University of Sheffield, School of Nursing & Midwifery, Samuel Fox House, Northern General Hospital, Herries Road, Sheffield, South Yorkshire, S5 7AU, UK.
Perspect Public Health. 2011 Jan;131(1):24-31. doi: 10.1177/1757913910369089.
World Health Organization data illustrate a worldwide re-emergence of interest in the scope of lay health workers for extending services to 'hard-to-reach' community groups. In the UK, the health trainer model of service delivery represents one such innovative way of working, first described in the White Paper Choosing Health: Making Healthier Choices Easier and more recently in the Kings Fund report. The scheme was introduced into selected primary care settings in England from 2005 and rolled out nationally from 2007. The aim of this study was to examine the perceived value of the health trainer scheme.
This paper describes qualitative data from two studies undertaken in 2007-2009, comprising in-depth consultations with key primary care stakeholders, health trainers and their clients in two primary care trusts in northern and central England. Data was collected via 12 semi-structured interviews with key stakeholders and service users and from 8 focus groups with a total of 33 trainee and qualified health trainers.
The UK health trainer approach was regarded as effective in contributing to the support of a broad spectrum of health and welfare issues across widely diverse communities in the two primary care trusts evaluated. Study data also indicated a wide-ranging impact of the health trainer service, extending not only to the lay health workers themselves, but also to their families, friends and colleagues.
The health trainer service appears to be not only 'fit for purpose', but also to bring with it certain 'added value', which was not predicted by the two primary care service providers at the outset. A critical factor in this success appears to be the unique combination of time, the 'person next door' and a 'one-to-one' approach, which facilitated an innovative and highly productive connection between the health trainer and client. However, participants in this evaluation perceived that the current format and constituents of service performance data were significantly failing to credit the health trainer scheme with the full extent of this impact.
世界卫生组织的数据表明，全球范围内重新兴起了对非专业卫生工作者服务范围的兴趣，希望将服务扩大到“难以接触”的社区群体。在英国，健康培训师服务交付模式是一种具有创新性的工作方式，该模式最早在《选择健康：让健康选择更容易》白皮书中有所描述，最近在国王基金会的报告中也有提及。该计划于 2005 年在英格兰的一些基层医疗环境中引入，并于 2007 年在全国范围内推广。本研究旨在探讨健康培训师计划的感知价值。
本文描述了 2007-2009 年进行的两项研究中的定性数据，包括对英格兰北部和中部两个初级保健信托的主要初级保健利益相关者、健康培训师及其客户进行深入协商。数据通过对 12 名主要利益相关者和服务使用者进行半结构化访谈以及对 8 个焦点小组（共 33 名培训和合格的健康培训师）收集。
在评估的两个初级保健信托中，英国健康培训师方法被认为在支持广泛多样化社区的广泛健康和福利问题方面是有效的。研究数据还表明，健康培训师服务具有广泛的影响，不仅延伸到基层卫生工作者本身，还延伸到他们的家人、朋友和同事。
健康培训师服务不仅“适用”，而且还带来了一定的“附加价值”，这是最初的两个初级保健服务提供者所没有预料到的。这种成功的一个关键因素似乎是时间、“隔壁的人”和“一对一”方法的独特结合，这促进了健康培训师和客户之间的创新和高效联系。然而，评估中的参与者认为，当前的服务绩效数据格式和组成在很大程度上未能充分认可健康培训师计划的全部影响。
