NHS health trainers: a review of emerging evaluation evidence

Pamela Attree, Stephen Clayton, Sakthi Karunanithi, Shilpa Nayak, Jennie Popay, Donald Reed

Research output: Contribution to journalArticle (journal)peer-review

10 Citations (Scopus)
245 Downloads (Pure)


Recent years have seen a change in focus in UK public health policies towards an emphasis on individual lifestyle choices. As part of this shift, NHS health trainers were introduced in disadvantaged communities in England, to provide peer support to people ‘at risk’ of developing lifestylerelated health problems and to help them to self manage their behaviour. Concerns have been expressed, however, about the strength of the evidence supporting the initiative. This article outlines a number of gaps between the theory and rhetoric underpinning the NHS health trainer initiative, and the reality in practice. This article critiques the evaluation evidence, questions the assumption that engaging lay people in health promotion activities in place of health professionals is necessarily a preferable option, identifies inconsistencies in the evidence supporting individually based health improvement initiatives, and suggests that interventions which target deprived areas but neglect the social determinants of health may be limited in their effectiveness.
Original languageEnglish
JournalCritical Public Health
Issue number1
Early online date8 Jun 2011
Publication statusPublished - Jan 2012


  • health
  • evaluation
  • evidence


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