背景:有据可查,个人难以理解心血管疾病(CVD)百分比风险评分,这导致了心脏年龄的发展,作为一种沟通风险的手段。开发用于临床用途,作为自我指导的数字测试的一部分,它在提高公众对心脏健康的认识方面的应用以前没有被考虑过。
目的:这项研究旨在了解谁访问了英格兰的心脏年龄测试(HAT)及其对用户感知的影响,知识,以及对CVD风险的理解;未来的行为意图;以及与初级保健服务的潜在参与。
方法:有3个数据来源:常规收集的所有个人访问HAT的数据(2015年2月至2020年6月);基于网络的调查,分布在2021年1月至2021年3月之间;以及对调查受访者子样本的采访(2021年2月至2021年3月)。数据用于描述测试用户人群,并探索对CVD风险的知识和理解,对解释和控制CVD风险的信心,以及对未来行为意图和潜在参与初级保健的影响。访谈采用反身性主题分析法进行分析。
结果:在2015年2月至2020年6月之间,HAT完成了大约500万次,男性完成更多(2,682,544/4,898,532,54.76%),年龄在50至59岁之间(1,334,195/4,898,532,27.24%),白人背景的人(3,972,293/4,898,532,81.09%),以及生活在最贫困的20%地区的人(707,747/4,898,532,14.45%)。该研究以819份调查回复和33份半结构化访谈结束。参与者表示,他们理解高估计心脏年龄的含义,并且自我报告在理解和控制CVD风险方面的理解和信心至少有一些改善。当估计的心脏年龄不等于他们以前的风险认知时,用户会产生负面的情绪反应。当生理风险因素信息缺失时,完成它或产生结果所需的有限信息(即,血压和胆固醇水平)导致一些用户质疑该测试的可信度。然而,大多数接受采访的参与者都提到他们会推荐或已经推荐给其他人,将来会再次使用它,并且更有可能接受国家卫生服务健康检查的提议,并自我报告他们已经或打算改变他们的健康行为,或者感到被鼓励继续改变他们的健康行为。
结论:英国基于网络的HAT已经吸引了大量的人参与他们的心脏健康。改进英国的帽子,本文指出,可以提高用户满意度并防止混淆。有必要进行未来的研究,以了解测试对行为结果的长期益处。
BACKGROUND: It is well documented that individuals struggle to understand cardiovascular disease (CVD) percentage risk scores, which led to the development of heart age as a means of communicating risk. Developed for clinical use, its application in raising public awareness of heart health as part of a self-directed digital test has not been considered previously.
OBJECTIVE: This study aimed to understand who accesses England\'s heart age test (HAT) and its effect on user perception, knowledge, and understanding of CVD risk; future behavior intentions; and potential engagement with primary care services.
METHODS: There were 3 sources of data: routinely gathered data on all individuals accessing the HAT (February 2015 to June 2020); web-based survey, distributed between January 2021 and March 2021; and interviews with a subsample of survey respondents (February 2021 to March 2021). Data were used to describe the test user population and explore knowledge and understanding of CVD risk, confidence in interpreting and controlling CVD risk, and effect on future behavior intentions and potential engagement with primary care. Interviews were analyzed using reflexive thematic analysis.
RESULTS: Between February 2015 and June 2020, the HAT was completed approximately 5 million times, with more completions by men (2,682,544/4,898,532, 54.76%), those aged between 50 to 59 years (1,334,195/4,898,532, 27.24%), those from White ethnic background (3,972,293/4,898,532, 81.09%), and those living in the least deprived 20% of areas (707,747/4,898,532, 14.45%). The study concluded with 819 survey responses and 33 semistructured interviews. Participants stated that they understood the meaning of high estimated heart age and self-reported at least some improvement in the understanding and confidence in understanding and controlling CVD risk. Negative emotional responses were provoked among users when estimated heart age did not equate to their previous risk perceptions. The limited information needed to complete it or the production of a result when physiological risk factor information was missing (ie, blood pressure and cholesterol level) led some users to question the credibility of the test. However, most participants who were interviewed mentioned that they would recommend or had already recommended the test to others, would use it again in the future, and would be more likely to take up the offer of a National Health Service Health Check and self-reported that they had made or intended to make changes to their health behavior or felt encouraged to continue to make changes to their health behavior.
CONCLUSIONS: England\'s web-based HAT has engaged large number of people in their heart health. Improvements to England\'s HAT, noted in this paper, may enhance user satisfaction and prevent confusion. Future studies to understand the long-term benefit of the test on behavioral outcomes are warranted.