An investigation of non-participation in health promotion interventions and its impact on population level outcome

Davies, Gill M.; Boothman, Nicola J.; Duxbury, Jackie T.; Davies, Robin M.; Blinkhorn, Anthony S.
August 2008
International Journal of Health Promotion & Education;2008, Vol. 46 Issue 3, p107
Academic Journal
Background Many health promotion interventions rely on active participation, if uptake is low the impact of the intervention is diminished at population level. This study aimed to identify the main reasons for non-participation in a modelled health promotion programme. Methods A classification for eligibility and for participation in a modelled health promotion intervention was applied to a database of all 3-5 year olds in 3 PCTs in Manchester, UK. This identified which children would have been participants and which nonparticipants. Results Of the 29,220 children in the cohort, 90% would have been eligible to have received the model intervention as they were resident in Manchester before they became 24 months old. Of these, 75% would have participated by having either of the required contacts with health care personnel in the Manchester PCT area. Of these only 43% were attending Manchester LEA schools or pre-schools at the age of 3-5 years when the health benefits would be evaluated. Population churn, uptake of health services outside of the intervention area and non-uptake all accounted for a high level of 'non-participation'. Conclusions The success of public health interventions are seriously threatened by high levels of nonparticipation due to population transience in some areas.


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