Using screening

What is screening

Screening means checking people who think or feel they are healthy to find if they have certain health problems or risk factors they did not know about before. Screening can be done by:

• asking questions, for example, about smoking
• examining the person, for example, checking blood pressure
• doing tests, for example, a blood test for iron levels

A person who has a positive screening test will usually need further tests to identify specific health problems. For example, a urine dipstick test might show protein, but you need to do further tests to know if the person really has kidney disease.

Types of screening

Mass (untargeted) screening means screening a whole population (defined by geographical location, age groups or gender), for example, cervical screening for all women of reproductive age, screening adults for risk factors for chronic diseases.

Targeted screening is screening a group of people who are more likely to have a par-ticular problem, for example, screening for diabetes in a person who has a close family member with diabetes.

Opportunistic screening is screening individuals when you have an opportunity, for example, when they attend the health centre for some other reason such as a cold or a minor injury, for example:

• offer a diabetes check to an adult who has a family history of diabetes
• when checking blood pressure, ask about smoking and alcohol consumption

Problems identified by screening should be followed by appropriate action, such as:

• brief intervention
• referral
• treatment
• family consultation

Using screening as a health promotion strategy

Screening is an opportunity for education for health. It can be used as a tool to mobi-lise community, group or individual, action. When community results are fed back and compared with NT and national figures, people may ask questions about how to prevent the problem and decide to improve their situation.

When individuals are fed back results of their screening test, you have an opportunity for doing an early or brief intervention. This timely and personal information may help the person to change his or her health behaviour, or encourage the person to maintain positive health behaviours.

In summary, screening can be used in a way which helps to motivate and support people to develop skills and to make decisions, collectively or individually, which are right for them. Used in this way screening becomes an effective health promotion strategy.

		For more information see the chapter 'Sharing Health Information'
		See 'Brief Interventions' in the chapter 'Strategies for Health Promotion'

Why screen

• To detect health problems or risk factors early so people can be offered treatment or other interventions to either stop a disease developing, or to prevent complica-tions or early death
• To reinforce with people who do not show risk factors that what they are doing is right. Feeding back the results of screening provides opportunities to give en-couragement and praise to those people who live a healthy lifestyle
• To alert people, even those who do not currently show risk factors, that they are predisposed to developing health problems:
  - the family living environment and lifestyle may predispose people to de-veloping problems; for example, eating the same foods as others who have developed nutrition related problems, and smoking passively. These life-style factors are modifiable
  - the family health history may suggest that individuals are predisposed to developing certain health problems. While genetic pre-disposition is not modifiable, there are things that you can encourage individuals and families to do which lower the risk
  - both lifestyle and genetic predispositions may by present in one individual or group
• To raise community awareness about shared health problems, or a set of risk factors, that can stimulate community level action
• To complement a range of health promotion strategies

Information gathered through screening can also be used to:

• help plan services by collecting baseline and ongoing information about the prevalence of disease, health related problems, or risk factors
• raise people's awareness about the prevalence of a health problem in their community