Can lay health trainers increase uptake of NHS Health Checks in hard-to-reach populations? A mixed-method pilot evaluation.

摘要

Background The NHS Health Check Programme was launched in England in 2009, offering a vascular risk assessment to people aged 40–74udyears without established disease. Socio-economic deprivation is associated with higher risk of cardiovascular disease and lower uptake ofudscreening. We evaluated the potential impact of a community-based health check service that sought to address health inequalities throughudthe involvement of lay health trainers.udMethods Key stakeholder discussions (n ¼ 20), secondary analysis of client monitoring data (n ¼ 774) and patient experience questionnairesud(n ¼ 181).udResults The health check programme was perceived as an effective way of engaging people in conversations about their health. More than halfud(57.6%) of clients were aged under 50 years and a similar proportion (60.5%) were from socio-economically deprived areas. Only 32.7% fromudthe least affluent areas completed a full health check in comparison with 44.4% from more affluent areas. Eligible men were more likely thanudeligible women to complete a health check (59.4 versus 33.8%).udConclusions A community-based, health trainer-led approach may add value by offering an acceptable alternative to health checks deliveredudin primary care settings. The service appeared to be particularly successful in engaging men and younger age groups. However, there exists theudpotential for intervention-generated inequalities.