Nuffield Department of Primary Care Health Sciences, Oxford University, Oxford, UK
Nuffield Department of Primary Care Health Sciences, Oxford University, Oxford, UK.
BMJ Open. 2021 Apr 14;11(4):e048937. doi: 10.1136/bmjopen-2021-048937.
The NHS Health Check aims to identify individuals at increased risk of cardiovascular diseases (CVDs) among the adult population in England. The Health Check includes calculation of CVD risk and discussion of pharmacological and lifestyle approaches to manage risk, including referral to lifestyle support services. The programme is commissioned by Local Authorities (LAs) and is delivered by a range of different providers in different settings. There is significant variation in activity, with uptake ranging from 25% to 85% in different areas, and clear evidence of variation in implementation and delivery practice.
We aim to understand how the NHS Health Check programme works in different settings, for different groups, so that we can recommend improvements to maximise intended outcomes. To do so, we will undertake a realist review and a survey of LA public health teams. Our review will follow Pawson's five iterative stages: (1) locate existing theories, (2) search for evidence, (3) article selection, (4) extract and organise data and (5) synthesise evidence and draw conclusions. Our review will include documents describing local implementation alongside published research studies. We will recruit a stakeholder group (including Public Health England, commissioners and providers of Health Checks, plus members of the public and patients) to advise us throughout. Our survey will be sent to all 152 LAs in England to gather detailed information on programme delivery (including COVID-19-related changes) and available referral services. This will enable us to map delivery across England and relate these data to programme outcomes.
Ethical approval is not required for this review. For the survey, we have received approval from the University of Kent Research Ethics Committee. Our findings will be used to develop recommendations on tailoring, implementation and design strategies to improve delivery of the NHS Health Check in different settings, for different groups.
CRD42020163822.
国民保健制度 (NHS) 健康检查旨在识别英格兰成年人口中心血管疾病 (CVD) 风险增加的个体。健康检查包括 CVD 风险计算以及讨论药物和生活方式方法来管理风险，包括向生活方式支持服务转介。该计划由地方当局 (LAs) 委托，由不同环境下的各种不同提供者执行。活动存在显著差异，不同地区的参与率从 25%到 85%不等，并且在实施和交付实践方面存在明显的差异。
我们旨在了解 NHS 健康检查计划在不同环境中、针对不同群体的运作方式，以便我们能够提出改进建议以最大限度地提高预期效果。为此，我们将进行现实主义审查和对地方公共卫生团队的调查。我们的审查将遵循 Pawson 的五个迭代阶段：（1）定位现有理论，（2）搜索证据，（3）文章选择，（4）提取和组织数据，以及（5）综合证据并得出结论。我们的审查将包括描述当地实施情况的文件以及已发表的研究报告。我们将招募一个利益相关者小组（包括英格兰公共卫生署、健康检查的委托人和提供者，以及公众和患者），在整个过程中为我们提供建议。我们的调查将发送给英格兰所有 152 个地方当局，以收集有关计划交付（包括与 COVID-19 相关的变化）和可用转介服务的详细信息。这将使我们能够绘制英格兰各地的交付情况，并将这些数据与计划结果相关联。
本综述不需要伦理批准。对于调查，我们已获得肯特大学研究伦理委员会的批准。我们的发现将用于制定有关定制、实施和设计策略的建议，以改善不同环境中、针对不同群体的 NHS 健康检查的交付。
PROSPERO 注册号：CRD42020163822。
