Advertisement

Journal of Public Health

, Volume 26, Issue 2, pp 137–144 | Cite as

The use of routine health check-ups and psychological factors—a neglected link. Evidence from a population-based study

  • André Hajek
  • Jens-Oliver Bock
  • Hans-Helmut König
Original Article

Abstract

Aim

It is well known that the use of routine health check-ups is associated with socio-demographic and lifestyle factors. However, the link between psychological factors and the use of routine health check-ups has not been investigated intensively so far. Consequently, the purpose of this study was to determine the psychological factors associated with routine health check-ups.

Subjects and methods

Cross-sectional data were obtained from a population-based study (German Aging Survey) of individuals ≥40 years of age and residing in private households in Germany in the year 2014 (n = 7708). Screening data and data on psychological factors were collected in self-administered questionnaires. Multiple logistic regressions were used to identify psychological correlates of screening behavior, adjusted for socio-demographic, lifestyle and health-related variables.

Results

Of the participants, 65.4% used routine health check-ups regularly. After adjusting for various potential confounders, multiple logistic regressions showed that the use of routine health check-ups was positively associated with life satisfaction, positive affect, optimism, self-efficacy, self-esteem and self-regulation, whereas the outcome measure was not significantly associated with loneliness, negative affect and perceived stress. Furthermore, the outcome measure was positively associated with age, being married and living together with a spouse or partner, body mass index, being a non-daily smoker, drinking alcohol less than once a day and exercising. However, it was not associated with gender, income, number of physical illnesses or region.

Conclusions

The current study stresses the importance of the association between screening behavior and psychological factors. This may help to identify individuals at risk for underuse.

Keywords

Routine health check-ups General medical examination Preventive health examination Psychological factors 

Notes

Compliance with ethical standards

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Please note that an ethical statement for the DEAS study was not necessary because criteria for the need of an ethical statement were not met (risk for the respondents, lack of information about the aims of the study, examination of patients).

Informed consent

Prior to the interview, written informed consent was given by all study participants.

Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

10389_2017_840_MOESM1_ESM.doc (213 kb)
ESM 1 (DOC 213 kb)

References

  1. Antonovsky A (1993) The structure and properties of the sense of coherence scale. Soc Sci Med 36:725–733Google Scholar
  2. Bowen DJ, Alfano CM, McGregor BA, Andersen MR (2004) The relationship between perceived risk, affect, and health behaviors. Cancer Detect Prev 28:409–417CrossRefPubMedGoogle Scholar
  3. Brandtstädter J, Wentura D (1994) Veränderungen der Zeit-und Zukunftsperspektive im Übergang zum höheren Erwachsenenalter: entwicklungspsychologische und differentielle Aspekte. Z Entwickl Padagogis 26:2–21Google Scholar
  4. Bundesministerium für Gesundheit (2016) Teilnahme am gesetzlichen Gesundheits-Check-up. Gliederungsmerkmale: Jahre, Deutschland, Alter, Geschlecht. www.gbe-bund.de. Accessed 26 Sep 2016
  5. Calnan M (1985) Patterns in preventive behavior: A study of women in middle age. Soc Sci Med 20:263–268CrossRefPubMedGoogle Scholar
  6. Casey MM, Call KT, Klingner JM (2001) Are rural residents less likely to obtain recommended preventive healthcare services? Am J Prev Med 21:182–188CrossRefPubMedGoogle Scholar
  7. Cohen S, Kamarck T, Mermelstein R (1983) A global measure of perceived stress. J Health Soc Behav 24:385–396Google Scholar
  8. Crawford JR, Henry JD (2004) The Positive and Negative Affect Schedule (PANAS): Construct validity, measurement properties and normative data in a large non-clinical sample. Br J Clin Psychol 43:245–265CrossRefPubMedGoogle Scholar
  9. Freund AM, Baltes PB (2002) Life-management strategies of selection, optimization and compensation: Measurement by self-report and construct validity. J Pers Soc Psychol 82:642–662CrossRefPubMedGoogle Scholar
  10. Gierveld JDJ, Van Tilburg T (2006) A 6-item scale for overall, emotional, and social loneliness confirmatory tests on survey data. Res Aging 28:582–598Google Scholar
  11. Hautzinger M, Bailer M (1993) ADS-Allgemeine Depressions-Skala. Weinheim, BeltzGoogle Scholar
  12. Hoebel J, Richter M, Lampert T (2013) Sozialer Status und Teilnahme am Gesundheits-Check-up von Männern und Frauen in Deutschland: Ergebnisse der GEDA-Studie 2009 und 2010 Deutsches Ärzteblatt 110:679–685Google Scholar
  13. Hoebel J, Starker A, Jordan S, Richter M, Lampert T (2014) Determinants of health check attendance in adults: findings from the cross-sectional German Health Update (GEDA) study. BMC Public Health 14:913Google Scholar
  14. Jo H, Lee S, Ahn MO, Jung SH (2003) Structural relationship of factors affecting health promotion behaviors of Korean urban residents. Health Promot Int 18:229–236CrossRefPubMedGoogle Scholar
  15. Kinney AY, Bloor LE, Martin C, Sandler RS (2005) Social ties and colorectal cancer screening among blacks and whites in North Carolina. Cancer Epidemiol Biomark Prev 14: 182–189Google Scholar
  16. Kivimäki M, Feldt T, Vahtera J, Nurmi J-E (2000) Sense of coherence and health: evidence from two cross-lagged longitudinal samples. Soc Sci Med 50:583–597CrossRefPubMedGoogle Scholar
  17. Klaus D, Engstler H (2016) Daten und Methoden des Deutschen Alterssurveys. In: Mahne K, Wolff JK, Simonson J, Tesch-Römer C (eds) Altern im Wandel: Zwei Jahrzehnte Deutscher Alterssurvey (DEAS). Berlin pp 25–42Google Scholar
  18. Klaus D, Engstler H, Mahne K, Wolff JK, Simonson J, Wurm S, Tesch-Römer C (2017) Cohort profile: The German Ageing Survey (DEAS). Int J Epidemiol: 1–8.  https://doi.org/10.1093/ije/dyw326
  19. Lin EH, Peterson C (1990) Pessimistic explanatory style and response to illness. Behav Res Ther 28:243–248CrossRefPubMedGoogle Scholar
  20. Lüngen M, Siegel M, Drabik A, Büscher G, von Törne I (2009) Ausmaß und Gründe für Ungleichheiten der gesundheitlichen Versorgung in Deutschland Studien zu Gesundheit, Medizin und Gesellschaft 5/2009Google Scholar
  21. Mulkana SS, Hailey BJ (2001) The role of optimism in health-enhancing behavior. Am J Health Behav 25:388–395CrossRefPubMedGoogle Scholar
  22. Neller K (2005) Kooperation und Verweigerung. Eine Non-Response-Studie ZUMA Nachrichten 29:9–36Google Scholar
  23. Ng DM, Jeffery RW (2003) Relationships between perceived stress and health behaviors in a sample of working adults. Health Psychol 22:638–642CrossRefPubMedGoogle Scholar
  24. O'Malley AS, Mandelblatt J (2003) Delivery of preventive services for low-income persons over age 50: a comparison of community health clinics to private doctors' offices. J Community Health 28:185–197CrossRefPubMedGoogle Scholar
  25. Oscarsson MG, Wijma BE, Benzein EG (2008) ‘I do not need to… I do not want to… I do not give it priority…’—Why women choose not to attend cervical cancer screening. Health Expect 11:26–34CrossRefPubMedPubMedCentralGoogle Scholar
  26. Pavot W, Diener E (1993) Review of the satisfaction with life scale. Psychol Assess 5:164–172CrossRefGoogle Scholar
  27. Pirraglia PA, Sanyal P, Singer DE, Ferris TG (2004) Depressive symptom burden as a barrier to screening for breast and cervical cancers. J Women's Health 13:731–738CrossRefGoogle Scholar
  28. Richter M, Brand H, Rössler G (2002) Sozioökonomische Unterschiede in der Inanspruchnahme von Früherkennungsuntersuchungen und Maßnahmen der Gesundheitsförderung in NRW. Gesundheitswesen 64:417–424Google Scholar
  29. Ridolfi DR, Crowther JH (2013) The link between women's body image disturbances and body-focused cancer screening behaviors: A critical review of the literature and a new integrated model for women. Body Image 10:149–162CrossRefPubMedGoogle Scholar
  30. Rimer BK, Orleans CT, Keintz MK, Cristinzio S, Fleisher L (1990) The older smoker. Status, challenges and opportunities for intervention. Chest J 97:547–553CrossRefGoogle Scholar
  31. Rosenberg M (1965) Society and the adolescent self-image. Princeton University Press, PrincetonGoogle Scholar
  32. Schwarzer R, Jerusalem M (1999) Skalen zur Erfassung von Lehrer- und Schülermerkmalen. Dokumentation der psychometrischen Verfahren im Rahmen der Wissenschaftlichen Begleitung des Modellversuchs Selbstwirksame Schulen. Freie Universität Berlin, BerlinGoogle Scholar
  33. Steptoe A, Wright C, Kunz-Ebrecht SR, Iliffe S (2006) Dispositional optimism and health behaviour in community-dwelling older people: Associations with healthy ageing. Br J Health Psychol 11:71–84CrossRefPubMedGoogle Scholar
  34. Thorpe JM, Kalinowski CT, Patterson ME, Sleath BL (2006) Psychological distress as a barrier to preventive care in community-dwelling elderly in the United States. Med Care 44:187–191CrossRefPubMedGoogle Scholar
  35. Tolma EL, Reninger BM, Evans A, Ureda J (2006) Examining the theory of planned behavior and the construct of self-efficacy to predict mammography intention. Health Educ Behav 33:233–251CrossRefPubMedGoogle Scholar
  36. Ware JE Jr, Sherbourne CD (1992) The MOS 36-item short-form health survey (SF-36): I. Conceptual framework and item selection. Med Care 30:473–483CrossRefPubMedGoogle Scholar
  37. Watson D, Clark LA, Tellegen A (1988) Development and validation of brief measures of positive and negative affect: the PANAS scales. J Pers Soc Psychol 54:1063–1070CrossRefPubMedGoogle Scholar
  38. Woolhandler S, Himmelstein DU (1988) Reverse targeting of preventive care due to lack of health insurance. Jama 259:2872–2874CrossRefPubMedGoogle Scholar
  39. Ylöstalo P, Ek E, Laitinen J, Knuuttila M (2003) Optimism and life satisfaction as determinants for dental and general health behavior—oral health habits linked to cardiovascular risk factors. J Dent Res 82:194–199CrossRefPubMedGoogle Scholar
  40. Zhang P, Too G, Irwin KL (2000) Utilization of preventive medical services in the United States: a comparison between rural and urban populations. J Rural Health 16:349–356CrossRefPubMedGoogle Scholar
  41. Ziegelmann JP, Lippke S (2006) Selbstregulation in der Gesundheitsverhaltensänderung: Strategienutzung und Bewältigungsplanung im jungen, mittleren und höheren Alter. Z Gesundheitspsychol 14:82–90Google Scholar

Copyright information

© Springer-Verlag GmbH Germany 2017
corrected publication January/2018

Authors and Affiliations

  1. 1.Department of Health Economics and Health Services Research, Hamburg Center for Health EconomicsUniversity Medical Center Hamburg-EppendorfHamburgGermany

Personalised recommendations