title: Influences on the uptake of diabetes screening: a qualitative study in primary care.
abstract: BACKGROUND
  To address the increasing global prevalence of type 2 diabetes healthcare organisations have been contemplating different screening and intervention strategies. Patient acceptability is a key criterion of a screening programme.
  
  
  OBJECTIVE
  To explore  the perspectives of those invited to attend the MY-WAIST screening study for type 2 diabetes, particularly explanations for attending or not, and views on the specific screening strategy.
  
  
  METHODS
  Qualitative study of 11 general practices in Leicestershire, UK.
  
  
  METHODS
  Semi-structured interviews were conducted with 24 individuals (40-69 years) invited to attend the MY-WAIST screening study, comprising 13 who attended and 11 who did not attend the screening. Additional data included reply slips from 73 individuals who declined  the offer of screening. Analysis was informed by the constant comparative method.
  
  
  RESULTS
  Two categories of influence on the decision about attending screening emerged. 1) Beliefs about type 2 diabetes candidacy and type 2 diabetes was more common among those who had attended;  lack of perceived severity of type 2 diabetes was more common among those who did not attend. 2) Practical aspects about the screening strategy: the lengthy, early morning screening appointments were a barrier to uptake; screening attendees found the procedure largely acceptable. Pre-screening  waist self-measurement was more memorable than the remainder of the risk-score calculation; neither impacted on uptake.
  
  
  CONCLUSIONS
  The barriers to screening uptake highlighted contribute to current debates about different screening and diagnostic tests for type 2 diabetes  and future risk of type 2 diabetes. The findings are useful for those contemplating implementation of screening programmes for identifying type 2 diabetes and pre-diabetes.
authors.affiliation: Department of Health Sciences, University of Leicester, Leicester, UK. hce3@le.ac.uk
authors.forename: Helen
authors.initials: H
authors.lastname: Eborall
authors.forename: Margaret
authors.initials: M
authors.lastname: Stone
authors.forename: Navneet
authors.initials: N
authors.lastname: Aujla
authors.forename: Nicholas
authors.initials: N
authors.lastname: Taub
authors.forename: Melanie
authors.initials: M
authors.lastname: Davies
authors.forename: Kamlesh
authors.initials: K
authors.lastname: Khunti
mesh_terms: D000328:Adult; D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis* / Q000523:psychology; D042241:Early Diagnosis; D004739:England; D005194:Family Practice; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000175:diagnosis / Q000523:psychology; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D012649:Self Concept; D055105:Waist Circumference