Interventions

The intervention included (i) an invitation to a prescheduled health check, (ii) a health check at the GP and (iii) a health consultation at the GP which included an offer of further action if necessary.

All participants allocated to the intervention group received a postal invitation to a prescheduled health check from their GP and the research team. Included with the invitation was a written description of the project. Furthermore, it was clarified that study participation was voluntary and that withdrawal could occur at any time. Three days before the prescheduled appointment, participants in the intervention group were reminded by phone by a member of the research team.

Before the health check, the GPs received results from the patient-reported questionnaire in the GPs electronic patient record in the form of an electronic data interchange message including summed scores and categorisation of items from the baseline questionnaire (see online supplementary file 1). The health check was free of charge and took place during the opening hour of the general practice clinic to which the patient was registered and was conducted by either the GP or other health staff at the clinic as per usual clinical practice. The health check consisted of measurements of weight and height, hip and waist circumference, cholesterol, glycated haemoglobin, thyroidal status and spirometry for smokers or former smokers. The health consultation with the purpose of review of results was scheduled at the health checks.

bmjopen-2019-029180supp001.pdf

At the health consultation, the GP reviewed the results from the health check in combination with the summarised results of the questionnaire. Participants with abnormal screens, or health behaviour amenable to intervention at the health check, either follow the medical standards for general practice on procedures for diagnostics and treatment or received the offer of a referral to the municipality health centre for a lifestyle change programme. Furthermore, these participants were offered an additional health check scheduled 6 months after the first health check. Decisions for further action and reasons for referral or not were indicated by the GP in a project specified form.

Participants allocated to the control group received unrestricted usual care during the intervention period. The results from the questionnaires were entered in the GPs electronic patient record; however, no feedback was provided to the patients.