Factors Influencing Residents’ Decision to Participate in Health Screening in Taiwan: A Qualitative Study

Abstract

Introduction: Chronic diseases have affected the health and quality of life of people in a vast number of countries. Critically, chronic diseases have been rapidly increasing worldwide and inflicting a heavy burden on society. As such, health screening has been applied to reduce individuals’ risks of developing chronic diseases and to initiate health promotion or disease prevention. However, the participant rate is low, especially for people living in rural areas. The purpose of this study was to identify the factors that influence people’s decisions to undergo health screening. Method: Semi-structured interviews were undertaken for 16 people aged between 30 - 60 years, and all interviewees had never attended health screening at our hospital despite being invited. Interviewees were from four districts in Taiwan: Anle District of Keelung City; and Ruifang, Gongliao, and Wanli Districts of New Taipei City. These districts were sampled to represent urban and rural areas, respectively, and people in these rural areas were suspected to have high risk of metabolic diseases, kidney and lung diseases or cancers. Interviews were audio-recorded and transcribed verbatim, and NVivo 11 was used for data management. Result: Six motivating factors or barriers were identified: 1) Health attitudes and beliefs about the benefits of participating in health screening; 2) expectation of health screening from the perspective of participants; 3) cost consideration; 4) impact of social influence on willingness to participate in health screening; 5) the experiences of health screening; and 6) practical motivations or barriers of undergoing health screening. Conclusion: Health attitudes and beliefs about the benefits of having a health screening, personal health expectations, and free health services were identified as the top three important factors that influence a resident’s decision to undergo health screening for chronic diseases in Taiwan.