title: Individual decision making in relation to participation in cardiovascular screening: a study of revealed and stated preferences.
abstract: OBJECTIVE
  The (cost-)effectiveness of a screening programme may be strongly influenced by the participation rate. The objective of this study was to compare participants' and non-participants' motives for the attendance decision as well as their overall preferences for participation in cardiovascular disease screening.
  
  
  METHODS
  This study sampled 1053 participants and 1006 non-participants from a screening trial and randomly allocated the participants to receive different levels of additional information about the screening programme. An ad hoc survey questionnaire about doubt and arguments in relation to the participation decision was given to participants and non-participants along with a contingent valuation task.
  
  
  RESULTS
  Among participants, 5% had doubt about participation and the most frequent argument was that they did not want the test result. Among non-participants, 40% would reconsider their non-participation decision after having received additional information while the remainder 60% stood by their decision and provided explicit arguments for it. After having received additional information the participants still valued the programme significantly higher than non-participants, but the difference was relatively small.
  
  
  CONCLUSIONS
  Participants and non-participants in cardiovascular screening programmes seem to have different strengths of preferences, which signals that their behavioural choice is founded in rational thinking. Furthermore, it appears that additional information and a second reflection about the participation decision may affect a substantial proportion of non-participants to reverse their decision, a finding that should receive policy interest.
authors: CAST Centre for Health Services Research and Technology Assessment, Institute of Public Health, University of Southern Denmark, Odense C, Denmark. ris@cast.sdu.dk
authors: Rikke
authors: R
authors: Søgaard
authors: Jes
authors: J
authors: Lindholt
authors: Dorte
authors: D
authors: Gyrd-Hansen
mesh_terms: D000368:Aged; D002318:Cardiovascular Diseases / Q000175:diagnosis*; D003657:Decision Making; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data*; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D010353:Patient Education as Topic / Q000379:methods; D057240:Patient Preference / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires