Exploring Equity in Uptake of the NHS Health Check and a Nested Physical Activity Intervention Trial

Overview

Journal J Public Health (Oxf)

Publisher Oxford University Press

Specialty Public Health

Date 2015 Jun 4

PMID 26036701

Citations 20

Authors

S Attwood

K Morton

S Sutton

Affiliations

Soon will be listed here.

Abstract

Background: Socio-demographic factors characterizing disadvantage may influence uptake of preventative health interventions such as the NHS Health Check and research trials informing their content.

Methods: A cross-sectional study examining socio-demographic characteristics of participants and non-participants to the NHS Health Check and a nested trial of very brief physical activity interventions within this context. Age, gender, Index of Multiple Deprivation (IMD) and ethnicity were extracted from patient records of four General Practices (GP) in England.

Results: In multivariate analyses controlling for GP surgery, the odds of participation in the Health Check were higher for older patients (OR 1.05, 95% CI 1.04-1.07) and lower from areas of greater deprivation (IMD Quintiles 4 versus 1, OR 0.37, 95% CI 0.18-0.76, 5 versus 1 OR 0.42, 95% CI 0.20-0.88). Older patients were more likely to participate in the physical activity trial (OR 1.04, 95% CI 1.02-1.06).

Conclusions: Younger patients and those living in areas of greater deprivation may be at risk of non-participation in the NHS Health Check, while younger age also predicted non-participation in a nested research trial. The role that GP-surgery-specific factors play in influencing participation across different socio-demographic groups requires further exploration.

Citing Articles

NHS Health Check programme: a rapid review update.

Tanner L, Kenny R, Still M, Ling J, Pearson F, Thompson K BMJ Open. 2022; 12(2):e052832.

PMID: 35172998 PMC: 8852663. DOI: 10.1136/bmjopen-2021-052832.

Test@work: evaluation of workplace HIV testing for construction workers using the RE-AIM framework.

Jones W, Somerset S, Evans C, Whittingham K, Middleton M, Blake H BMC Public Health. 2021; 21(1):1737.

PMID: 34560853 PMC: 8464147. DOI: 10.1186/s12889-021-11739-z.

Modelling tool to support decision-making in the NHS Health Check programme: workshops, systematic review and co-production with users.

Oflaherty M, Lloyd-Williams F, Capewell S, Boland A, Maden M, Collins B Health Technol Assess. 2021; 25(35):1-234.

PMID: 34076574 PMC: 8201571. DOI: 10.3310/hta25350.

Unwillingness to participate in health checks for cardiometabolic diseases: A survey among primary health care patients in five European countries.

de Waard A, Korevaar J, Hollander M, Nielen M, Seifert B, Carlsson A Health Sci Rep. 2021; 4(2):e256.

PMID: 33778166 PMC: 7988616. DOI: 10.1002/hsr2.256.

Incorporating a brief intervention for personalised cancer risk assessment to promote behaviour change into primary care: a multi-methods pilot study.

Mills K, Paxton B, Walter F, Griffin S, Sutton S, Usher-Smith J BMC Public Health. 2021; 21(1):205.

PMID: 33485309 PMC: 7824918. DOI: 10.1186/s12889-021-10210-3.

References

McLaren L, McIntyre L, Kirkpatrick S . Rose's population strategy of prevention need not increase social inequalities in health. Int J Epidemiol. 2009; 39(2):372-7. DOI: 10.1093/ije/dyp315. View

Warburton D, Nicol C, Bredin S . Health benefits of physical activity: the evidence. CMAJ. 2006; 174(6):801-9. PMC: 1402378. DOI: 10.1503/cmaj.051351. View

Cochrane T, Gidlow C, Kumar J, Mawby Y, Iqbal Z, Chambers R . Cross-sectional review of the response and treatment uptake from the NHS Health Checks programme in Stoke on Trent. J Public Health (Oxf). 2012; 35(1):92-8. PMC: 3580053. DOI: 10.1093/pubmed/fds088. View

Dalton A, Bottle A, Okoro C, Majeed A, Millett C . Uptake of the NHS Health Checks programme in a deprived, culturally diverse setting: cross-sectional study. J Public Health (Oxf). 2011; 33(3):422-9. DOI: 10.1093/pubmed/fdr034. View

Capewell S, Graham H . Will cardiovascular disease prevention widen health inequalities?. PLoS Med. 2010; 7(8):e1000320. PMC: 2927551. DOI: 10.1371/journal.pmed.1000320. View

James D, Johnston L, Crone D, Sidford A, Gidlow C, Morris C . Factors associated with physical activity referral uptake and participation. J Sports Sci. 2007; 26(2):217-24. DOI: 10.1080/02640410701468863. View

ONeill J, Tabish H, Welch V, Petticrew M, Pottie K, Clarke M . Applying an equity lens to interventions: using PROGRESS ensures consideration of socially stratifying factors to illuminate inequities in health. J Clin Epidemiol. 2013; 67(1):56-64. DOI: 10.1016/j.jclinepi.2013.08.005. View

Harris T, Victor C, Carey I, Adams R, Cook D . Less healthy, but more active: opposing selection biases when recruiting older people to a physical activity study through primary care. BMC Public Health. 2008; 8:182. PMC: 2426698. DOI: 10.1186/1471-2458-8-182. View

Sargeant L, Simmons R, Barling R, Butler R, Williams K, Prevost A . Who attends a UK diabetes screening programme? Findings from the ADDITION-Cambridge study. Diabet Med. 2010; 27(9):995-1003. PMC: 3428846. DOI: 10.1111/j.1464-5491.2010.03056.x. View

10.

Frohlich K, Potvin L . Transcending the known in public health practice: the inequality paradox: the population approach and vulnerable populations. Am J Public Health. 2008; 98(2):216-21. PMC: 2376882. DOI: 10.2105/AJPH.2007.114777. View

11.

Rose G . Sick individuals and sick populations. Int J Epidemiol. 1985; 14(1):32-8. DOI: 10.1093/ije/14.1.32. View

12.

Visram S, Carr S, Geddes L . Can lay health trainers increase uptake of NHS Health Checks in hard-to-reach populations? A mixed-method pilot evaluation. J Public Health (Oxf). 2014; 37(2):226-33. PMC: 5942531. DOI: 10.1093/pubmed/fdu041. View

13.

. Effects of physical activity counseling in primary care: the Activity Counseling Trial: a randomized controlled trial. JAMA. 2001; 286(6):677-87. DOI: 10.1001/jama.286.6.677. View

14.

Braveman P, Gruskin S . Defining equity in health. J Epidemiol Community Health. 2003; 57(4):254-8. PMC: 1732430. DOI: 10.1136/jech.57.4.254. View

15.

Lawton B, Rose S, Elley C, Dowell A, Fenton A, Moyes S . Exercise on prescription for women aged 40-74 recruited through primary care: two year randomised controlled trial. BMJ. 2008; 337:a2509. PMC: 2769033. DOI: 10.1136/bmj.a2509. View

16.

Chinn D, White M, Howel D, Harland J, Drinkwater C . Factors associated with non-participation in a physical activity promotion trial. Public Health. 2006; 120(4):309-19. DOI: 10.1016/j.puhe.2005.11.003. View

17.

Pavey T, Taylor A, Hillsdon M, Fox K, Campbell J, Foster C . Levels and predictors of exercise referral scheme uptake and adherence: a systematic review. J Epidemiol Community Health. 2012; 66(8):737-44. DOI: 10.1136/jech-2011-200354. View

18.

Pill R, French J, Harding K, Stott N . Invitation to attend a health check in a general practice setting: comparison of attenders and non-attenders. J R Coll Gen Pract. 1988; 38(307):53-6. PMC: 1711284. View

19.

Sowden S, Breeze E, Barber J, Raine R . Do general practices provide equitable access to physical activity interventions?. Br J Gen Pract. 2008; 58(555):e1-8. PMC: 2553553. DOI: 10.3399/bjgp08X342237. View

20.

Dryden R, Williams B, McCowan C, Themessl-Huber M . What do we know about who does and does not attend general health checks? Findings from a narrative scoping review. BMC Public Health. 2012; 12:723. PMC: 3491052. DOI: 10.1186/1471-2458-12-723. View