Bromley Primary Care Trust, Beckenham, UK.
Perspect Public Health. 2012 Sep;132(5):221-7. doi: 10.1177/1757913910393864. Epub 2011 Apr 7.
Health trainers represent a new occupational role within the NHS which has been developing since 2006, when the first 'early adopter' sites were funded by the Department of Health. Health trainers are 'lay' people recruited to engage 'harder-to-reach' people from their communities, offering one-to-one support to enable them to make the healthy lifestyle changes of their choice. The aim of this study was to explore the experiences and approaches adopted by health trainers in engaging with marginalized communities.
This paper describes an exploratory study using in-depth semi-structured interviews with 10 currently employed health trainers with diverse backgrounds, forms of employment and interpretation of role, drawn from seven London primary care trusts (PCTs) or boroughs.
The study found tensions between the lay identity of health trainers and their adoption of a formalized role. Health trainers emphasized their similarities but underestimated their often significant differences to their communities. Health trainers based in community or voluntary groups found engagement easier than those based in PCTs, and saw engagement as an end in itself, through its creation of opportunities for health.
There remains a lack of clarity about the role of the health trainer. Lay workers are not necessarily part of the marginalized communities they are expected to engage, while their ability to do so is compromised by the professional culture of the NHS and its approach to community engagement. Health trainers based in the community or voluntary sector appear to offer greater potential for engaging communities and providing those communities with practical opportunities for health gain.
健康培训师是英国国民保健制度（NHS）中的一个新职业角色，自 2006 年以来一直在发展，当时第一批“早期采用者”站点由卫生部资助。健康培训师是从社区招募的“非专业人士”，旨在与“更难接触”的人接触，为他们提供一对一的支持，使他们能够做出自己选择的健康生活方式的改变。本研究的目的是探讨健康培训师在接触边缘化社区时的经验和方法。
本文描述了一项探索性研究，使用深度半结构化访谈，对来自伦敦七个初级保健信托基金（PCT）或行政区的 10 名目前在职的、具有不同背景、就业形式和角色解释的健康培训师进行了访谈。
研究发现健康培训师的非专业身份与其采用的正式角色之间存在紧张关系。健康培训师强调他们的相似之处，但低估了他们与社区之间往往存在的显著差异。在社区或志愿团体工作的健康培训师发现参与比在 PCT 工作的健康培训师更容易，他们将参与视为一种目的，通过创造健康机会来实现参与。
健康培训师的角色仍然缺乏明确性。非专业人员不一定是他们预期要接触的边缘化社区的一部分，而他们这样做的能力受到国民保健制度的专业文化及其社区参与方法的限制。在社区或志愿部门工作的健康培训师似乎更有潜力接触社区，并为社区提供获得实际健康收益的机会。
