Cardiovascular risk assessments at occupational health services: employee experiences

Occup Med (Lond). 2019 Apr 13;69(2):106-112. doi: 10.1093/occmed/kqy156.


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 facilitated (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 difficulties in making lifestyle changes. Participants reported confusion and anxiety when GP advice about medication appeared to contradict what participants 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 potential harm to participants.

Keywords: Cardiovascular; diabetes; obesity stigma; occupational health provision; primary health care; qualitative study; risk assessment.

MeSH terms

  • Adult
  • Aged
  • Cardiovascular Diseases / prevention & control*
  • Diabetes Mellitus, Type 2 / prevention & control*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Occupational Health Services*
  • Qualitative Research
  • Risk Assessment
  • Risk Reduction Behavior*