is not necessarily a good idea, there is still an emphasis on methods to improve uptake
of screening. Perhaps promoting uptake implicitly accepts the biomedical belief that
screening is beneficial.2 Changes in theory reflect progression. It is often assumed that changes in
theoretical perspective reflect greater knowledge about how individuals work and
an improved understanding of health and illness. Therefore, within this perspective, a
shift in focus towards an examination of the potential negative consequences of
screening can be understood as a better understanding of ways to promote
health. However, perhaps the ‘backlash’ against screening also reflects a different (not
necessarily better) way of seeing individuals – a shift from individuals who require
expert help from professionals towards a belief that individuals should help
themselves.
FURTHER READING
➧ Norman, P. (1993) Predicting uptake of health checks in General Practice:
Invitation methods and patients’ health beliefs, Social Science and Medicine,
37: 53–9.
This paper illustrates how to use the HBM and how theory can be translated into
practice.
➧ Orbell, S. and Sheeran, P. (1993) Health psychology and uptake of preventive
health services: A review of 30 years’ research on cervical screening,
Psychology and Health, 8: 417–33.
This paper provides a comprehensive overview of the literature on screening
and examines the contribution of psychological, service provision and demo-
graphic factors.
➧ Shaw, C., Abrams, K. and Marteau, T.M. (1999) Psychological impact of pre-
dicting individuals’ risk of illness: A systematic review, Social Science and
Medicine, 49: 1571–98.
This comprehensive review examines the research to date on the impact of
receiving either a positive or negative test result in terms of cognitive, emotional
and behavioural outcomes.
SCREENING 231