Patient experiences of telephone outreach to enhance uptake of NHS Health Checks in more deprived communities and minority ethnic groups: A qualitative interview study

Abstract

Background The NHS Health Checks preventative programme aims to reduce cardiovascular morbidity across England. To improve equity in uptake, telephone outreach was developed in Bristol, involving community workers telephoning patients amongst communities potentially at higher risk of cardiovascular disease and/or less likely to take up a written invitation, to engage them with NHS Health Checks. Where possible, caller cultural background/main language is matched with that of the patient called. The call includes an invitation to book an NHS Health Check appointment, lifestyle questions from the Health Check, and signposting to lifestyle services. Objective To explore the experiences of patients who received an outreach call. Design/Setting/Participants Thematic analysis of semi‐structured interviews with 24 patients (15 female), from seven primary care practices, who had received an outreach call. Results The call increased participants’ understanding of NHS Health Checks and overcame anticipated difficulties with making an appointment. Half reported that they would not have booked if only invited by letter. The cultural identity/language skills of the caller were important in facilitating the interaction for some who might otherwise encounter language or cultural barriers. The inclusion of lifestyle questions and signposting prompted a minority to make lifestyle changes. Conclusions Participants valued easily generalizable aspects of the intervention—a telephone invitation with ability to book during the call—and reported that it prompted acceptance of an NHS Health Check. A caller who shared their main language/cultural background was important for a minority of participants, and improved targeting of this would be beneficial.

Concept Analysis of Community Health Outreach

“…Brangan, Stone, Chappell, Harrison, and Horwood [21] reported on a telephone outreach intervention conducted to enhance the UK National Health Service (NHS) Health Check program, which provides cardiovascular risk assessment across England every five years for individuals who have not been diagnosed with the disease. In this program, those community workers were used who were almost identical to the study participants' cultural background and language.…”

“…For instance, the outreach staff of a street outreach program went to certain places, such as streets, night clubs and buses, to meet the target audience of young male adults to educate them on sexually transmitted disease prevention methods [35]. Telephonic outreach activities have been shown to enhance health checks [21], and mailing outreach activities to increase colorectal cancer screenings [18,19]. These methods were used to reach target populations wherever they were.…”

Concept Analysis of Community Health Outreach: a systematic review

“…Due to these activities, the rate of mammogram screening completion increased from 35% in 2010 to 72% in 2014 [18]. E Brangan, TJ Stone, A Chappell, V Harrison and J Horwood [19] reported on a telephone outreach intervention conducted to enhance the UK National Health Service(NHS) Health Check program, which provides cardiovascular risk assessment across England every 5 years to individuals who have not been diagnosed with the disease. It successfully engaged a population with higher health needs and reduced health inequalities in the city of Bristol, the most deprived area.…”

“…These antecedents are necessary for the occurrence of community health outreach: Several studies [8][9][10][15][16][17][18][19][20][21][22] showed that community outreach has resulted in increasing levels of public health screenings and accessibility. Other studies [9,[23][24][25][26][27][28][29][30]…”

“…For instance, the outreach staff of a street outreach program goes to certain places such as streets, night clubs, and buses to meet the target young male adults to educate them on sexually transmitted disease prevention methods [22]. Telephone outreach activities enhance health checks [19], and mailing outreach activities increase colorectal cancer screenings [16,17]. These various methods reach target populations wherever they are.…”