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• Patients' estimations of the importance of preventive health services, the disconnect in knowledge translation
  Ingrid Wood
  Published on: 21 November 2016

• Published on: 21 November 2016

  Patients' estimations of the importance of preventive health services, the disconnect in knowledge translation

  • Ingrid Wood, MSc(A) Candidate

  I found the article "Patients' estimations of the importance of preventative health services: a nationwide population-based cross- sectional study in Portugal" by Sa and colleagues to be yet another poignant example illustrating the disconnect in knowledge translation between healthcare researchers and professionals and the general public.

  The authors conducted phone interviews with 1000 Portuguese adults and a...

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  I found the article "Patients' estimations of the importance of preventative health services: a nationwide population-based cross- sectional study in Portugal" by Sa and colleagues to be yet another poignant example illustrating the disconnect in knowledge translation between healthcare researchers and professionals and the general public.

  The authors conducted phone interviews with 1000 Portuguese adults and asked them to rate the importance of 20 preventative medical activities on a 1-10 scale. The interventions deemed most important were blood and urine tests followed by female-specific exams.

  Preventative health campaigns certainly appear to have been effective in raising awareness of illnesses and their preventative screenings, as we see with regards to women's reproductive health, but unsurprisingly the risk and relevance of such screenings are rarely emphasized. This is illustrated by that fact that gynecological ultrasounds were, on average, considered equally important, as preventative health interventions, as mammography among study participants. This idea is also supported by the continued perceived importance of PSA (prostate serum antigen) tests despite the fact that it is now thought that the inclusion of PSA tests as part of routine screening may have contributed to the spike in prostate cancer diagnoses in the 1990s, leading to more invasive and risky testing, and treatment of cancers that would not have been life- threatening (Croswell et al., 2011; Ilic et al., 2011).

  Furthermore, running public health campaigns is very costly and with preventative health recommendations changing quite frequently (e.g. type of screening, frequency of screening, age at which to start screening) the information spread through these campaigns can become outdated within a few years. This is covered in more detail in a partner study by the same team which examined what preventative health exams were considered necessary and how often they should be performed (Martins et al., 2013).

  This article also exemplifies the gap between healthcare worker's and the population's expectation of what preventative healthcare really means.

  In the medical field, the focus is shifting from the traditional biomedical model which emphasizes treating the disease, to a patient or person-centered model which emphasizes treating the person. This second model, lends itself more readily to the concept of preventative care, by placing emphasis on examining the individual's lifestyle and environment in addition to their current physical health. In doing so, the goal is to identify potential risks, develop strategies and help access resources that can mitigate the risks and encourage healthier living. Unfortunately, it appears as though this message is slow to reach the Portuguese public as exams perceived as more 'medicalized' were also viewed as more important whereas guidance and counseling to encourage healthier lifestyles were perceived to be the least important.

  Ultimately the responsibility falls on healthcare workers and health organizations to try to open a more nuanced discussion about illness, risk and preventative health.

  References:

  Croswell, J. M., & Kramer, B. S. (2011). Screening for prostate cancer with PSA testing: current status and future directions. Oncology, 25(6), 452.

  Ilic D, O'Connor D, Green S, Wilt TJ. (2001). Screening for prostate cancer: an updated Cochrane systematic review. BJU international.107(6):882-891

  Martins, C., Azevedo, L. F., Ribeiro, O., S?, L., Santos, P., Couto, L., ... & Hespanhol, A. P. (2013). A Population-Based Nationwide Cross -Sectional Study on Preventive Health Services Utilization in Portugal-- What Services (and Frequencies) Are Deemed Necessary by Patients?. PloS one, 8(11), e81256.

  Conflict of Interest:

  None declared

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  Conflict of Interest:
  None declared.

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