title: Primary care and population factors associated with NHS Health Check coverage: a national cross-sectional study.
abstract: BACKGROUND
  High and equitable coverage of systematic cardiovascular disease (CVD) prevention programmes, such as the NHS Health Check programme in England, is essential if they are to effectively reduce the population CVD burden.
  
  
  METHODS
  We conducted a cross-sectional study using data from 151 English primary care trusts (PCTs) on NHS Health Check coverage during 2011-12. We examined the associations between programme coverage and primary care and population factors, including patient demographics, primary care workforce and cardiovascular health need.
  
  
  RESULTS
  Median coverage of NHS Health Checks was 8.2%, with wide PCT-level variation (range = 0-29.8%). Coverage was significantly higher in PCTs in the most deprived areas compared with the least deprived (P = 0.035), adjusting for covariates. Significant negative associations between coverage and a higher proportion of PCT population aged 40-74 years-the eligible Health Check age group, a larger total population size and higher practice staffing levels were found in the unadjusted analyses.
  
  
  CONCLUSIONS
  NHS Health Check coverage during 2011-12 was lower than the government projection of 18% coverage. Coverage must be increased through concerted multi-disciplinary strategies, for the programme to improve cardiovascular health in England. Considerable variation in participation between PCTs warrants attention, with enhanced support for poor performers.
authors.affiliation: Department of Primary Care and Public Health, Imperial College London, London, UK. macide.artac08@imperial.ac.uk
authors.forename: M
authors.initials: M
authors.lastname: Artac
authors.forename: A R H
authors.initials: AR
authors.lastname: Dalton
authors.forename: H
authors.initials: H
authors.lastname: Babu
authors.forename: S
authors.initials: S
authors.lastname: Bates
authors.forename: C
authors.initials: C
authors.lastname: Millett
authors.forename: A
authors.initials: A
authors.lastname: Majeed
mesh_terms: D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D003430:Cross-Sectional Studies; D006801:Humans; D008403:Mass Screening / Q000706:statistics & numerical data; D008875:Middle Aged; D011320:Primary Health Care / Q000706:statistics & numerical data*; D012307:Risk Factors; D013222:State Medicine / Q000706:statistics & numerical data*; D006113:United Kingdom / Q000453:epidemiology
keywords: circulatory disease; population-based and preventative services; primary care; screening