Visram S, Carr S M, Geddes L
Centre for Public Policy and Health (CPPH), School of Medicine, Pharmacy and Health, Durham University Queen's Campus, Stockton-on-Tees TS17 6BH, UK Fuse (UKCRC Centre for Translational Research in Public Health), Newcastle University, Newcastle-upon-Tyne NE2 4AX, UK.
Fuse (UKCRC Centre for Translational Research in Public Health), Newcastle University, Newcastle-upon-Tyne NE2 4AX, UK Department of Public Health and Wellbeing, Faculty of Health and Life Sciences, Northumbria University, Coach Lane Campus, Newcastle-upon-Tyne NE7 7XA, UK.
J Public Health (Oxf). 2015 Jun;37(2):226-33. doi: 10.1093/pubmed/fdu041. Epub 2014 Jul 2.
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.
Key stakeholder discussions (n = 20), secondary analysis of client monitoring data (n = 774) and patient experience questionnaires (n = 181).
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%).
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.
英国国民健康服务（NHS）健康检查计划于2009年在英格兰启动，为40至74岁无确诊疾病的人群提供血管风险评估。社会经济剥夺与心血管疾病风险较高以及筛查参与率较低相关。我们评估了一项基于社区的健康检查服务的潜在影响，该服务旨在通过外行人健康培训师的参与来解决健康不平等问题。
关键利益相关者讨论（n = 20）、客户监测数据的二次分析（n = 774）和患者体验问卷（n = 181）。
健康检查计划被视为促使人们参与健康话题讨论的有效方式。超过一半（57.6%）的客户年龄在50岁以下，类似比例（60.5%）来自社会经济贫困地区。最贫困地区只有32.7%的人完成了全面健康检查，而较富裕地区这一比例为44.4%。符合条件的男性比符合条件的女性更有可能完成健康检查（59.4%对33.8%）。
基于社区、由健康培训师主导的方法可能通过提供一种可接受的替代方案，为初级保健机构提供的健康检查增加价值。该服务在吸引男性和年轻人群体方面似乎特别成功。然而，存在干预导致不平等的可能性。
