title: Impact of an informed choice invitation on uptake of screening for diabetes in primary care (DICISION): randomised trial.
abstract: OBJECTIVE
  To compare the effect of an invitation promoting informed choice for screening with a standard invitation on attendance and motivation to engage in preventive action.
  
  
  METHODS
  Randomised controlled trial.
  
  
  METHODS
  Four English general practices.
  
  
  METHODS
  1272 people aged 40-69 years, at risk for diabetes, identified from practice registers using a validated risk score and invited to attend for screening.
  
  
  METHODS
  Intervention was a previously validated invitation to inform the decision to attend screening, presenting diabetes as a serious potential problem, and providing details of possible costs and benefits of screening and treatment in text and pie charts. This was compared with a brief, standard invitation simply describing diabetes as a serious potential problem.
  
  
  METHODS
  The primary end point was attendance for screening. The secondary outcome measures were intention to make changes to lifestyle and satisfaction with decisions made among attenders.
  
  
  RESULTS
  The primary end point was analysed for all 1272 participants. 55.8% (353/633) of those in the informed choice group attended for screening, compared with 57.6% (368/639) in the standard invitation group (mean difference -1.8%, 95% confidence interval -7.3% to 3.6%; P=0.51). Attendance was lower among the more deprived group (most deprived third 47.5% v least deprived third 64.3%; P<0.001). Interaction between deprivation and effect of invitation type on attendance was not significant. Among attenders, intention to change behaviour was strong and unaffected by invitation type.
  
  
  CONCLUSIONS
  Providing information to support choice did not adversely affect attendance for screening for diabetes. Those from more socially deprived groups were, however, less likely to attend, regardless of the type of invitation received. Further attention to invitation content alone is unlikely to achieve equity in uptake of preventive services.
  
  
  BACKGROUND
  Current Controlled Trials ISRCTN 73125647.
authors.affiliation: King's College London, Psychology Department (at Guy's), Health Psychology Section, Psychology and Genetics Research Group, Guy's Campus, London SE1 9RT. theresa.marteau@kcl.ac.uk
authors.forename: Theresa M
authors.initials: TM
authors.lastname: Marteau
authors.forename: Eleanor
authors.initials: E
authors.lastname: Mann
authors.forename: A Toby
authors.initials: AT
authors.lastname: Prevost
authors.forename: Joana C
authors.initials: JC
authors.lastname: Vasconcelos
authors.forename: Ian
authors.initials: I
authors.lastname: Kellar
authors.forename: Simon
authors.initials: S
authors.lastname: Sanderson
authors.forename: Michael
authors.initials: M
authors.lastname: Parker
authors.forename: Simon
authors.initials: S
authors.lastname: Griffin
authors.forename: Stephen
authors.initials: S
authors.lastname: Sutton
authors.forename: Ann Louise
authors.initials: AL
authors.lastname: Kinmonth
mesh_terms: D000328:Adult; D000368:Aged; D002755:Choice Behavior; D016000:Cluster Analysis; D003657:Decision Making; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis*; D005194:Family Practice; D005260:Female; D006293:Health Promotion; D006801:Humans; D007258:Informed Consent; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009042:Motivation; D010342:Patient Acceptance of Health Care / Q000523:psychology / Q000706:statistics & numerical data*; D012307:Risk Factors
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