Public Health England, Waterfront 4, Goldcrest Way, Newburn Riverside, Newcastle upon Tyne, United Kingdom; Department of Health Sciences, University of York, York, United Kingdom.
Public Health. 2016 Feb;131:92-8. doi: 10.1016/j.puhe.2015.10.019. Epub 2015 Dec 21.
Success in reaching target populations is an important factor in determining the impact of public health programmes. The NHS Health Check (NHSHC) Programme is directed towards reducing excess cardiovascular mortality in England. As the programme is locally commissioned, local monitoring of programme reach is essential. This study aimed to assess indicators of programme reach available to local service commissioners.
Ecological.
The programme reach of NHSHC was assessed in three health districts in the North East of England. Local data returned from GP practices to commissioners on their NHSHC activities was collated for the period October 2010 to March 2013 together with related national published data. Three candidate indicators were chosen and the association between each of these and NHSHCs at GP practice level was examined by univariate logistic regression.
Data were available from 101 GP practices, together undertaking almost 20,000 health checks a year. Number of NHSHCs by practices explained most (77-92%) of the variance the numbers identified at high risk of cardiovascular disease (two for every ten NHSHCs). NHSHCs were not associated with growth in GP practice disease registers for either diabetes or hypertension. NHSCHs predicted practices identification of new cases of hypertension (with one case identified for every ten checks), albeit the proportion of variation explained was much more variable (2-60%) less consistent effect.
Data routinely available to NHSHC commissioners can support monitoring programme reach, with numbers of new cases of hypertension being the most promising indicator of reach.
在确定公共卫生计划的影响时，目标人群的参与度是一个重要因素。NHS 健康检查（NHSHC）计划旨在降低英格兰心血管疾病的超额死亡率。由于该计划是在地方委托进行的，因此对地方服务专员进行项目覆盖范围的监测至关重要。本研究旨在评估 NHSHC 项目覆盖范围的指标，这些指标可用于地方服务专员。
生态学。
在英格兰东北部的三个卫生区评估了 NHSHC 的项目覆盖范围。将 2010 年 10 月至 2013 年 3 月期间，从 GP 诊所返回给委员会的有关 NHSHC 活动的本地数据与相关的国家公布数据进行了整理。选择了三个候选指标，并通过单变量逻辑回归检查了每个指标与 GP 诊所一级的 NHSHC 之间的关联。
来自 101 家 GP 诊所的数据可用，这些诊所每年进行近 20,000 次健康检查。实践中的 NHSHC 数量解释了大多数（77-92%）确定患有心血管疾病高危人群的数量（每 10 个 NHSHC 中有两个）。NHSHC 与 GP 实践中糖尿病或高血压疾病登记册的增长无关。NHSHC 预测了高血压新病例的出现（每进行 10 次检查就有 1 例新病例），尽管解释的变异比例变化较大（2-60%），但效果不太一致。
NHSHC 专员常规获得的数据可以支持监测项目覆盖范围，新的高血压病例数量是最有希望的覆盖范围指标。
