Cant/don’t want to answer Financial
vulnerability
Have you experienced difficulties managing your expenses the last 12 months?
No Yes
Cant/don’t want to answer
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Part 2. Choice scenarios
We will soon ask you to make a number of choices. In the choice scenarios, we would like you to imagine the following situation:
• You are invited to the health examination by the region office where you live.
• Your primary health care center will conduct the health examination.
• The health examination includes several different tests; blood sample for analysis of fat (cholesterol) and sugar (glucose) level, measurement of blood pressure, waist circumstance, height and weight. You will also be asked to fill out a survey about your life style and family history of heart diseases.
• In this scenario the test results did not indicate the need for medical treatment or further investigation. Therefore you will not be contacted for further investigations.
The Health check
In the following choice scenarios you will be asked to chose between two different health checks. The health checks are described based on 6 characteristics that occur in different combinations:
1. The written test results 2. Notification method 3. Waiting time for test result 4. Life style recommendations
5. Consultation time with medically trained person 6. The cost for the health examination
On the next page, each characteristic will be explained and we will describe how they can differ.
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The written test result
How the written test results are presented in written format. The different variations of written test results:
• Lab numbers with a reference value.You get your test result presented in numerical values including a reference value that indicates whether your results are within the normal range. The results from the different test will be presented separately. Below you find an example of how this could look like for blood lipids:
Measure Your
resultat
Reference value
Total cholesterol (mmol/l)
4.5 Normal <5.0
• Numbers with reference value AND every day words translation. Besides the
numbers with reference values, you also get written explanation in every day words (non- medical terms). Below you find an example of how this could look like for blood lipids:
Measure Your
resultat
Reference value Everyday words description
Total cholesterol (mmol/l)
4.5 Normal <5.0 Blood lipids.High values
increase the risk of getting a heart disease. Your value of total blood lipids is 4.5, which is lower than 5.0 and therefore within the normal range.
• Numbers with reference value AND every day words translation AND an overall assessment. Besides the numerical values and the everyday word description, you also get an overall assessment where all the test results are taken into account as well as individual factors e.g. sex, age and life style factors. Below you find an example of how this could look like.
Measure Your
resultat
Reference value Everyday words description
Total cholesterol (mmol/l)
4.5 Normal <5.0 Blood lipids.High values
increase the risk of getting a heart disease. Your value of total blood lipids is 4.5, which is lower than 5.0 and therefore within the normal range.
Overall assessment Age: 58 Sex: male Smoking: yes Family history of CVD: no
Your blood pressure-, blood lipids and blood sugar values are within the normal range. However, as you smoke and have a waiste circumference above the normal range, your CV risk is higher compared with other men in your age group who do not have these risk factors. Your risk of experiencing a heart infarction within the next ten years is 5 %. The risk for a man in the same age with the same risk factors but does not smoke is 2 %.
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How your results are notified
The way that the written test results are notified.
• Accessible through electronic medical record only. You can find your written test resultonly by logging in to your Electronic Patient Health Record.
• Electronic medical record AND Postal letter/email. Besides being able to access your test results via your Electronic Patient Health Record, you also get your written test result sent to you by a postal letter or e-mail.
Waiting time for your test results:
The time you have to wait between conducting the health examination and receiving your written test results.
• Two days. You need to waittwo days between conducting the health examination and receiving your written test results.
• 1 week. You need to wait1 weekbetween conducting the health examination and receiving your written test results.
• 2 weeks. You need to wait2 weeks between conducting the health examination and receiving your written test results.
• 3 weeks. You need to wait3 weeks between conducting the health examination and receiving your written test results.
Life style recommendations
There are usually things you can do yourself to influence your risk of having a heart attack; linked to your lifestyle. Test results may contain recommendations about what you can do yourself to influence your health and reduce your risk of having a heart attack. The alternatives in the following health examinations are:
• Yes, life style recommendations are included
• No, life style recommendations are not included
Consultation time with a medically trained person
Refers to the possibility to get time to discuss your test results and the opportunity to ask question to a health care professional with high competence about the health examination.
• No consultation time. No consultation time is included. You only get written test results.
• 15 minutes consultation. You get 15 minutes consultation time (phone or visit at the primary health care center) with a medically trained person.
• 30 minutes consultation. You get 30 minutes consultation time (phone or visit at the primary health care center) with a medically trained person.
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Cost for health examination
How much you pay out of your own pocket for the health examination. The costis not included in the high-cost threshold/maximum rate/high cost insurance.
• € 0. The health examination is free of charge.
• € 15. You pay€15 (not included in high-cost threshold).
• € 30. You pay€30 (not included in high-cost threshold).
• € 60. You pay€60 (not included in high-cost threshold).
• € 90. You pay€90 (not included in high-cost threshold).
• € 120. You pay€120 (not included in high-cost threshold).
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Time to choose!
We will now ask you to make a number of choices where you are faced with two different health examinations. In some cases, the differences between the health examinations will be small.
Choose the health examination you prefer the most! Once you have made your choice, you will have to decide if you would like to participate in a comparable health examination in real life. See the example below.
Tip! Remember that you can always go back to read the explanation of the characteristics again. If you answer on a mobile phone, it can be easier if you hold it horizontally. Example of an choice situation:
Start by comparing the two alternatives. Than chose the alternative you prefer.
In this example, the respondent chose alternative B, which includes receiving written test results presented in numerical values, everyday words and with an overall assessment. The results are notified through your electronic medical record online. You will wait 3 weeks for you test results. Lifestyle recommendations are included. 15 minutes consultation time with a medically trained person is
included. The health examination is free of charge.
Then you decide whether you would participate in a health check similar to the one you chose, if you were faced with the choice in real life. In this example they chose to participate in real life.
9 (The respondents were randomized to one out of four blocks. Each block contained 15 choice tasks.)
Block 1.
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Block 2
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Block 3
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Block 4
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Part 3. Questions about your health
(Question 17, 18 and 19 is about illness perceptions. These questions were not used in this study.) 8 General health In general, how would you define
your health?
Bad Fair Good Very good Excellent
Cant/don’t want to answer
9 Medical
background
Have you been treated or diagnosed with one or more of the following conditions:Multiple answers possible
Hypertension High cholesterol Diabetes
Myocardial infarction Stroke
Heart failure Valvular disease Other CVD
Other chronic disease No, non of the above Cant/don’t want to answer
10 BMI How much do you weigh?
How tall are you?
Kg Cm
Cant/don’t want to answer 11 Family history Have your father, mother or
siblings experienced/deceased from a MI?
Yes No
Cant/don’t want to answer
13 Smoke Do you smoke? Yes
No
Cant/don’t want to answer Physical activity How often have you exercised in
training clothes in the last three months? In order to improve your fitness and / or to feel good.
Never
Now and then, not regularly 1-2 times a week
2-3 times a week
>3 times a week
Cant/don’t want to answer 14 Stress By stress we mean feeling tense,
irritable, nervous, anxious, trouble sleeping as a result of conditions at work or at home. Have you
experienced that?
Never Some period
Some period the last 5 years Constant stress the last year Constant stress the last 5 years Cant/don’t want to answer 15 Risk perception
Categorical
Compared to others of same age and sex, how do you perceive your risk of experiencing a MI the next 10 years?
Much lower Slightly lower
Neither lower or higher Slightly higher
Much higher
Cant/don’t want to answer 17 Illness
perception:
myocardial infarction
Illness perception questionnaire 10 point Likert scale
a Impact How much does this illness affect your life
Not at all-affect life severely
70 b Illness duration How long do you think this illness
will continue?
A very short period- forever c Personal control How much control do you feel you
have over the risk of experiencing this illness?
No control -extreme amount of control
d Effect of drug treatment
How much do you think drug treatment can prevent this illness?
Not at all-extremely much e Worry of CVD How concerned are you about this
illness?
Not at all-extremely much f Understanding
of disease
How well do you feel you understand this illness?
Not at all- understand it clearly 18 Causes to
myocardial in
How much do you think these factors causes MI?
- Overweight/obesity - Hypertension
- Unhealthy eating habits - Heritage/runs in the family - Smoking
- Inadequate exercise - Bad luck/coincidence - Aging
- Stress - Diabetes - Bacteria/virus
- High alcohol consumption - Emotional state e.g. worry,
loneliness, emptiness
5 point Likert scale Don’t agree at all- agree completely
Cant/don’t want to answer
19 Personal causes What do you think are the three factors that contribute the most to your personal risk?
- Overweight/obesity - Hypertension
- Unhealthy eating habits - Heritage/runs in the family - Smoking
- Inadequate exercise - Bad luck/coincidence - Aging
- Stress - Diabetes - Bacteria/virus
- High alcohol consumption - Emotional state e.g. worry,
loneliness, emptiness - Non of the above
- Cant/don’t want to answer 20 Health literacy Sometimes people may find it
difficult to understand and interpret health information. Here are some statements which is about
information that has to do with health, diseases and healthcare.
We are curious about your experiences. Select the option on each line that best matches your answer:
5 point Likert scale Don’t agree at all- agree completely
71 - Health information is
difficult to read
- It is difficult to understand words or numbers in health information
- It take long time reading the information
- You sometimes ask others to read and explain health information
You have finished the survey. Here you can comment on your answers or give feedback on the survey:
How easy or difficult do you think it was to answer the questions?
• Very easy
• Pretty easy
• Neither easy nor difficult
• Pretty difficult
• Very difficult
• Cant/don’t want to answer
What do you think about the length of the survey?
• Far too long
• Too long
• Manageable
• Just the right length
