Targeting those in need: Baseline data from the first English National Health Service (NHS) Health Trainer Service

Wilkinson, Dawn; Sniehotta, Falko F.; Michie, Susan

doi:10.1080/13548506.2011.564191

Cited by 17 publications

(10 citation statements)

References 15 publications

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“…Allgemeine Maßnahmen wie Gesundheitskurse der Krankenkassen usw. erscheinen nicht ausreichend, weil diese Angebote vorrangig diejenigen erreichen, die sie am wenigsten benötigen [ 42 ] . Für die Praxis plädieren wir, die Relevanz des Gesundheitsverhaltens deutlich stärker als bisher in die Weiterbildung zu integrieren, um Chancen der Primär-und Sekundärprävention in der psychiatrisch-und psychosomatisch-psychotherapeutischen Versorgung in der Zukunft besser nutzen zu können.…”

Section: 8 (67)unclassified

Ungesunder Lebensstil bei Patienten einer psychosomatischen Poliklinik und Konsilambulanz

Beutel

Weiser

Zwerenz

et al. 2014

Psychother Psych Med

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Patients with mental disorders have an increased risk for somatic diseases. Especially life style risk factors contribute to this increased risk. In order to identify targets for preventive measures, we aimed to determine the prevalence of an unhealthy lifestyle in a clinical sample and to analyze associations with severity of mental disorders and somatic complaints. We analyzed the medical records of n=1 919 outpatients, who were treated between 2009-2011 in the Department of Psychosomatic Medicine and Psychotherapy of the University Medical Center Mainz. 62.4% of the patients were physically inactive, 33.2% were smokers and 17.4% were obese. Lifestyle risk factors were associated with increased symptom burden and impairment. Smoking was strongly associated with more previous psychiatric or psychosomatic inpatient treatments. These results indicate an urgent need for targeting health behavior more rigorously in the treatment of patients with common mental disorders.

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Section: 8 (67)unclassified

Ungesunder Lebensstil bei Patienten einer psychosomatischen Poliklinik und Konsilambulanz

Beutel

Weiser

Zwerenz

et al. 2014

Psychother Psych Med

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“…One strategy gaining popularity is financial incentives to encourage healthy behaviours. 6 There are many examples where financial incentives have significantly changed behaviour at a relatively low cost. However, applying principles from behavioural economics can increase effectiveness, as the incentive structure can affect their impact.…”

Section: Introductionmentioning

confidence: 99%

Financial disincentives? A three-armed randomised controlled trial of the effect of financial Incentives in Diabetic Eye Assessment by Screening (IDEAS) trial

Judah¹,

Darzi²,

Vlaev³

et al. 2018

Br J Ophthalmol

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ObjectiveConflicting evidence exists regarding the impact of financial incentives on encouraging attendance at medical screening appointments. The primary aim was to determine whether financial incentives increase attendance at diabetic eye screening in persistent non-attenders.Methods and analysisA three-armed randomised controlled trial was conducted in London in 2015. 1051 participants aged over 16 years, who had not attended eye screening appointments for 2 years or more, were randomised (1.4:1:1 randomisation ratio) to receive the usual invitation letter (control), an offer of £10 cash for attending screening (fixed incentive) or a 1 in 100 chance of winning £1000 (lottery incentive) if they attend. The primary outcome was the proportion of invitees attending screening, and a comparative analysis was performed to assess group differences. Pairwise comparisons of attendance rates were performed, using a conservative Bonferroni correction for independent comparisons.Results34/435 (7.8%) of control, 17/312 (5.5%) of fixed incentive and 10/304 (3.3%) of lottery incentive groups attended. Participants who received any incentive were significantly less likely to attend their appointment compared with controls (risk ratio (RR)=0.56; 95% CI 0.34 to 0.92). Those in the probabilistic incentive group (RR=0.42; 95% CI 0.18 to 0.98), but not the fixed incentive group (RR=1.66; 95% CI 0.65 to 4.21), were significantly less likely to attend than those in the control group.ConclusionFinancial incentives, particularly lottery-based incentives, attract fewer patients to diabetic eye screening than standard invites in this population. Financial incentives should not be used to promote screening unless tested in context, as they may negatively affect attendance rates.

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“…They aim to promote affordable and sociocultural relevant lifestyle advice within communities. However, they were not designed to work with specific health conditions and little work has explored their efficacy in chronic long-term condition management, such as diabetes [11, 12]. Nonetheless, Pennington and colleagues, in their systematic review of the effectiveness, cost-effectiveness, equity, and acceptability of different types of HRLA role, identified some evidence that lay-led self-management interventions can be both effectual and cost-effective [9].…”

Section: Introductionmentioning

confidence: 99%

Lay Health Trainers Supporting Self-Management amongst Those with Low Heath Literacy and Diabetes: Lessons from a Mixed Methods Pilot, Feasibility Study

Bartlam

Rathod

Rowlands

et al. 2016

Journal of Diabetes Research

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This article reports a mixed methods process evaluation of a pilot feasibility randomised controlled trial comparing a Lay Health Trainer (LHT) intervention and usual care for those with poorly controlled Type 2 Diabetes Melitus (T2DM). Set in a deprived area in the UK, this research explores patient and health care practitioner (HCP) views on whether a structured interview between a patient and a Lay Health Trainer (LHT), for the purpose of developing a tailored self-management plan for patients, is acceptable and likely to change health behaviours. In doing so, it considers the implications for a future, randomised controlled trial (RCT). Participants were patients, LHTs delivering the intervention, service managers, and practice nurses recruiting patients to the study. Patients were purposively sampled on their responses to a baseline survey, and semistructured interviews were conducted within an exploratory thematic analysis framework. Findings indicate that the intervention is acceptable to patients and HCPs. However, LHTs found it challenging to work with older patients with long-term and/or complex conditions. In order to address this, given an ageing population and concomitant increases in those with such health needs, LHT training should develop skills working with these populations. The design of any future RCT intervention should take account of this.

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Targeting those in need: Baseline data from the first English National Health Service (NHS) Health Trainer Service

Cited by 17 publications

References 15 publications

Ungesunder Lebensstil bei Patienten einer psychosomatischen Poliklinik und Konsilambulanz

Ungesunder Lebensstil bei Patienten einer psychosomatischen Poliklinik und Konsilambulanz

Financial disincentives? A three-armed randomised controlled trial of the effect of financial Incentives in Diabetic Eye Assessment by Screening (IDEAS) trial

Lay Health Trainers Supporting Self-Management amongst Those with Low Heath Literacy and Diabetes: Lessons from a Mixed Methods Pilot, Feasibility Study

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