Stakeholders’ perceptions of factors influencing uptake, delivery, and commissioning of health checks

BACKGROUND: General health checks are offered through national programs and commercial providers in many healthcare systems. Despite their popularity, it has been argued that health checks have little or no impact on population morbidity and mortality. The aim of the qualitative evidence synthesis was to identify factors that influence the uptake, delivery, and commissioning of general health checks from the perspective of stakeholders. METHODS: We searched Medline and CINAHL for relevant studies up to 20 January 2022. We dually selected abstracts and fulltexts according to predefined criteria and sampled studies using a maximum variation. We developed a logical model representing individual, intervention, and contextual factors which guided data extraction and synthesis. RESULTS: A total of 110 studies met the inclusion criteria, and we selected 37 as sample. Individual factors identified were awareness of the existence of general health checks, personal risk perception, social factors, patient-doctor relationship, financial and time resources, experience during examination and fears regarding outcomes, feedback on health status as impetus for lifestyle changes. Intervention factors included information and invitation systems, discussions about the components and impact of general health checks, modalities of follow-up care, staff qualifications, framework conditions, logistical aspects, and setting. The contextual factors included cultural differences in the perception of disease and prevention, effects of general health checks on morbidity, mortality and social inequality, accessibility, and political climate. CONCLUSIONS: The results show a variety of perceptions regarding factors that influence the uptake, delivery, and commissioning of general health checks. They shed light on the debate about general health checks as a preventive measure in the health care system and highlight the limitations of the evidence regarding effectiveness. KEY MESSAGES: • Clients, providers and commissioners may define the “effectiveness” of general health checks not merely on the grounds of population-wide morbidity and mortality reduction. • Clients, providers and commissioners might seek in general health checks the fulfillment of individual needs that are context dependent.