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谁会使用国民保健署健康检查?调查种族、性别及邀请方式对国民保健署健康检查接受率的影响。

Who uses NHS health checks? Investigating the impact of ethnicity and gender and method of invitation on uptake of NHS health checks.

作者信息

Cook Erica J, Sharp Chloe, Randhawa Gurch, Guppy Andy, Gangotra Raj, Cox Jonathon

机构信息

Department of Psychology, University of Bedfordshire, Park Square, Luton, UK.

Institute for Health Research, University of Bedfordshire, Putteridge Bury, Hitchin Road, Luton, UK.

出版信息

Int J Equity Health. 2016 Jan 20;15:13. doi: 10.1186/s12939-016-0303-2.

Abstract

BACKGROUND

NHS Health Checks is a national risk assessment prevention programme for all individuals aged 40-74 that reside in England. Through the systematic assessment of an individual's ten year disease risk, this programme aims to provide early identification and subsequent management of this risk. However, there is limited evidence on how socio-demographic factors impact on uptake and what influence the invitation method has on uptake to this programme.

METHODS

NHS Health Check data from April 2013 to March 2014 was analysed (N = 50,485) for all 30 GP Practices in Luton, a culturally diverse town in England, UK. Data was collected for age, ethnicity, uptake (attendance and non attendance) and invitation method (letter written, verbal face-to-face, telephone). Actual usage of NHS Health Checks was determined for each ethnic group of the population and compared using Chi-square analysis.

RESULTS

The overall uptake rate for Luton was 44 %, markedly lower that the set target of 50-75 %. The findings revealed a variation of uptake in relation to age, gender, level of deprivation. Ethnicity and gender variations were also found, with 'White British' 'Black Caribbean' and 'Indian' patients most likely to take up a NHS Health Check. However, patients from 'Any Other White Background' and 'Black African' were significantly less likely to uptake an NHS Health Check compared to all other ethnic groups. Ethnicity and gender differences were also noted in relation to invitation method.

CONCLUSIONS

The findings revealed that different invitation methods were effective for different ethnic and gender groups. Therefore, it is suggested that established protocols of invitation are specifically designed for maximizing the response rate for each population group. Future research should now focus on uncovering the barriers to uptake in particular culturally diverse population groups to determine how public health teams can better engage with these communities.

摘要

背景

国民健康服务(NHS)健康检查是一项针对所有居住在英格兰、年龄在40至74岁之间个体的全国性风险评估预防计划。通过对个体十年疾病风险的系统评估,该计划旨在实现对这一风险的早期识别及后续管理。然而,关于社会人口因素如何影响参与率以及邀请方式对该计划参与率有何影响的证据有限。

方法

对英国卢顿(一个文化多元的城镇)30家全科医生诊所2013年4月至2014年3月的NHS健康检查数据(N = 50,485)进行了分析。收集了年龄、种族、参与情况(出勤和未出勤)以及邀请方式(书面信函、面对面口头、电话)的数据。确定了每个种族群体对NHS健康检查的实际使用率,并使用卡方分析进行比较。

结果

卢顿的总体参与率为44%,明显低于设定的50%至75%的目标。研究结果显示,参与率在年龄、性别、贫困程度方面存在差异。还发现了种族和性别差异,“英国白人”“加勒比黑人”和“印度裔”患者最有可能接受NHS健康检查。然而,与所有其他种族群体相比,“任何其他白人背景”和“非洲黑人”的患者接受NHS健康检查的可能性明显较低。在邀请方式方面也注意到了种族和性别差异。

结论

研究结果表明,不同的邀请方式对不同的种族和性别群体有效。因此,建议针对每个群体专门设计既定的邀请方案,以最大限度提高回应率。未来的研究现在应侧重于揭示特别是文化多元群体参与的障碍,以确定公共卫生团队如何能更好地与这些社区互动。

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