Assessment of the operation of a pilot program of preventive medicine for adults in three primary care centers of Athens and Piraeus: a cross-sectional study


patient satisfaction
screening program
Greek Healthcare System
Program of Preventive Medicine for Adults


Objective. To evaluate the operation of the pilot Program of Preventive Medicine for Adults (PPMA) from the provision of healthcare services in three primary health care centers of Athens and Piraeus (Greece).

Design. An observational, cross-sectional study was undertaken. A structured questionnaire was used to collect data.
Setting. Three public primary health centers of Athens, Greece. Participants. 142 participants, 40-55 years of age, with no previously identified/diagnosed health issues (overall healthy) that should not have undergone any type of screening in the past 12 months.

Measures and results. The majority of participants were female (75.4%), aged 40-45 years (43.7%), Greek nationals (88%), employed (62.7%) and high school graduates (52.8%). 68.3% of participants scheduled an appointment in the first two days and 58.9% waited up to 5 minutes in the waiting room. The paramedical personnel scored higher evaluation (4.94) than the doctor (4.61), but all health care centers received a very high general evaluation (4.87). Multiple linear regression showed significant association between the evaluation of the pilot PPMA, the evaluation of health visitor/nurse (B = .240) and the communication of results to participants (B = .245).

Conclusions. Findings show an extremely positive evaluation of the pilot PPMA, a result that can be used by healthcare managers for the expansion of the screening program to the general population.


[1] V. G. Athyros et al., “The prevalence of the metabolic syndrome in Greece: The MetS-Greece Multicentre Study,” Diabetes Obes. Metab., vol. 7, no. 4, pp. 397–405, 2005.
[2] Organization for Economic Cooperation and Development (OECD) Staff, Health at a Glance 2013: OECD Indicators. Paris; Washington: Organization for Economic Cooperation & Development Brookings Institution Press [distributor, 2013.
[3] J. Viguier, J.-F. Morère, L. Brignoli-Guibaudet, C. Lhomel, S. Couraud, and F. Eisinger, “Colon Cancer Screening Programs: Impact of an Organized Screening Strategy Assessed by the EDIFICE Surveys,” Curr. Oncol. Rep., vol. 20, no. S1, Mar. 2018.
[4] “Screening Strategies for Cardiovascular Disease in Asymptomatic Adults,” Prim. Care, vol. 41, no. 2, pp. 371–397, Jun. 2014.
[5] “Disease Management in Greece Running Head: Disease Management in Greece,” Health Sci. J., vol. 9, no. 1, Apr. 2015.
[6] “Use of cancer screening services in Greece and associated social factors: results from the nation-wide Hellas Health I survey,” Eur. J. Cancer Prev., vol. 18, no. 3, pp. 248–257, Jun. 2009.
[7] I. Karathanasi et al., “Moving ahead in diabetics’ cancer screening; food for thought from the Hellenic experience,” Eur. J. Cancer Care (Engl.), vol. 18, no. 3, pp. 255–263, Mar. 2009.
[8] G. Kourlaba, G. Hillas, T. Vassilakopoulos, and N. Maniadakis, “The disease burden of chronic obstructive pulmonary disease in Greece,” Int. J. Chron. Obstruct. Pulmon. Dis., vol. 11, pp. 2179–2189, Mar. 2016.
[9] “Effect of parental obesity and gestational diabetes on child neuropsychological and behavioral development at 4 years of age: the Rhea mother-child cohort, Crete, Greece,” Eur. Child Adolesc. Psychiatry, vol. 26, no. 6, pp. 703–714, Jun. 2017.
[10] S. Theodoridou et al., “Efficacy of the National Thalassaemia and Sickle Cell Disease Prevention Programme in Northern Greece: 15-Year Experience, Practice and Policy Gaps for Natives and Migrants,” Hemoglobin, vol. 42, no. 4, pp. 257–263, Jul. 2018.
[11] “The role of general practitioners in promoting cervical cancer screening: a field survey in a rural area of Crete, Greece,” Eur. J. Cancer Prev., vol. 19, no. 2, pp. 160–166, Mar. 2010.
[12] M. Decision 2456, “Government Gazette (ΦΕΚ) (in Greek) (National Printing House) Β: 35013-35048,” 11 2011.
[13] M. Flessa, A. Melios, M. Papachristopoulou, E. Vrana, M. Armeni, and A. Paparoupas, “Pilot program of preventive medicine for adults: First results from Primary Health Practice of Kallithea (in Greek). Oral session presented at the 10th Panhellenic Conference of Preventive Medicine,” 2010.
[14] N. Mead, P. Bower, and M. Roland, “The General Practice Assessment Questionnaire (GPAQ) – Development and psychometric characteristics,” BMC Fam. Pract., vol. 9, no. 1, Dec. 2008.
[15] S. Granado de la Orden, A. C. Garcia, L. F. Rodriguez Gijon, C. Rodriguez Rieiro, C. Sanchidrian de Blas, and P. Rodriguez Perez, “Development and validation of a questionnaire to assess satisfaction with hospital emergency care,” Emerg. Med. J., vol. 28, no. 9, pp. 770–774, Sep. 2011.
[16] V. H. Aletras, E. A. Papadopoulos, and D. A. Niakas, “Development and preliminary validation of a Greek-language outpatient satisfaction questionnaire with principal components and multi-trait analyses,” BMC Health Serv. Res., vol. 6, p. 66, Jun. 2006.
[17] S. Bodur, Y. E. Özdemir, and F. Kara, “Outpatient Satisfaction with Health Centers in Urban Areas,” Turk. J. Med. Sci., vol. 32, no. 5, pp. 409–414, Sep. 2002.
[18] H. R. Rubin, J. E. Ware, E. C. Nelson, and M. Meterko, “The Patient Judgments of Hospital Quality (PJHQ) Questionnaire,” Med. Care, vol. 28, no. 9 Suppl, pp. S17–18, 09 1990.
[19] F. C. Maseko, M. L. Chirwa, and A. S. Muula, “Client satisfaction with cervical cancer screening in Malawi,” BMC Health Serv. Res., vol. 14, p. 420, 2014.
[20] Y. Y. Meng, D. E. Jatulis, J. P. McDonald, and A. P. Legorreta, “Satisfaction with access to and quality of health care among Medicare enrollees in a health maintenance organization,” West. J. Med., vol. 166, no. 4, pp. 242–247, Apr. 1997.
[21] C. Cochran and S. Kapella, “Patient Satisfaction in a Statewide Cervical Cancer Screening Program,” Nev. J. Public Health, vol. 2, no. 1, Nov. 2012.
[22] M. Trigoni, F. Griffiths, D. Tsiftsis, E. Koumantakis, E. Green, and C. Lionis, “Mammography screening: views from women and primary care physicians in Crete,” BMC Womens Health, vol. 8, no. 1, p. 20, 2008.
[23] M. B. Johns, M. F. Hovell, C. A. Drastal, C. Lamke, and K. Patrick, “Promoting prevention services in primary care: a controlled trial,” Am. J. Prev. Med., vol. 8, no. 3, pp. 135–140, 06 1992.
[24] L. E. Boulware et al., “Systematic review: the value of the periodic health evaluation,” Ann. Intern. Med., vol. 146, no. 4, pp. 289–300, Feb. 2007.
[25] C. J. Holm, D. I. Frank, and J. Curtin, “Health beliefs, health locus of control, and women’s mammography behavior,” Cancer Nurs., vol. 22, no. 2, pp. 149–156, Apr. 1999.
[26] D. A. Davis, M. A. Thomson, A. D. Oxman, and R. B. Haynes, “Evidence for the effectiveness of CME. A review of 50 randomized controlled trials,” JAMA, vol. 268, no. 9, pp. 1111–1117, Sep. 1992.
[27] T. D. Denberg, S. E. Ross, and J. F. Steiner, “Patient acceptance of a novel preventive care delivery system,” Prev. Med., vol. 44, no. 6, pp. 543–546, Jun. 2007.
[28] D. D. Hensrud, “Clinical Preventive Medicine in Primary Care: Background and Practice: 2. Delivering Primary Preventive Services,” Mayo Clin. Proc., vol. 75, no. 3, pp. 255–264, Mar. 2000.
[29] L. S. Wolff, H. A. Massett, D. Weber, R. E. Mockenhaupt, S. Hassmiller, and E. W. Maibach, “Opportunities and barriers to disease prevention counseling in the primary care setting: a multisite qualitative study with US health consumers,” Health Promot. Int., vol. 25, no. 3, pp. 265–276, 09 2010.
[30] E. Gulitz, M. B. Hernandez, and E. B. Kent, “Missed cancer screening opportunities among older women: a review,” Cancer Pract., vol. 6, no. 5, pp. 289–295, 10 1998.