P992
Socio-demographic inequalities in the uptake of screening for atrial fibrillation within the STROKESTOP II study: support for decentralised screening

Roche Diagnostics, The Swedish Heart and Lung Foundation, Carl Bennett AB

To prevent stroke as a first clinical manifestation of atrial fibrillation (AF), screening for AF has been suggested. In the STROKESTOP I (SSI) study, participation was significantly influenced by socio-demographic and geographic factors.

The main aim was to improve participation in the STROKESTOP II (SSII) study, especially aiming at socioeconomically weaker groups.

As in the SSI study, in the SSII study all 75/76-year-olds were randomised 1:1 to either a screening arm or a control arm. The individuals in the screening arm were invited to an AF-screening-program. Two screening sites were added in the SSII study, located closer to low-income neighbourhoods with very low participation rates in the SSI study. Information on each invitee’s residential parish was used for a geo-mapping analysis of the geographical disparities in participation. Individual data for the participants and non-participants were obtained with respect to the following socioeconomic variables: educational level, disposable income, immigrant and marital status. Geographic and socio-demographic disparities in the uptake of the SS2 study were analysed and the results compared between the STROKESTOP trials.

Overall, higher participation was observed in those with higher education, high income as well as among non-immigrants and married individuals. Participation between the SSI and SSII improved significantly in the two areas where additional screening sites were introduced. These improvements were generally significant, in each population group according to the socio-demographic characteristics.

Decentralisation of the screening sites in an AF-screening-program had significant impact on the screening uptake. Addition of local screening sites in areas with a very low uptake may have a beneficial impact on the uptake across the full spectrum of socio-demographic groups

Abstract Figure. Participation map