Qipp, Health Trainers and Prevention

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Qipp, Health Trainers and Prevention

• By Sue Green East of England HT Hub Lead
• sgreen_at_s-norfolk.gov.uk

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What is a Health Trainer?

• Is a Peer trainer
• Someone employed from the community to work in
  their community
• Works in the most deprived 20 IMD postcodes
• Trained to do 1-1 behaviour change
• 4 Core competencies
• Nationally recognised transferable qualifications

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Health Inequalities

• Reducing health inequalities is a key priority
• Such differences are often avoidable and always
  unjust
• In a fair and prosperous society, everyone
  should have the same chance to lead a long and
  healthy life and enjoy the same opportunities for
  education, employment, recreation and fulfilment
  that good health brings, (DoH, 2008).

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• Health Trainers (HT) tackle health inequalities
  by using a health psychology approach
• 1. Understanding the determinants of health and
  the role of behaviour in health. Plus the role
  beliefs and motivations in unhealthy behaviours.
• 2. Behaviour change and the methods needed for
  enhansing motivation. Provide 1-1 support to
  those that want to change

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Prevention

• Should be at the heart of any PCTs overall
  approach to future planning
• This can be done by addressing worklessness in
  the deprived areas e.g. employing those from the
  deprived postcodes.
• Employing those with no prior qualifications or
  training in health.
• Up-skilling existing lower paid staff with
  transferable qualifications and training .

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Areas where Health Trainers Work

• 1. Community most deprived 20.
• 2. In Offender settings,7 prisons signed up so
  far in the East of England( approx. 50).
• 3.Probation service (1 PCT currently recruiting
  ex-offenders).
• 4. Gypsy/Travellers (1 PCT working on this).
• 5.Voluntary sector
• 6. Third sector

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Health Inequalities Work

• 1. Weight management, healthy eating
• 2. Smoking Cessation
• 3.Alcohol
• 4. Increasing exercise
• 5. CVD risk assessments
• 6. Mental health
• 7. Improving access to health services

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Social Marketing

• Several PCTs have canvassed their deprived
  populations to find out-
• 1. What health inequalities they have.
• 2. What they think the problem health
  inequalities are in their area.
• 3. Where they think the service should be based.
• 4.Times of opening.
• Ensures those working in lower paid jobs can
  access the service and can get help to change
  behaviours causing them ill health.

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What evidence is there that HTs are working in
deprived areas and reducing health inequalities?

• All PCTs were canvassed for their data with a 95
  response rate.
• 169 HT services
• 34 increase from 2007/8
• 50 increase from 2006/7
• 2076 HT (many more will be added especially in
  the East)

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• Findings
• 77,816 clients seen April 2008 to March 09
• Only 2 PCTs in the East using the data collection
  system therefore many more clients seen (but many
  being trained to use the system).
• This was a 34 increase from 2007-8
• 493 increase since 2006/7

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• 51 clients were from the most deprived
  postcodes.
• 37 were self referrals
• 11,388 had a personal health plan
• 52 fully achieved
• 31 partly achieved

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PHP achievement by target health behaviours

• Diet
• 52 fully achieved target weight
• 36 partly achieved
• Alcohol
• 52 Fully achieved
• 33 partly

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• Exercise
• 56 Fully achieved
• 31 Partly achieved
• Smoking Cessation
• 54 Fully achieved
• 24 Partly

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Achieved PHP and Client deprivation

• Greater numbers of clients from IMD quintiles 1
  and 2 (most deprived) successfully achieved their
  targets, with-
• 2766 fully successful in Quintile 1
• 1263 in Quintile 2
• 1424 in Quintiles 3,4, and 5 (least deprived)

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Changes in BMI and Self Efficacy

• 2039 clients wanted to eat healthier
• 58 saw a decrease in their BMI
• 66 perceived their health to have improved after
  working with a HT
• Latest reports show that over 80 clients that
  changed their behaviours have continued to do so
  after one year.