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Impact and acceptability of lay health trainer-led lifestyle interventions delivered in primary care: a mixed method study

Lookup NU author(s): Dr Shelina Visram

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This is the authors' accepted manuscript of an article that has been published in its final definitive form by Cambridge University Press, 2017.

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Abstract

© Cambridge University Press 2017.Aim To evaluate the impact and acceptability of offering one-to-one lifestyle interventions delivered by lay health trainers in the primary care setting. Background Chronic conditions represent major causes of ill-health, avoidable disability, pain and anxiety, and tend to be more prevalent in less affluent groups. This is due, in part, to the link between unhealthy lifestyles and lower socio-economic status, although factors such as poverty, worklessness and social exclusion play a larger role. Lay health trainers were introduced in England with the aim of providing personalised lifestyle advice, support and access to services for people living in disadvantaged areas. There is a body of literature on the effectiveness of lay or community health workers in the management of chronic conditions. However, little is known about their potential to promote lifestyle changes in newly diagnosed patients. An innovative health trainer service was piloted in the primary care setting, to work with people diagnosed with a chronic condition or identified as potentially benefitting from one-to-one support. Methods A mixed method study design was utilised. Semi-structured interviews and focus groups were conducted with practice staff (n=11) and patients (n=15) from one primary care practice in North East England, United Kingdom. Discussions were audio-recorded and analysed using a thematic content approach. Routinely collected pre-/post-intervention data (n=246 patients at baseline; sample sizes varied at end line) were analysed and appropriate descriptive and summary statistics produced. Findings The discussions highlighted a high level of satisfaction with the health trainer model in terms of supporting positive lifestyle changes. Locating the intervention within the practice removed access barriers, particularly for those with long-term conditions. Anecdotal evidence of health improvement was supported by the quantitative analyses, which revealed statistically significant improvements in body mass index, blood pressure, dietary habits, exercise levels, alcohol intake, self-rated health and self-efficacy amongst those who completed the intervention.


Publication metadata

Author(s): Visram S

Publication type: Article

Publication status: Published

Journal: Primary Health Care Research and Development

Year: 2017

Volume: 18

Issue: 4

Pages: 333-343

Print publication date: 01/07/2017

Online publication date: 10/04/2017

Acceptance date: 07/02/2017

Date deposited: 29/09/2017

ISSN (print): 1463-4236

ISSN (electronic): 1477-1128

Publisher: Cambridge University Press

URL: https://doi.org/10.1017/S146342361700010X

DOI: 10.1017/S146342361700010X


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