An evaluation of the Gloucestershire partnerships for older people project

This report presents the background to and findings of a UWE evaluation of the Gloucestershire Partnerships for Older People project, which was called 'Care Homes, Part of Our Community'

Experiences of patients and healthcare professionals of NHS cardiovascular health checks: a qualitative study

Background NHS Health Checks are a national cardiovascular risk assessment and management programme in England and Wales. We examined the experiences of patients attending and healthcare professionals (HCPs) conducting NHS Health Checks. Methods Interviews were conducted with a purposive sample of 28 patients and 16 HCPs recruited from eight general practices across a range of socio-economic localities. Interviews were audio recorded, transcribed, anonymized and analysed thematically. Results Patients were motivated to attend an NHS Health Check because of health beliefs, the perceived value of the programme, a family history of cardiovascular and other diseases and expectations of receiving a general health assessment. Some patients reported benefits including reassurance and reinforcement of healthy lifestyles. Others experienced confusion and frustration about how results and advice were communicated, some having a poor understanding of the implications of their results. HCPs raised concerns about the skill set of some staff to competently communicate risk and lifestyle information. Conclusions To improve the satisfaction of patients attending and improve facilitation of lifestyle change, HCPs conducting the NHS Health Checks require sufficient training to equip them with appropriate skills and knowledge to deliver the service effectively

A Step Toward Workplace Obesity Prevention: Evaluation of Weight Management Program for Hospital-based Health Care Providers

Background: Obesity is a worldwide problem. Healthy workplace and lifestyle are crucial in preventing obesity. A workplace weight management program could create a culture of health and facilitate weight control among health care providers. The present study aims to describe and evaluate the health outcomes of the interaction of professional practice and organizational infrastructure. Method: The hospital-based weight management program was an eight-week pilot randomized controlled study for obese health care providers. The primary outcomes were body weight and body mass index. The secondary outcomes included serum fasting glucose, fasting cholesterol, triglyceride, high- and low-density lipoprotein, body fat percentage, body mass, and quality of life. The RE-AIM framework was used to examine the intervention’s reach, effectiveness, adoption, implementation and maintenance at individual and organizational levels. Results: The program successfully attained the target population. Health care providers demonstrated short-term weight loss and decreased serum fasting cholesterol level after completing the program. The excellent retention rate (95%) of the study suggested that the participants were well-engaged in self-weight management. The program was implemented with adequate resource and support from the health organization. The organization may consider continuing the program in view of its long-term benefits to health care providers. Conclusion: Supportive organizational structure and culture enhanced professional practice and improved the health outcomes of the hospital-based weight management program participants

The provision of NHS health checks in a community setting: an ethnographic account

Background: The UK National Health Service Health Checks programme aims to reduce avoidable cardiovascular deaths, disability and health inequalities in England. However, due to the reported lower uptake of screening in specific black and minority ethnic communities who are recognised as being more at risk of cardiovascular disease, there are concerns that NHS Health Checks may increase inequalities in health. This study aimed to examine the feasibility and acceptability of community outreach NHS Health Checks targeted at the Afro-Caribbean community. Methods: This paper reports findings from an ethnographic study including direct observation of four outreach events in four different community venues in inner-city Bristol, England and follow up semi-structured interviews with attendees (n = 16) and staff (n = 4). Interviews and field notes were transcribed, anonymized and analysed thematically using a process of constant comparison. Results: Analysis revealed the value of community assets (community engagement workers, churches, and community centres) to publicise the event and engage community members. People were motivated to attend for preventative reasons, often prompted by familial experience of cardiovascular disease. Attendees valued outreach NHS Health Checks, reinforcing or prompting some to make healthy lifestyle changes. The NHS Health Check provided an opportunity for attendees to raise other health concerns with health staff and to discuss their test results with peers. For some participants, the communication of test results, risk and lifestyle information was confusing and unwelcome. The findings additionally highlight the need to ensure community venues are fit for purpose in terms of assuring confidentiality. Conclusions: Outreach events provide evidence of how local health partnerships (family practice staff and health trainers) and community assets, including informal networks, can enhance the delivery of outreach NHS Health Checks and in promoting the health of targeted communities. To deliver NHS Health Checks effectively, the location and timing of events needs to be carefully considered and staff need to be provided with the appropriate training to ensure patients are supported and enabled to make lifestyle changes

Motivators and de-motivators for adherence to a program of sustained walking

Objective: To investigate motivators, de-motivators and adherence to regular physical activity during and at six months after participation in a 12-week randomized controlled trial (RCT) of walking. Design: Purposive sampling in a group of men who participated in a RCT of supported, home-based walking in Bristol, England, between December 2002 and June 2005. Method: 38 sedentary, hypercholesterolemic men (54.8 (5.0) years) who participated in a 12-week RCT of walking with regular professional support, were interviewed by telephone six months after the RCT. Results: Health or fitness were the main motivational themes for adherence to walking during the RCT. Six-months after the RCT, 27 participants were still doing some walking and 18 were more physically active than before the RCT. In those who were still physically active, health benefits were motivators for adherence. In those who were less active, lack of time was a de-motivator with external support identified as a motivator for becoming more active. Conclusion: Health was the main motivating factor for adherence to physical activity during and after the supported RCT. Lack of external support was a de-motivator for sustaining physical activity. © 2009 Elsevier Inc. All rights reserved

The effect of a home-based walking program on risk factors for coronary heart disease in hypercholesterolaemic men. A randomized controlled trial

Background: Hypercholesterolaemia and physical inactivity significantly contribute towards risk of coronary heart disease. Increased physical activity may be an effective way to improve lipid profiles in hypercholesterolaemic individuals. The aim of this study was to investigate whether a home-based physical activity program meeting current guidelines improved the lipid profile of hypercholesterolaemic men. Methods: Sixty-seven hypercholesterolaemic men (55.1 (4.9) years), from Bristol England, recruited between 2002-2004, were randomized to either 12weeks of brisk walking sufficient to expend at least 300kcal each walk or control condition. Fasting lipids including total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), triglycerides (TG), glucose, insulin, blood pressure and anthropometric characteristics were measured at baseline and follow-up. Compliance was monitored using accelerometers and activity logs. Results: After controlling for baseline differences, TC/HDL-C was significantly lower in the intervention group at follow-up (- 0.28, 95% CI: - 0.52, - 0.03, p = 0.03). An increase in HDL-C (0.07 mmol/l: - 0.01, 0.12, p = 0.07) and reduction in TG (- 0.30 mmol/l: - 0.64, 0.03, p = 0.07) in intervention participants were of borderline statistical significance. Weight significantly decreased in intervention participants (- 1.40kg: - 2.43, - 0.38, p < 0.01). No other significant between group effects were found. Compliance to the walking program was 97.6%. Conclusions: Twelve weeks of moderate intensity walking was sufficient to improve TC/HDL-C in hypercholesterolaemic men, primarily through improvement in HDL-C. © 2008 Elsevier Inc. All rights reserved