Eberhardt Judith, Kane Laura, Portman Robert, Ling Jonathan, Goddard Tracy, Johnston Mark, Robinson Claire, Reay Abigail, Divers Andrew, Newbury-Birch Dorothy
School of Social Sciences, Humanities and Law, Teesside University, UK.
Independent Researcher, Darlington, UK.
Health Expect. 2025 Apr;28(2):e70199. doi: 10.1111/hex.70199.
Preventive health services, such as the NHS Health Check programme, aim to identify and address key health risks, yet participation is particularly low in socioeconomically deprived areas, such as the North East of England. Understanding barriers and facilitators to engagement is critical to improving access and outcomes for these communities. This study aimed to explore barriers and facilitators to NHS Health Check attendance in these underserved communities using a participatory research approach.
This study employed a qualitative design with a participatory approach, involving peer researchers from the target communities. Two peer research associates (PRAs) from socioeconomically deprived areas were trained to conduct semi-structured online or telephone interviews with 12 community members eligible for NHS Health Checks. Additionally, 5 stakeholders involved in the programme's delivery were interviewed. Thematic analysis was conducted in collaboration with the PRAs to ensure community perspectives were authentically captured.
Barriers to participation included limited awareness, cultural perceptions of self-reliance, fear of health-related discoveries, mistrust of healthcare systems and logistical challenges exacerbated by structural inequalities. Participants emphasised the need for culturally tailored communication and flexible, accessible health checks. Stakeholders highlighted the role of collaboration, targeted outreach and digital tools in addressing these barriers.
The study highlights key barriers to NHS Health Check uptake in socioeconomically deprived communities in the North East of England. Improving communication, increasing accessibility through community-based services and building trust in healthcare are recommended key strategies to enhance participation and reduce health inequalities in these regions.
Peer researchers, individuals with lived experience of being from socioeconomically deprived communities in North East England and eligible for NHS Health Checks, were involved in the design and conduct of this study. They were trained to conduct interviews with community members and contributed to the thematic analysis, ensuring that public perspectives were integral to the interpretation of the data.
诸如国民健康服务（NHS）健康检查计划之类的预防性健康服务旨在识别并应对关键的健康风险，但在社会经济贫困地区，如英格兰东北部，参与率特别低。了解参与的障碍和促进因素对于改善这些社区的可及性和健康结果至关重要。本研究旨在采用参与式研究方法，探索这些服务不足社区中NHS健康检查参与率的障碍和促进因素。
本研究采用定性设计和参与式方法，让来自目标社区的同伴研究人员参与其中。两名来自社会经济贫困地区的同伴研究助理（PRA）接受培训，对12名符合NHS健康检查条件的社区成员进行半结构化在线或电话访谈。此外，还对5名参与该计划实施的利益相关者进行了访谈。与PRA合作进行主题分析，以确保真实地捕捉社区的观点。
参与的障碍包括意识有限、对自力更生的文化认知、对健康相关发现的恐惧、对医疗系统的不信任以及结构不平等加剧的后勤挑战。参与者强调需要进行文化上量身定制的沟通以及灵活、可及的健康检查。利益相关者强调了合作、有针对性的外展和数字工具在克服这些障碍方面的作用。
该研究突出了英格兰东北部社会经济贫困社区中NHS健康检查接受率的关键障碍。建议通过改善沟通、通过社区服务提高可及性以及建立对医疗保健的信任等关键策略，来提高这些地区的参与率并减少健康不平等。
同伴研究人员，即来自英格兰东北部社会经济贫困社区且有资格接受NHS健康检查的有生活经验的个人，参与了本研究的设计和实施。他们接受培训以对社区成员进行访谈，并参与主题分析，确保公众观点融入数据解读之中。
