Although use of clinical preventive services (CPS) such as cholesterol screening, pap smears and mammograms is rising, the rate of patient CPS utilization is still considered suboptimal by many health practitioners. This study used a telephone survey of adults in eight rural southeastern states to assess whether an individual's beliefs about periodic checkups contributed to the likelihood of their receiving CPS. Southeastern states consistently rank in the bottom quartile on measurements assessing receipt of preventive care and rural areas also tend to report low use of preventive care.
Results indicated that belief in the value of a periodic health examination—whether or not such an examination had actually been received during the past year—is associated with higher rates of receipt of CPS. Individuals who did not value or were ambivalent about checkups received fewer mammograms, colon cancer screenings, pap smears and cholesterol checks. Men and younger people less often valued CPS relative to women and older people in this study. Also, rate differences between those who did and did not value checkups varied by test, although reasons for these variations were not explored in this study. For example, patients suffering from diabetes and/or hypertension may receive more frequent cholesterol screening; therefore, their beliefs about the value of checkups may have less influence on receiving that particular screening test than the beliefs of an individual who does not have these conditions.
Because the U.S. health system utilizes opportunistic screening during medical encounters for other conditions, those who do not endorse annual checkups are at high risk for not receiving other CPS. This study is cross-sectional, and therefore causal inferences cannot be made with certainty. However, the above findings suggest that outreach to these skeptical individuals may be best accomplished through press and television advertising and campaigns, through the workplace, or by mandates from insurers, rather than through medical channels.