1. An ethnographic account of the benefits and challenges of providing NHS Health Checks at community outreach events
Background
NHS Health Checks:
Vascular disease risk assessment - for all aged
Prevention programme → management/lifestyle intervention
Aim = to reduce health inequalities
Black & minority ethnic populations at greater risk of vascular disease
Inner City Health Improvement Team & GP practices → community based health checks aimed to increase uptake within BME communities
Methods
Observations of community NHS Health Check events (n=4)
Interviews with service users and staff (n=20)
- NHS Health Checks - Vascular disease (heart disease, stroke, diabetes, kidney disease)
Not screening – but given qrisk score – preventative programme – management/lifestyle services
Aim to reduce inequalities – but needs to reach all
The burden of these conditions falls disproportionately on people living in deprived circumstances and on particular ethnic groups
Commissioned through local authority public health – conducted in primary care
- conducted HC in community setting such as church halls and community centres
-ethnography – observations and interviews
Riley, R. Coghill, N. Montgomery, A.
Feder, G. & Horwood, J.

2. Benefits Challenges Reasons for attending Engaging community Valued
Family history
Proactive/preventative
Opportunistic
Peers
Engaging community
Community workers
Accessible venues
Stepping out of practice
Valued
Reaffirmed healthy behaviours
Information/education/ lifestyle tips
Peer engagement in health talk
Challenges
Barriers to attending
Health beliefs
Mistrust of institutions
Time of day
Venue
Lack of space
Confidentiality
Technology
Delivery of results/advice
Basic
Medicalisation rather than prevention
Not personal to prompt behaviour change
Results
Benefits
Reason for attending – number of reasons – family history of stroke, diabetes, concerned about health and preventative, waling past, told about it by friends
engaging community – health outreach worker – spread the words amongst contacts – driving force, central location, appreciated HC being taken to community
- Valued – reinforced healthy lifestyle, gained information, added value – men talking to others about health and HC
Challenges
Barriers - engagement workers – told not for them, mistrust of imitations – surveillance, during day so workers couldn’t attend
Venue – one room, confidentiality for weighing, providing results, Qrisk scores not given to some as internet not working
- Delivery results – some wanted more information, felt given a label and did not know what to do about it, general advice on Bhr change which was not personal to them

3. Conclusions
Practices working in collaboration with local community organisations is valuable to engage the target community
Community location vital – but venue must be fit for purpose
Important to:
provide meaningful results/advice
not pathologise patients
adopt a patient centred approach
Important to work with local community/organisations – step out of practice
- good to be where people normally go – but has to be fit for purpose
- vital to
- make the check meaningful – understandable results + personal advice
- not to lable patients – prevention rather than screening
- be person central – advice and information and services that work for that person – limited time