Health Trainers DCRS. May National Report Produced by BPCSSA. Version 1.0

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1 Health Trainers DCRS National Report Produced by BPCSSA May 2011 Version 1.0

2 C O N T E N T S 1 Report Highlights Current Position Client Demographics Assessment Overview Key Health Gain Outcomes Key Emotional Wellbeing Outcomes Sustaining Change Offender Health Health Trainer Profile Community Engagement Activity Appendices A U T H O R S Compiled by: Alexandra Gowers (BPCSSA ICT) Reviewed by: David Hopkinson & Ertan Fidan (BPCSSA ICT) I N T E R P R E T A T I O N Please be aware when interpreting the various reports produced herein additional factors should also be considered (e.g. sample size, exceptions, regional variances, system changes, individual HT service lifespan etc). Wherever pertinent, such factors have been detailed within surrounding commentary/ comments. F E E D B A C K This report was compiled by BPCSSA.nhs.uk. All feedback relating to the contents of this report is welcomed htsupport@bpcssa.nhs.uk. Page 2 of 34

3 1 R E P O R T H I G H L I G H T S For those with limited time here are the report highlights for Financial Year Over 123,000 new clients seen across 114 organisations 69.39% of those clients are from the deprived client group areas (Quintiles 1 & 2) and 6.63% of these clients reported no GP registration (compared to national average of 0.44%). Over 31,000 full Personal Health Plans created. Of those 47.05% were classed as fully successful, a further 23.34% were part successful. There have been consistent key health gain area improvements: The plus scores: vigorous exercise %, fruit & veg % The minus scores: BMI -2.99%, fatty foods %, smoking % There have been consistent improvements in Emotional Wellbeing Mental Health scores in all areas: % Self-Efficacy % General Health % WHO-5 Wellbeing Of those clients who achieved/part achieved their personal health plan and had a maintenance check carried out, 85.08% of checks reported change had been successfully maintained Offender Health clients of which, 360 full Personal Health Plans created (75.00% achieved/part achieved). Similar Page 3 of 34

4 2 C U R R E N T P O S I T I O N This section is designed to provide a few summary facts before and equal to the 31 st March N A T I O N A L U S A G E S U M M A R Y Since inception organisations have recorded data using the DCRS (15x with clients, 17x between clients, 28x between clients, 50x between clients, 5x with less than 100 clients). There are nearly 240,000 client records (210,000+ with single assessment, 14,000+ with multiple assessments and 14,000+ waiting for an assessment/not contactable) 89 organisations are registered to use remote access tokens with over distributed across the region 19 organisations are entering Offender Health Data totalling 2944 clients C O U N T O F N E W C L I E N T S The tables below show significant DCRS usage growth and an organisational breakdown for all Strategic Health Authorities. National > StHA East Midlands East of England London North East North West South Central South East Coast South West West Midlands Yorkshire & the Humber Total st Qtr 2nd Qtr 3rd Qtr 4th Qtr Total Total A significant year on year growth in client number continues although this is at a signiicantly lower rate than The year does however show some significant turbulence in quarter by quarter system usage in the different regions (considered contributable to the current operational changes many services are going through). 1 Since inception: calculated average results from all clients recorded within the DCRS before 31/03/2011. Page 4 of 34

5 2. 3 S U M M A R Y I T E M S National All Financial year 2006/ / / / /11 Total Client Count Assessment Count Personal Health Plans Set Health Trainers Started Health Trainer Leavers HT Champion Assessments Offender Health Clients New DCRS Organisations Annual new starter numbers have now reduced. Just under 50% of new assessments creating PHPs. Growth in HT Champions and Offender health usage but still a relatively small proportion compared to overall. Page 5 of 34

6 3 C L I E N T D E M O G R A P H I C S This section provides a series of summary charts that outline the basic demographic profile of new clients attending Health Trainer services nationally. Please note that throughout this section null responses e.g. unstated, unknown, not recorded have been excluded to enable clearer year on year comparison of all positive responses G E N D E R Sample size: 238,827 Gender 2006/ / / / /11 Count % Count % Count % Count % Count % Female % % % % % Male % % % % % Other % % % % % % % % % % A small increase in male clients since 2008, however the service remains predominately accessed by women. Page 6 of 34

7 3. 2 A G E B A N D Sample size: 222,408 (age-band declined responses excluded from this report) Age 2006/ / / / /11 Count % Count % Count % Count % Count % < % % % % % % % % % % % % % % % % % % % % % % % % % % % % % % Over % % % % % % % % % % Some very small increases in the two youngest and the two oldest client agegroups since 2007 but the service remains slightly more predominantly accessed by the and age-groups. Page 7 of 34

8 3. 3 E T H N I C I T Y Sample size: 214, 205 ( Not stated responses removed from this report) Ethnicity 2006/ / / / /11 Count Percent Count Percent Count Percent Count Percent Count Percent A: White - British % % % % % B: White - Irish % % % % % 1941 C: Other White Background % % % % % 3730 D: Mixed - White and Black Caribbean % % % % % 1288 E: Mixed - White and Black African % % % % % 545 F: Mixed - White and Asian % % % % % 460 G: Mixed - Any Other Mixed Background % % % % % 633 H: Asian or Asian British - Indian % % % % % 7070 I: Asian or Asian British - Pakistani % % % % % J: Asian or Asian British - Bangladeshi % % % % % 7230 K: Any Other Asian Background % % % % % 1506 L: Black or Black British - Caribbean % % % % % 3867 M: Black or Black British - African % % % % % 4170 N: Any Other Black Background % % % % % 1050 O: Chinese % % % % % 590 P: Any Other Ethnic Group % % % % % 2867 A gradual reduction in the overall proportion of White British clients since 2008, however they remain the significant majority service user 77.13% (compared to 85.67% 2 for the wider UK population) Consistent 2009/10 and 2010/11 client ethnic breakdown 24, 928 unstated ethnicity results have been excluded to support comparison % % % % % Source: Census 2001, see Page 8 of 34

9 3. 4 D E P R I V A T I O N S T A T U S Q U I N T I L E S Sample size: 225,024 Postcode Deprivation Status 2006/ / / / /11 Count Percent Count Percent Count Percent Count Percent Count Percent No fixed abode % % % % % 442 Q1 - Most deprived % % % % % Q % % % % % Q % % % % % Q % % % % % Q5 - Least deprived % % % % % % % % % % With greater system rollout overall Q1 results have slightly dropped so this must be monitored, however 69.39% of clients are still form Q1 and Q2 areas. Postcode deprivation scores are based on an overall average across of the following indicators 3 : Income Employment Health Deprivation & Disability Education, Skills & Training Barriers to Housing & Services Crime Living Environment 3 [Deprivation data is based on indices of deprivation and grid-link which can be found from the following links: Page 9 of 34

10 3. 5 D E P R I V A T I O N S T A T U S ( A N Y I N D I C A T O R ) Sample Size: 223,609 Deprivation Status Quintiles 2006/ / / / /11 Count % Count % Count % Count % Count % Less deprived % % % % % Most deprived % % % % % % % % % % A significant majority of client postcodes 71.33% fell into one or more of the Q1 deprivation indicators during 2010 slightly lower than previous years but still a significant majority. This report details clients who fall within any one or more of the following indicators 4 for the 20% deprivation threshold: Income Employment Health Deprivation & Disability Education, Skills & Training Barriers to Housing & Services Crime Living Environment 4 [Deprivation data is based on indices of deprivation and grid-link which can be found from the following links: Page 10 of 34

11 3. 6 A D D I T I O N A L P E R S O N A L I N F O Sample size: 23,527 Additional Personal Information 2008/ / /11 Count % Count % Count % Carer % % % 838 Difficulty accessing services (eg NHS) % % % 2124 Disability/ vulnerable group % % % 7381 Ethnic Minority Group (BME) % % % 1607 Full time carer % % % 20 Long term condition % % % 6017 Long-term unemployed (1yr+) % % % 2610 Offender % % % 1 Prison % % % 639 Probation % % % % % % /07 & 2007/08 is not provided as this field was only added during 2008/09. Listed above we see that clients with long term conditions and disability/ vulnerable group are significantly more prevalent (58.18% combined for 2010/11). We also notice a continued growth in long term condition clients. NB: Additional personal information is a non-mandatory field, hence lower sample sizes. Page 11 of 34

12 3. 7 G P R E G I S T R A T I O N Sample size: 238,939 GP registration 2006/ / / / /11 Count % Count % Count % Count % Count % Not registered % % % % % Registered % % % % % % % % % % A significantly higher proportion of clients report themselves as not registered with GPs compared to national figures (below). National figures (for comparison) 5 GP Registration Count Percent Registered % Female % Male % Not registered % Female % Male % % 5 Source: Census 2001, see Page 12 of 34

13 3. 8 H O W H E A R D A B O U T T H E S E R V I C E Sample size: 238,868 How heard 2006/ / / / /11 Count % Count % Count % Count % Count % Activity % % % % % 2967 At work % % % % % 1826 By being referred % % % % % Community services % % % % % 6874 Local media % % % % % 5410 Other care services % % % % % 5632 Poster / leaflet % % % % % Promotional event % % % % % Website % % % % % 76 Word of mouth % % % % % % % % % % Slightly greater result consistency since 2008, but no clear trends. By being referred and promotional events now have formed a significant majority from 2008/09 onwards, although word of mouth has dropped back slightly. Page 13 of 34

14 4 A S S E S S M E N T O V E R V I E W This section reviews the assessment source, primary issue and outcomes of those carrying out PHPs for client assessments added in the financial year 2010/11. Please note that throughout this section null responses e.g. unstated, unknown, not recorded have been excluded to enable clearer year on year comparison of all positive responses A S S E S S M E N T B R E A K D O W N B Y S T A G E S Sample size: 241,051 Status / Completion Summary Stages Completed 6 Signed-off In total 85.25% of all client assessments have been fully signed off. These are broken down into 3 categories: o 24.23% have completed a full PHP assessment o 45.17% are quick sign-offs (a majority of which are signpost only or information only ) o 15.85% are early sign-offs. Count Percent Full PHP assessment completed IA > A > WB > PHP > WA > SO % Early sign-off Quick sign-offs (Signposted, information only, not eligible, did not want to proceed) Not signed-off Assessment still active IA > A > PHP > SO % IA > A > WB > PHP > SO % IA > A > WB > SO % IA > A > SO % IA > SO % IA % IA > A % IA > A > WB % IA > A > WB > PHP % IA > A > PHP % IA > A > WB > PHP > WA % % 6 IA- Initial assessment, A- Assessment, WB - Wellbeing Before, PHP Personal Health Plan, WA - Wellbeing After, SO - Sign-off Page 14 of 34

15 4. 2 E M P L O Y M E N T S T A T U S Sample size: 240,941 Employment Status 2006/ / / / /11 Count % Count % Count % Count % Count % Employed full-time % % % % % Employed part-time % % % % % Full time carer % % % % % 2040 Looking after home or family full time % % % % % N/A - Offender health % % % % % 74 Other % % % % % 4548 Permanently Sick / Disabled % % % % % Retired % % % % % Self-employed % % % % % 1883 Student % % % % % 4606 Unemployed % % % % % Volunteer % % % % % % % % % % The bar chart graphically depicts a fairly consistent employment status outlook overall, particularly over the past two years. However analysing the figures we see a marked reduction in employed full-time clients, whilst adversely a growth in unemployed and retired clients. Page 15 of 34

16 4. 3 P R I M A R Y I S S U E Sample size: 87,015 Primary Issue 2006/ / / / /11 Count % Count % Count % Count % Count % Alcohol % % % % % 1710 Diet % % % % % Exercise % % % % % Local issue % % % % % 5882 Smoking % % % % % % % % % % The largest primary issue groupings are consitently diet and exercise (78.55% combined in 2010/11), however the past three years have all seen small growth in smoking, alcohol and particulaly local issue (i.e. emotional wellbeing) clients. Page 16 of 34

17 4. 4 P E R S O N A L H E A L T H P L A N O U T C O M E Sample size: 85,790 PHP Outcome 2006/ / / / /11 Count % Count % Count % Count % Count % ACHIEVED % % % % % PART ACHIEVED % % % % % NOT ACHIEVED % % % % % OUTCOME UNKNOWN % % % % % % % % % % % of completed Personal Health Plans were either achieved or part achieved in 2010/11, up from 58.83% the previous year an excellent result. A significant growth in client numbers since 2009/10 has also seen a significant growth in outcome unknown reporting 7. 7 Also likely to be attributable to more robust management and subsequent sign-off of clients previously left active within the system prior to Page 17 of 34

18 4. 5 R E A S O N S F O R N O T C O M P L E T I N G A P H P Sample size: 150,808 Reasons for not completing a PHP 2006/ / / / /11 Count % Count % Count % Count % Count % Chose an alternative service % % % % % 2604 Client DNAs (Did not attend) % % % % % Could not afford desired activities % % % % % 296 Could not contact client % % % % % Did not follow plan % % % % % 2194 Did not realise commitment required % % % % % 2870 Disappointed with rate of progress % % % % % 317 Insufficient support from significant others % % % % % 286 Not eligible % % % % % 967 Not ready to make changes % % % % % Only wanted some information % % % % % Other % % % % % Recommended to primary care % % % % % 1041 Referral to accredited Health Trainer % % % % % 1275 Signpost only % % % % % % % % % % Staff added value through signposting and information giving in 52.93% of cases where a full PHP was not completed. Client DNA and Could not make contact clients are both areas where services have managed to achieve significant reductions which is a positive result 8, however this is to some degree offset by an adverse increase in Not ready to make change results. 8 Those service not making use of the systems SMS remionder service are recommended to contact BPCSSA htsupport@bpcssa.nhs.uk to help further support the reduction in DNAs! Page 18 of 34

19 4. 6 S I G N P O S T I N G / P H P R E F E R R A L S B R E A K D O W N Sample size: 30,114 / 65,390 Signposting Breakdown (signposting is where no further 1-1 HT service interaction occurs) 2006/ / / / /11 Count % Count % Count % Count % Count % Advice and Guidance % % % % % 1218 Community / voluntary services % % % % % 2899 Disability services % % % % % 42 Emotional wellbeing services % % % % % 501 Employment service % % % % % 89 GP or other primary care services % % % % % 4170 Health Trainer Services % % % % % 1948 Hospital services % % % % % 33 Lifestyle Risk Management Services % % % % % Local authority services % % % % % 734 Other % % % % % % % % % % PHP Referral To Breakdown (referrals as part of a continued HT Service interaction) 2006/ / / / /11 Count % Count % Count % Count % Count % Activity % % % % % 640 Advice and Guidance % % % % % 2828 Community / voluntary services % % % % % 8471 Disability services % % % % % 8 Emotional wellbeing services % % % % % 1280 Employment service % % % % % 336 GP or other primary care services % % % % % 2323 Health Trainer Services % % % % % 1289 Hospital services % % % % % 15 Lifestyle change/support services % % % % % Local authority services % % % % % 322 Other % % % % % % % % % % In both instances a majority of clients are sent to specialised lifestyle services % of signposting were to GP or other primary care services. 2009/10 saw the addition of two new categories Health Trainer Services and Emotional Wellbeing Services. We note that this immediately lead to full decline in recorded Other responses. Page 19 of 34

20 5 K E Y H E A L T H G A I N O U T C O M E S This section is designed to review the before Vs after change outcomes achieved by clients carrying out Health Trainer Personal Health Plans in financial years year (2006/07 has not been included due to low sample sizes) P R E & P O S T P E R S O N A L H E A L T H P L A N R E S U L T S BMI Sample size Averaged pre/post BMI values Before After Change (%) 2007/ / / / % Down 5.40% Down 3.85% Down 2.99% Down Weight Sample size Averaged pre/post KG values Before After Change (%) 2007/ / / / % Down 4.91% Down 3.83% Down 3.05% Down Moderate Exercise Sample size Averaged no. pre/post 30 min. moderate exercise sessions/ week values Before After Change (%) 2007/ / / / % Up 55.37% Up 68.06% Up 61.31% Up Vigorous Exercise Sample size Averaged no. pre/post 20 min. vigorous exercise sessions/ week values Before After Change (%) 2007/ / / / % Up % Up % Up % Up Fruit & Vegetable Sample size Averaged pre/post Portions Per Day values Before After Change (%) 2007/ / % Up 62.24% Up Page 20 of 34

21 2009/ / % Up 54.33% Up Fried, Fat & Snacks Sample size Averaged pre/post Portions Per Day values Before After Change (%) 2007/ / / / % Down 56.07% Down 58.27% Down 58.10% Down Alcohol Sample size Averaged pre/post Alcohol Units Per Day values Before After Change (%) 2007/ / / / % Down 46.69% Down 41.94% Down 43.23% Down Smoking Sample size Averaged pre/post cigarettes (or equivalent) per day values (of smoker only clients) Before After Change (%) 2007/ / / / % Down 72.27% Down 76.30% Down 76.77% Down Clear and consistent year on year significant improvements in all areas, excellent results overall. Some reduction in percentage change benefits being achieved during 2010/11 in several areas however also noticeable is that in several measures (notably exercise and BMI) clients have a slightly improved starting point making greater change more difficult to achieve. Page 21 of 34

22 6 K E Y E M O T I O N A L W E L L B E I N G O U T C O M E S 6. 1 W E L L B E I N G I M P R O V E M E N T Wellbeing Measure Self-Efficacy Sample size Averaged pre/post Personal Health Plan values Before After Change (%) 2007/ / / / % Up 7.76% Up 9.19% Up 9.74% Up Wellbeing Measure General Health Sample size Averaged pre/post Personal Health Plan values Before After Change (%) 2007/ / / / % Up 37.61% Up 39.15% Up 35.35% Up Wellbeing Measure WHO 5 Sample size Averaged pre/post Personal Health Plan values Before After Change (%) 2007/ / / / % Up 42.83% Up 38.36% Up 37.47% Up Clear and consistent improvements in self-efficacy and even more so general health and WHO-5 year on year, a very positive result overall. Results largely consistent 2009/10 onwards. Page 22 of 34

23 6. 2 W E L L B E I N G I M P R O V E M E N T ( P R I M A R Y I S S U E = E M O T I O N A L W E L L B E I N G S P E C I F I C ) These results review emotional wellbeing change specifically for those clients whose Personal Health Plan primary issue was local issue - emotional wellbeing. Wellbeing Measure: Self-Efficacy Sample size Averaged pre/post Percentage values Before After Change (%) 2007/ / / / % Up 14.54% Up 15.14% Up 14.67% Up Wellbeing Measure: General Health Sample size Averaged pre/post Percentage values Before After Change (%) 2007/ / / / % Up 56.63% Up 43.90% Up 38.51% Up Wellbeing Measure: WHO 5 Sample size Averaged pre/post Percentage values Before After Change (%) 2007/ / / / % Up 83.97% Up 46.63% Up 44.84% Up Again, clear and consistent improvements in self-efficacy and even more so general health and WHO-5 year on year, a very positive result overall. Whilst we note the clients summarised here were also included in the wider results of section 6.1, we notice that whilst these clients had lower start and end point scores they nevertheless successfully achieved a greater level of improvement than the overall HT client population (again see section 6.1), particularly so for self-efficacy. Page 23 of 34

24 7 S U S T A I N I N G C H A N G E This section focuses on the review of maintenance checks for those clients that part or fully achieved their Personal Health Plan. Maintenance checks are simple checks usually carried out after assessment sign-off. These are gradually being carried out in increasing numbers M A I N T A I N I N G C H A N G E B Y T I M E L A P S E D Sample size: 18,820 Maintaining Change by Time Lapsed No, not maintained Yes, maintained Count % Count % < 3 months % % months % % months % % months % % 521 Over 12 months % % % % a very significant majority 69.79% of maintenance checks report a continued achievement. Interestingly we see an increase in yes, maintained responses up to 6-9 months before a subsequent decrease. Notable however is significantly higher samples sizes prior to 6-9 months. Page 24 of 34

25 7. 2 C H A N G E M A I N T A I N E D R E S U L T S Sample Size: 13,421 Maintenance Outcome No, not maintained Yes, maintained 2006/ / / / /11 Count % Count % Count % Count % Count % < 3 months % % % % % months % % % % % months % % % % % months % % % % % 138 Over 12 months % % % % % % % % % % 5731 < 3 months % % % % % months % % % % % months % % % % % months % % % % % 405 Over 12 months % % % % % % % % % % With significantly increased sample sizes we see a significant growth in yes maintained results 85.08% recorded in 2010/11 which is an excellent result. Recent significant growth in checks carried out within 3 months which will inevitably account for some of the increase. Page 25 of 34

26 8 O F F E N D E R H E A L T H In light of Offender Health HT services being developed, with some services now reporting into DCRS the system can be used to reflect contribution HTs are making to 7 pathways 9 to reducing risk of re offending: Alcohol and drugs Physical and Mental Health Employment training and education Accommodation Attitudes thinking and behaviour Finance, benefit and dept. Children Families and community support 8. 1 O F F E N D E R H E A L T H T Y P E C O M P A R I S O N Probation Vs Prison 2007/ / / /11 Count % Count % Count % Count % Prison Caseload % % % % 639 Probation Caseload % % % % % % % % 2944 Significant majority of probationary clients however the proportion of offender health prison clients growing rapidly. Still a relatively low number of Offender Health clients (1698 in total during 2010/11) compared to the wider Health Trainer client population. 2006/07 data not included due to limited sample size. 9 Page 26 of 34

27 8. 2 O F F E N D E R H E A L T H P H P O U T C O M E s Offender Health PHP Outcome 2008/ / /11 Count % Count % Count % ACHIEVED % % % 382 PART ACHIEVED % % % 245 NOT ACHIEVED % % % 152 OUTCOME UNKNOWN % % % 99 Total % % % 878 It is noted that compared to the overall client base achievement rates are marginally higher, i.e % achieved/part achieved versus 70.39% for the general client population (see section 4.4). Year on year results see a light drop in full achievement rates but overall an improvement in combined achieved and part achieved results. NB: Pre-2008 data not included due to limited sample size W E L L B E I N G I M P R O V E M E N T Wellbeing Measure Self-Efficacy Sample size Averaged pre/post Personal Health Plan values Before After Change (%) 2009/ / % Up 4.63% Up Wellbeing Measure General Health Sample size Averaged pre/post Personal Health Plan values Before After Change (%) 2009/ / % Up 33.54% Up Wellbeing Measure WHO 5 Sample size Averaged pre/post Personal Health Plan values Before After Change (%) 2009/ / % Up 32.34% Up Page 27 of 34

28 s Albeit slightly lower in 2010/11 a fully positive set of change results, so an excellent result. Results prior to 2009/10 have been excluded due to low sample size and a warning must be noted that all sample sizes within this section are low. Compared to general population results, see section 6.1, it is perhaps surprising that both the averaged before scores are similar and change percentage results are largely similar or only slightly lower. Page 28 of 34

29 9 H E A L T H T R A I N E R P R O F I L E This section reviews the demographic profiles of Health Trainers added to DCRS before and equal to the 31/03/2011 and are still in position (except the 'Reason for Leaving' report which is based on Health Trainer that left prior to this date). Numbers are based on head counts not WTE H E A L T H T R A I N E R W O R K I N G H O U R S B R E A K D O W N Sample size: 1,939 Working Hours Breakdown (Health Trainer Profile) 2006/ / / / /11 Count % Count % Count % Count % Count % less than 16 hours % % % % % 472 over 37.5 hours % % % % % hours % % % % % to 37 hours % % % % % hours % % % % % 134 Not recorded % % % % % % % % % % 1939 Page 29 of 34

30 9. 2 H E A L T H T R A I N E R D E P R I V A T I O N S T A T U S Sample size: 1,944 Deprivation Status Quintiles (Health Trainer Profile) 2006/ / / / /11 Count % Count % Count % Count % Count % Q1 - Most deprived % % % % % 690 Q % % % % % 409 Q % % % % % 258 Q % % % % % 260 Q5 - Least deprived % % % % % 165 Unknown % % % % % 108 Not Recognised % % % % % 54 s % % % % % 1944 Financial years groupings are based on employee start date. The largest proportion of Health Trainers are from target quintiles 1 and 2 with 57.73% combined in 2010/11, highlighting a success in recruiting from target areas. Page 30 of 34

31 9. 3 H E A L T H T R A I N E R E T H N I C I T Y Sample size: 1,939 Ethnicity (Health Trainer Profile) 2006/ / / / /11 Count % Count % Count % Count % Count % A: White - British % % % % % 1333 B: White - Irish % % % % % 13 C: Other White Background % % % % % 41 D: Mixed - White and Black Caribbean % % % % % 15 E: Mixed - White and Black African % % % % % 7 F: Mixed - White and Asian % % % % % 7 G: Mixed - Any Other Mixed Background % % % % % 7 H: Asian or Asian British - Indian % % % % % 57 I: Asian or Asian British - Pakistani % % % % % 89 J: Asian or Asian British - Bangladeshi % % % % % 45 K: Any Other Asian Background % % % % % 12 L: Black or Black British - Caribbean % % % % % 50 M: Black or Black British - African % % % % % 63 N: Any Other Black Background % % % % % 7 O: Chinese % % % % % 15 P: Any Other Ethnic Group % % % % % 39 Z: Not Stated % % % % % 31 Not recorded % % % % % % % % % % 1939 s A fairly consistent year on year breakdown of staff ethnicity. A slightly lower proportion of White British staff 71.71% compared to the HT client average of 77.13% (see section 3.3). Page 31 of 34

32 9. 4 H E A L T H T R A I N E R A G E B A N D Sample size: 1,939 Age Band (Health Trainer Profile) 2006/ / / / /11 Count % Count % Count % Count % Count % < % % % % % % % % % % % % % % % % % % % % % % % % % % % % % % 89 Over % % % % % 36 Not recorded % % % % % % % % % % 1939 s A fairly consistent year on year breakdown of age with and age groups being consistently the most prominent groupings. Page 32 of 34

33 1 0 C O M M U N I T Y E N G A G E M E N T A C T I V I T Y Community Engagement activities 10 are group based events which have been organised, attended and (usually) run by Health Trainer services A C T I V I T Y T Y P E Sample Size: 5,382 Activity Type Count Percent Engage Community % Engage other professional/org % Own learning and development % % s The vast majority (86.70%) of activity types are classed as Engage Community (this is further sub-categorised only at a local organisation level) A C T I V I T Y T O P I C S C O V E R E D Sample Size: 2,806 Activity Type Count Percent Alcohol % Diet % Exercise % Smoking % Local Issue % % s Similar to PHP client (see primary issue results section 4.3) the topic most covered group topics are diet then exercise with combined form a small majority of 51.96%. Topics covered is a non-mandatory field hence lower a sample size. 10 Please note the ability to record community engagement activity was only added to the system in July Page 33 of 34

34 1 1 A P P E N D I C E S A B B R E V I A T I O N S U S E D H E R E I N DCRS Data Collection Reporting System (the system used to collect and report Health Trainer activity data) HT/ HTC Health Trainer, Health Trainer Champion (trained staff that carry out the client assessments) PHP Personal Health Plan (this is the plan followed by clients when participating in a full one to one assessment with a Health Trainer. This involves setting and working towards an overall health improvement objective). Page 34 of 34