Institute for Health and Wellbeing, Leeds Metropolitan University, Leeds LS2 4NU, UK.
Perspect Public Health. 2013 Jul;133(4):213-20. doi: 10.1177/1757913913490853.
The role that members of the public (non-professional lay people) can play in improving health is being increasingly recognised in research and policy. This paper explores what contribution lay people employed as health trainers are making to addressing health inequalities in England.
Data from eight local evaluations of health trainer services were synthesised using a data-extraction framework to find out about client populations, any lifestyle changes made, health trainers' background and community engagement activities. These data were compared with national data to assess how findings relating to addressing inequalities compared with the national picture.
Local data largely matched national data and showed that health trainers are reaching people living with disadvantage and enabling them to make lifestyle changes. The data suggest that they do this by engaging with communities and taking a person-centred approach. Being non-clinical peers is also important. However, no evidence was found that health trainers were impacting on health inequalities at a population level.
Health trainers are contributing to addressing health inequalities but the services evaluated were small and had been operating for a limited time, so to expect reductions in inequalities at a population level within districts would be unrealistic. The findings of this synthesis present a challenge to primary care and public health to employ health trainers in order to engage marginalised communities as one element of plans to address health inequalities.
公众（非专业的非医学人士）在改善健康方面所能发挥的作用，在研究和政策中正得到越来越多的认可。本文探讨了受雇为健康培训师的非专业人士在解决英格兰健康不平等问题方面所做出的贡献。
使用数据提取框架综合了八项针对健康培训师服务的本地评估数据，以了解客户群体、任何生活方式的改变、健康培训师的背景和社区参与活动。将这些数据与国家数据进行比较，以评估与解决不平等相关的发现与国家整体情况相比如何。
本地数据与国家数据基本一致，表明健康培训师正在接触生活困难的人群，并帮助他们改变生活方式。数据表明，他们通过与社区互动和采取以人为本的方法来实现这一目标。作为非临床同行也很重要。然而，没有证据表明健康培训师在人口层面上对健康不平等产生了影响。
健康培训师正在为解决健康不平等问题做出贡献，但评估的服务规模较小，且运营时间有限，因此期望在地区内降低人口层面的不平等是不现实的。这一综合研究结果对初级保健和公共卫生提出了挑战，即需要雇用健康培训师，将接触边缘社区作为解决健康不平等计划的一个要素。
