Occupational Medicine 2019;69:106–112 Advance Access publication on 26 November 2018 doi:10.1093/occmed/kqy156 © The Author(s) 2018. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com Cardiovascular risk assessments at occupational health services: employee experiences E. M. Di Battista 1 , R. M. Bracken 2,3 , J. W. Stephens 3 , S. Rice 4 , S. P. Williams 5 , M. Thomas 6 and S. D. Mellalieu 7 1 Aneurin Bevan University Health Board, Adult Weight Management Service, Saint Cadoc’s Hospital, Caerleon, Newport, NP18 3XQ, UK; University of South Wales, Faculty of Life Sciences and Education, Pontypridd, CF37 1DL, UK, 2 Applied Sports Technology Exercise and Medicine (A-STEM) Research Centre, College of Engineering, Swansea University, Swansea University Bay Campus, Swansea, SA1 8EP, UK, 3 Diabetes Research Group, Swansea University Medical School, Swansea University, Singleton Park, Swansea, SA2 8PP, UK, 4 Hywel Dda Health Board, Diabetes Centre, Prince Philip Hospital, Llanelli, Carmarthenshire, SA14 8QF, UK, 5 TATA Steel Packaging Recycling, Trostre, Llanelli, Carmarthenshire, SA14 9SD, UK, 6 Public Health Wales, Carmarthen, Carmarthenshire, SA31 3WY, UK, 7 Cardiff Metropolitan University, Cardiff School of Sport and Health Sciences, Cyncoed Campus, Cardiff, CF5 2YB, UK. Correspondence to: E. M. Di Battista, Aneurin Bevan University Health Board, Adult Weight Management Service, Saint Cadoc’s Hospital, Lodge Road, Caerleon, Newport, NP18 3XQ, UK. Tel: 07817012118; e-mail: enzo.dibattista@wales.nhs.uk Background Across England in the UK, population screening for cardiovascular disease (CVD) primarily takes place within general practice in the form of the National Health Service Health Check. Additional screening sites such as occupational health are advocated to improve the population impact. Aims To investigate participant experiences with cardiovascular and type 2 diabetes risk assessment (RA) at occupational health and subsequent support-seeking at general practice. Methods Face-to-face interviews were conducted for this qualitative study. Participants were recruited at three workplaces; a steel works and two hospital sites. Using interpretive phenomenological analyses, themes were drawn from salient narratives and categorically organized. Results There were 29 participants. Themes (n = 16) were organized into two domains; factors that facili- tated (n = 9) or thwarted (n = 7) participant engagement with the RA and general practice. All participants described the RA as worthwhile and strongly valued RA at occupational health. Those with obesity and high CVD risk highlighted their diffculties in making lifestyle changes. Participants reported confusion and anxiety when GP advice about medication appeared to contradict what par- ticipants had interpreted during RA at occupational health. Conclusions This study highlights factors that facilitate or thwart engagement in cardiovascular RA at occupational health services and general practice follow-up. Stakeholders can integrate these factors into standard operating procedures to enhance participant engagement and enable safeguards that minimize poten- tial harm to participants. Key words Cardiovascular; diabetes; obesity stigma; occupational health provision; primary health care; quali- tative study; risk assessment. Introduction Cardiovascular disease (CVD) is a leading cause of mortality [1]. In recent decades, following the infuential Framingham study [2], efforts to coordinate population-wide cardiovas- cular risk assessment (RA) have been implemented. Across England in the UK, the National Health Service (NHS) Health Check, a form of RA, is primarily delivered via gen- eral practice [3]. To enhance targeted RA, various additional operational sites (AOS) have been utilized, for example, community pharmacy and occupational health [4, 5]. Such AOS are reported to be effective in recruitment and the modifcation of risk factors in controlled studies [6]. RA at occupational health also identifes individuals at low risk and provides the necessary brief intervention without bur- dening general practice [4, 7]. In cases with increased risk where hypertension, hyperlipidaemia and impaired glucose regulation are established, AOS refer individuals into general practice to seek guidance on pharmacological treatment and longer-term management [8, 9]. Downloaded from https://academic.oup.com/occmed/article/69/2/106/5209930 by guest on 06 February 2024