title: Risk factors for not completing health interventions and the potential impact on health inequalities between educational groups - a mixed method study from Denmark.
abstract: BACKGROUND
  Individual-based interventions aim to improve patient self-management of chronic disease and to improve lifestyle among people at high risk, to reduce the prevalence of diseases contributing to health inequality. The present study investigates risk factors for uncompleted health interventions, via a combination of quantitative and qualitative methods.
  
  
  METHODS
  From a health centre in Copenhagen, questionnaire data on educational level, gender, age, and cohabitation status from 104 participants in health interventions were used to examine risks for dropout. Qualitative telephone interviews further investigated risk factors among 17 participants who were registered as uncompleted.
  
  
  RESULTS
  Our findings show that there is a significantly higher prevalence of uncompleted courses among participants below age 60 (OR 3.38, 95 % CI 1.08; 10.55) and an insignificantly higher prevalence among people with low education (OR 1.82, 95 % CI 0.66; 5.03). Qualitative elaboration of these findings points to low self-control in jobs and a higher degree of comorbidity and treatment of diseases among the lower educated as determinants for not completing, but not lower motivation or less positive attitude toward the intervention itself.
  
  
  CONCLUSIONS
  This study indicates a social difference in dropout, and if dropout is to be prevented, there is a need to acknowledge factors such as organization of the intervention, lack of job flexibility, and comorbidity. If these factors are not addressed, people with low socioeconomic status will most likely have reduced opportunities for making healthy choices, in this case, completing the intervention, and this may increase health inequality.
authors.affiliation: Section of Social Medicine, Institute of Public Health, University of Copenhagen, Gothersgade 160, Copenhagen, DK-1014 K, Denmark.
authors.forename: Nanna
authors.initials: N
authors.lastname: Kure-Biegel
authors.affiliation: Section of Social Medicine, Institute of Public Health, University of Copenhagen, Gothersgade 160, Copenhagen, DK-1014 K, Denmark.
authors.forename: Christina Warrer
authors.initials: CW
authors.lastname: Schnohr
authors.affiliation: Department of Learning and Philosophy, Aalborg University, A C Meyers Vaenge 15, DK-2450, Copenhagen, SV, Denmark. alh@learning.aau.dk.|Health Promotion Research, Steno Diabetes Center, Niels Steensens Vej 2, Gentofte, DK-2820, Denmark. alh@learning.aau.dk.
authors.forename: Anette Lykke
authors.initials: AL
authors.lastname: Hindhede
authors.affiliation: Section of Social Medicine, Institute of Public Health, University of Copenhagen, Gothersgade 160, Copenhagen, DK-1014 K, Denmark.
authors.forename: Finn
authors.initials: F
authors.lastname: Diderichsen
mesh_terms: D000328:Adult; D000368:Aged; D002908:Chronic Disease / Q000628:therapy; D003718:Denmark; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000379:methods* / Q000592:standards; D012307:Risk Factors; D012648:Self Care / Q000379:methods / Q000592:standards*; D011795:Surveys and Questionnaires
keywords: Health inequity; Health policy; Interventions; Lifestyle factors; Tertiary prevention