This Evidence Check was commissioned by the NSW Ministry of Health, as part of a project to improve how preventive, sensitive health issues are raised in general practice. The review looked at what is known about discussing sensitive preventive health issues from both patients and GPs perspectives and approaches and factors that have been shown to be effective. The identified evidence was generally of moderate to high methodological quality.

General behaviour change approaches that are applicable to this challenge include creating non-judgemental environments that normalise sensitive health issues; simulation training; and public campaigns that reduce stigma and challenge unhelpful cultural norms. Lack of time in consultations was identified as a challenging issue. Significant system-level change would be required to extend standard consultation times; focusing on optimising workflows may therefore be more feasible. Addressing GP patient–gender mismatch through diverse GP representation may also be feasible in larger practices.

The key theme identified was the use of prompting, screening or other structured tools by GPs. Collectively, these approaches have two main features. First, they are a way of approaching sensitive health conversations less directly, for example by focusing on underlying risk factors for sensitive health conditions such as obesity and mental illness rather than addressing the issues directly. Second, through either risk-factor or more general question prompts, these approaches take the onus away from GPs and patients to come up with a way of asking the question using their own words.


Bragge P, Delafosse V, Cong-Lem N, Tsering D, Wright B. General practitioners raising and discussing sensitive health issues with patients: an Evidence Check rapid review brokered by the Sax Institute for the NSW Centre for Population Health, 2023.

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