How Community Health Trainers in Manchester enable positive lifestyle changes

Performance indicators

A recent evaluation (1 April 2013 - 30 September 2013) of the Royal Society for Public Health shows that a key strength of this co-production approach is that the Health Trainers are being drawn from the populations they serve. From a record of 980 Trainers:

• 34% are drawn from the most deprived quintile of the population.
• A further 22% being drawn from the second most deprived quintile

Source: Royal Society for Public Health (2013, p. 9).

In quintile 1 approximately a third of the clients are male and two thirds female, this proportion carrying on into quintile 2. As the evaluation report argues: “From an equity perspective, there is an argument for saying more men need to be recruited. However in respect to family and community health and well-being the proportion of females engaging with HTS may be an advantage. Women as partners and mothers in families tend to be the dominant force in controlling food purchase, family meals and other health related activities” (Royal Society for Public Health (2013, p. 12).

The performance information about the clients participating in the programme is equally revealing. From total records of 28,633

• Diet (63%) is the most frequent area individuals wish to change and improve upon.
• Exercise on (19%) is next most popular.
• Local Issue (8%) was the third popular.

Source: Source: Royal Society for Public Health (2013, p. 13).

The 2013 evaluation also measures self-confidence for the first time and comes to the conclusion that “self-confidence along with Self Efficacy is an important quality in being able to manage life and its challenges”. The report shows considerable shifts in self-reported confidence scores:

• The greatest increase is recorded in quintile 2 – up a significant 41%.
• Quintile 1 up a respectable 25%.

Source: Source: Royal Society for Public Health (2013, p. 13).

The national results for developing personal health plans for all clients need to be interpreted with caution: The pathways of over recorded 48000 clients shows that encouragingly 13356 (28% of total) were signed off after completing the full personal health plan but nevertheless 12,280 (25%) ultimately failed to fully attend or were lost at some point upon follow-up contact (p.17).

However, as the evaluation report points out it may not be so surprising given that the Programme deals with clients from very deprived backgrounds. “It is also worth reminding ourselves that the methodology used by the HTS is one which accepts clients will not always be successful at the first, second or even third attempts at change. The methodology is predicated that the process of trying to change is itself a beneficial and positive experience, the experience itself leading to greater personal insight and resourcefulness” (p.18).