AbstractEvidence shows that annual health checks (AHCs) are effective in identifying unmet health needs and are generally acceptable to people with learning disabilities. Prior to this study, little was known about how the health issues identified within AHCs are followed up and addressed over time; how people with learning disabilities self-manage any conditions identified at the AHC, as well as the support that they may receive to support the self-management of health.
A prospective, longitudinal qualitative study was undertaken with 12 people with a learning disability, aged 18-64 years, residing in Wales and where appropriate their supporters. Participants were recruited via the third sector. Efforts were made to recruit people who lived independently, with their families, and within supported living accommodation. Individuals were interviewed just after the AHC to explore their experience, any issues identified, and any actions proposed. They were then interviewed at six months and again at 11 months. Follow-up interviews explored whether planned actions had been taken, participants’ perceptions of these and what they had(or had not) achieved, what may have changed in terms of self-management, as well as the support that people received for the self-management of health. A recurrent cross-sectional thematic analysis was used to analyse the findings.
Five main themes emerged from interview one: Going for a health check, Issues identified and actions taken, Supporting the self-management of health, The personal context and Addressing health inequities. AHC experiences varied. How the health check was carried out, whether any reasonable adjustments had been made and whether there were any communication issues appeared to be important in shaping participants’ experiences of the AHC. Participants also reported that no Health Action Plans had been shared and/or given to them.
Four main themes emerged from the follow-up interviews: Follow-up, Supporting the self-management of health, The need for reasonably adjusted health services, and Going for another health check. Some issues identified at the health check were appropriately followed up and/or addressed. Alack of reasonable adjustments appeared to result in a planned action being delayed or not carried out in some cases. For some participants, a planned action had not achieved the desired result and there was a reluctance to return to the GP to seek further advice.
There was a lack of support for the self-management of health at the AHC, with some participants struggling to understand and/or follow the advice given at the AHC. There was also alack of lifestyle advice. Support for self-management came mainly from family members or paid carers, which varied in terms of the amount and nature provided. However, many participants appeared capable of participating in self-management if they were given the right support and/or opportunities.
It was concluded that the AHC should become part of a broader system of support. This may include a role for health facilitators to work with GPs to ensure that actions from Health Action Plans are carried out, people have the right information to navigate the healthcare system and people are supported to self-manage their health.
|Date of Award||2022|
|Supervisor||Ruth Northway (Supervisor) & Stuart Todd (Supervisor)|