The Occupational Role of the Lay Health Trainer in England: A Review of Practice

Abstract

Health Trainers constitute an emergent occupational group in the Public Health system in England with the key purpose to reduce health inequalities by helping or 'nudging' people in local communities to adopt healthier lifestyles. Whilst primarily supplying health-related information and support regarding smoking cessation, diet, alcohol, physical activity and mental wellbeing issues, the role also requires awareness of, and sensitivity toward the specific needs of local communities. This literature review charts current research on the occupational context of the Health Trainer role since its implementation in the English Public Health system. It provides a critical examination of current literature whilst highlighting the theoretical basis of Health Trainers' roles, the potential boundary-crossing nature of their work, along with professional development issues.

‘We have the time to listen’: community Health Trainers, identity work and boundaries

“…Indeed, some of the HTs interviewed self-described their personal identities as professional healthcare workers, whilst noting how they felt cast by other health professionals as 'unskilled', 'unqualified', 'just lay' workers. As Williams et al (2016) have noted, the incorporation of HTs into the public health infrastructure in England has not proceeded without considerable inter-occupational tensions, especially where perceived overlap exists between the roles of HTs and those of other health occupations (see for example, Attree et al, 2012;South et al, 2007).…”

“…Allen 2001, Cregård 2018, Timmons and Tanner 2004, the everyday occupational identities and lifeworlds of HTs as lay health workers in less formal settings remain relatively under-researched (Rahman and Wills 2013). Such lay roles and programmes are important as they constitute bridges between disadvantaged populations and healthcare systems and are 4 | P a g e increasingly being implemented in Western industrialised countries (Williams et al 2016, Henderson et al 2018. Many lay health workers work alongside National Health Service (NHS) occupations and services, but the uncertainty surrounding their roles and relationship to other health professionals has been signalled as problematic (Kennedy et al 2008).…”