Altmetric

Evaluation of community provision of a preventive cardiovascular programme - the National Health Service Health Check in reaching the under-served groups by primary care in England: cross sectional observational study

File Description SizeFormat 
Woringer_Evaluation of community provision_BMC Health Ser Res.pdfPublished version490.59 kBAdobe PDFView/Open
Title: Evaluation of community provision of a preventive cardiovascular programme - the National Health Service Health Check in reaching the under-served groups by primary care in England: cross sectional observational study
Authors: Woringer, M
Cecil, E
Watt, H
Chang, K
Hamid, F
Khunti, K
Dubois, E
Evason, J
Majeed, A
Soljak, M
Item Type: Journal Article
Abstract: Background: Cardiovascular disease (CVD) is the leading cause of premature mortality and a major contributor of health inequalities in England. Compared to more affluent and white counterparts, deprived people and ethnic minorities tend to die younger due to preventable CVD associated with lifestyle. In addition, deprived, ethnic minorities and younger people are less likely to be served by CVD prevention services. This study assessed the effectiveness of community-based outreach providers in delivering England’s National Health Services (NHS) Health Check programme, a CVD preventive programme to under-served groups. Methods: Between January 2008 and October 2013, community outreach providers delivered a preventive CVD programme to 50,573 individuals, in their local communities, in a single consultation without prescheduled appointments. Community outreach providers operated on evenings and weekends as well as during regular business hours in venues accessible to the general public. After exclusion criteria, we analysed and compared socio-demographic data of 43,177 Health Check attendees with the general population across 38 local authorities (LAs). We assessed variation between local authorities in terms of age, sex, deprivation and ethnicity structures using two sample t-tests and within local authority variation in terms of ethnicity and deprivation using Chi squared tests and two sample t-tests respectively. Results: Using Index of Multiple Deprivation, the mean deprivation score of the population reached by community outreach providers was 6.01 higher (p < 0.05) than the general population. Screened populations in 29 of 38 LAs were significantly more deprived (p < 0.05). No statistically significant difference among ethnic minority groups was observed between LAs. Nonetheless some LAs – namely Leicester, Thurrock, Sutton, South Tyneside, Portsmouth and Gateshead were very successful in recruiting ethnic minority groups. The mean proportion of men screened was 11.39% lower (p < 0.001) and mean proportion of 40–49 and 50–59 year olds was 9.98% and 3.58% higher (p < 0.0001 and p < 0.01 respectively) than the general population across 38 LAs. Conclusions: Community-based outreach providers effectively reach under-served groups by delivering preventive CVD services to younger, more deprived populations, and a representative proportion of ethnic minority groups. If the programme is successful in motivating the under-served groups to improve lifestyle, it may reduce health inequalities therein.
Issue Date: 14-Jun-2017
Date of Acceptance: 30-May-2017
URI: http://hdl.handle.net/10044/1/48859
DOI: https://dx.doi.org/10.1186/s12913-017-2346-5
ISSN: 1472-6963
Publisher: BioMed Central
Journal / Book Title: BMC Health Services Research
Volume: 17
Copyright Statement: © The Author(s). 2017. Open Access. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
Sponsor/Funder: Department of Health
Funder's Grant Number: 009/0051
Keywords: Science & Technology
Life Sciences & Biomedicine
Health Care Sciences & Services
Cardiovascular disease
Primary prevention
Health inequalities
Young
Deprived
Ethnic minorities
GENERAL-PRACTICE
RISK-ASSESSMENT
NON-ATTENDANCE
HEART-DISEASE
PHARMACIES
MORTALITY
OBESITY
FORMATS
IMPACT
Health Policy & Services
1117 Public Health And Health Services
0807 Library And Information Studies
Publication Status: Published
Article Number: 405
Appears in Collections:Faculty of Medicine
Epidemiology, Public Health and Primary Care



Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.

Creative Commons