Key result
Lay-led vascular health checks show ~76% higher completion in men, but lag in deprived areas.
Why the study?
Socio-economic deprivation is associated with higher cardiovascular risk and lower uptake of NHS Health Checks, motivating evaluation of a community-based health check service involving lay health trainers to address health inequalities.
Does a community-based health check service led by lay health trainers increase uptake of NHS Health Checks in people aged 40-74 years without established disease?
Observational (n=774)
Does a community-based health check service led by lay health trainers increase uptake of NHS Health Checks in people aged 40-74 years without established disease?
A community-based, health trainer-led approach is acceptable and successful in engaging men and younger age groups for vascular risk assessments, though it may generate inequalities based on affluence.
May aid male engagement in vascular checks; leaves open whether lay-trainer models narrow or widen socioeconomic gaps.
BACKGROUND: The NHS Health Check Programme was launched in England in 2009, offering a vascular risk assessment to people aged 40-74 years without established disease. Socio-economic deprivation is associated with higher risk of cardiovascular disease and lower uptake of screening. We evaluated the potential impact of a community-based health check service that sought to address health inequalities through the involvement of lay health trainers. METHODS: Key stakeholder discussions (n = 20), secondary analysis of client monitoring data (n = 774) and patient experience questionnaires (n = 181). RESULTS: The health check programme was perceived as an effective way of engaging people in conversations about their health. More than half (57.6%) of clients were aged under 50 years and a similar proportion (60.5%) were from socio-economically deprived areas. Only 32.7% from the least affluent areas completed a full health check in comparison with 44.4% from more affluent areas. Eligible men were more likely than eligible women to complete a health check (59.4 versus 33.8%). CONCLUSIONS: A community-based, health trainer-led approach may add value by offering an acceptable alternative to health checks delivered in primary care settings. The service appeared to be particularly successful in engaging men and younger age groups. However, there exists the potential for intervention-generated inequalities.
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Visram et al. (2014) conducted an observational in Cardiovascular disease risk (n=774). Community-based health check service with lay health trainers was evaluated on Completion of a full health check. A community-based health check service led by lay health trainers achieved higher completion rates in men than women (59.4% vs 33.8%), but lower rates in the least affluent areas (32.7% vs 44.4%).
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