Reasons to Participate or not to Participate in Cardiovascular Health Checks: A Review of the Literature

Cardiovascular health checks test risk factors for cardiovascular disease (CVD). They are offered to improve health: in case of an increased risk, participants receive lifestyle advice and medication. With this review, we investigate what is known about the reasons why people do or do not test for CVD risk factors. To what extent do these reasons relate to health monitoring and/or improvement? And do reasons differ in different contexts in which health checks are offered? We conducted a literature search and included 22 papers in which we identified a broad range of motives. We conclude that (i) people have reasons to test related to health improvement and reasons other than health improvement, (ii) practical reasons related to the way health checks are offered (facilitators and barriers) play an important role and (iii) motives should be understood in the context of the situation in which health checks are offered. Our results are relevant for public health officials and providers of health checks: first, if people undergo testing for reasons unrelated to health, this could explain why participation in health checks does not necessarily lead to health improvement. Second, efforts to improve uptake not necessarily serve justice and may hamper informed consent.