Barriers and Facilitators of NHS Health Checks in Socioeconomically Deprived Communities in the North East of England: A Qualitative Study With Peer Researchers

Abstract

Introduction: Preventive health services, such as the NHS Health Check programme, aim to identify and address key health risks, yet participation is particularly low in socioeconomically deprived areas, such as the North East of England. Understanding barriers and facilitators to engagement is critical to improving access and outcomes for these communities. This study aimed to explore barriers and facilitators to NHS Health Check attendance in these underserved communities using a participatory research approach.

Methods: This study employed a qualitative design with a participatory approach, involving peer researchers from the target communities. Two peer research associates (PRAs) from socioeconomically deprived areas were trained to conduct semi-structured online or telephone interviews with 12 community members eligible for NHS Health Checks. Additionally, 5 stakeholders involved in the programme's delivery were interviewed. Thematic analysis was conducted in collaboration with the PRAs to ensure community perspectives were authentically captured.

Results: Barriers to participation included limited awareness, cultural perceptions of self-reliance, fear of health-related discoveries, mistrust of healthcare systems and logistical challenges exacerbated by structural inequalities. Participants emphasised the need for culturally tailored communication and flexible, accessible health checks. Stakeholders highlighted the role of collaboration, targeted outreach and digital tools in addressing these barriers.

Conclusion: The study highlights key barriers to NHS Health Check uptake in socioeconomically deprived communities in the North East of England. Improving communication, increasing accessibility through community-based services and building trust in healthcare are recommended key strategies to enhance participation and reduce health inequalities in these regions.

Patient or public contribution: Peer researchers, individuals with lived experience of being from socioeconomically deprived communities in North East England and eligible for NHS Health Checks, were involved in the design and conduct of this study. They were trained to conduct interviews with community members and contributed to the thematic analysis, ensuring that public perspectives were integral to the interpretation of the data.

Keywords: NHS Health Checks; barriers; facilitators; peer researchers; socioeconomic deprivation.