Prevention in practice: Results of a 2-year follow-up of routine health promotion interventions in general practice

Background. The effectiveness of health promotion activity in general practice on risk factor reduction for coronary heart disease remains the subject of active debate. Objective. The study aimed to assess the impact of practice-based health check-ups on health behaviours over a 2-year period. Method. A general practice cohort of 7123 patients from 18 practices was surveyed. Eight hundred and forty (12%) patients had been offered a health check within a 12-month period from September 1992 and 621 (9%) received one. Two hundred and fifty patients (40%) were asked back for follow-up after their health check. Results. Over a 2-year period there was no difference in smoking cessation, alcohol consumption, weight loss nor the amount of exercise taken between those who attended for a health check and those who did not. The food score chosen to assess dietary change (Oxcheck) showed a statistically significant 1.16-point rise for the whole sample over the survey period. There was a significant difference in mean food score change between health check attenders and non-attenders (Mann-Whitney U test: P < 0.002). Maintenance of dietary improvement over a 2-year period was not affected by health check attendance. Conclusions. This study confirms the low impact of health checks on the self reported modification of cardiovascular risk factors and shows that maintenance of appropriate health behaviour change is no more likely in those who have received a health check.