Trial reportBMC family practice2016
The effectiveness of an enhanced invitation letter on uptake of National Health Service Health Checks in primary care: a pragmatic quasi-randomised controlled trial.
Trial report in BMC family practice, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
32 citing papers in PubMed, 5 syntheses or guidelines pooled it.
- A systematic review of factors influencing NHS health check uptake: invitation methods, patient characteristics, and the impact of interventions.BMC public health · 2020Pooled it
- Lifestyle behaviour change for preventing the progression of chronic kidney disease: a systematic review.BMJ open · 2019Pooled it
- Delivery and impact of the NHS Health Check in the first 8 years: a systematic review.The British journal of general practice : the journal of the Royal College of General Practitioners · 2018Pooled it
- Reasons why people do not attend NHS Health Checks: a systematic review and qualitative synthesis.The British journal of general practice : the journal of the Royal College of General Practitioners · 2018Pooled it
- A Scoping Review of Behavioral Economic Interventions for Prevention and Treatment of Type 2 Diabetes Mellitus.Current diabetes reports · 2017Pooled it
- Can uptake of childhood influenza immunisation through schools and GP practices be increased through behaviourally-informed invitation letters and reminders: two pragmatic randomized controlled trials.BMC public health · 2023Trial
- Improving postal survey response using behavioural science: a nested randomised control trial.BMC medical research methodology · 2021Trial
- Increasing uptake of NHS Health Checks: a randomised controlled trial using GP computer prompts.The British journal of general practice : the journal of the Royal College of General Practitioners · 2021Trial
- A randomized controlled trial to test the effect of simplified guidance with visuals on comprehension of COVID-19 guidelines and intention to stay home if symptomatic.BMC public health · 2021Trial
- Effects of a Co-Design-Based Invitation Strategy on Participation in a Preventive Health Check Program: Randomized Controlled Trial.JMIR public health and surveillance · 2021Trial
- Feasibility and success rates of response enhancing strategies in a stepwise prevention program for cardiometabolic diseases in primary care.BMC family practice · 2020Trial
- Applying behavioural science to increase uptake of the NHS Health Check: a randomised controlled trial of gain- and loss-framed messaging in the national patient information leaflet.BMC public health · 2019Trial
- Evaluating the effectiveness of the NHS Health Check programme in South England: a quasi-randomised controlled trial.BMJ open · 2019Trial
- Pre-notification and reminder SMS text messages with behaviourally informed invitation letters to improve uptake of NHS Health Checks: a factorial randomised controlled trial.BMC public health · 2019Trial
- Randomised controlled trial comparing uptake of NHS Health Check in response to standard letters, risk-personalised letters and telephone invitations.BMC public health · 2019Trial
- Using behavioural insights to increase HIV self-sampling kit returns: a randomized controlled text message trial to improve England's HIV self-sampling service.HIV medicine · 2018Trial
- Enhanced Invitations Using the Question-Behavior Effect and Financial Incentives to Promote Health Check Uptake in Primary Care.Annals of behavioral medicine : a publication of the Society of Behavioral Medicine · 2018Trial
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- Agile evaluation including two pragmatic trials on the uptake of a digital screening service.NPJ digital medicine · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe National Health Service Health Check (NHS HC) is a population level public health programme. It is a primary prevention initiative offering cardiovascular risk assessment and management for adults aged 40-74 years (every five years). It was designed to reduce the incidence of major vascular disease events by preventing or delaying the onset of diabetes, heart and kidney disease, stroke and vascular dementia . Effectiveness of the programme has been modelled on a national uptake of 75% however in 2012/13 uptake, nationally, was 49%. Ensuring a high percentage of those offered an NHS HC actually receive one is key to optimising the clinical and cost effectiveness of the programme.
methodsA pragmatic quasi-randomised controlled trial was conducted in four general practitioner practices in Medway, England with randomisation of 3511 patients. The aim was to compare attendance at the NHS HC using the standard national invitation template letter (control) compared to an enhanced invitation letter using insights from behavioural science (intervention). The intervention letter includes i) simplification - reducing letter content for less effortful processing ii) behavioural instruction - action focused language iii) personal salience - appointment due rather than invited and iv) addressing implementation intentions with a tear off slip to record the date, time and location of the appointment. Logistic Regression explored the association between control and intervention group and attendance at a health check.
results29.3% of patients who received the control letter and 33.5% of those who received the intervention letter attended their NHS HC (adjusted odds ratio 1.26, 95% confidence interval 1.09-1.47, p < 0.01). This was an absolute difference in uptake of 4.2 percentage points for those receiving the intervention letter.
conclusionsAn invitation letter applying behavioural insights was more effective than the existing national template letter at encouraging attendance at an NHS HC. Making small, no cost behaviourally informed changes to letter invitations can improve uptake of the NHS HC. Further research is required to replicate the effect with more robust methodology and powered for sub-group analysis including socio-economic status.
trial registrationCurrent Controlled Trials ISRCTN66757664 , date of registration 28/3/2014.
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