An alternative to the 'one-size-fits -all' approach to public engagement in preventive healthcare, leading to healthier ageing for all

**我们知道预防性保健对于管理常见的老龄化投诉至关重要**管理常见的老龄化投诉就是理解它们。对于长期和慢性疾病(老龄化常见投诉的一个主要来源)，最好是通过参加国民保健制度预防方案来实现这一点。这些方案及早发现这些情况，以便采取预防行动，或帮助个人自我管理现有的情况。**公众高度参与预防是一项结构和行为挑战**问题是，并非每个人都能从这些方案中受益。老年人越来越有可能患有一种或多种长期或慢性疾病。这意味着随着我们的人口老龄化，对这些方案的需求每年都在增加。但管理或筛选这些疾病的预防性医疗保健计划表现不佳。表现不佳的原因既有行为方面的，也有行为方面的(如何让高比例的个人参与？)和结构性(如何让护理人员把预防放在首位？)。这两个原因在NHS全科医生实践过程中相交，以使公众参与预防计划。这包括向收件人发出的信件、短信或电子邮件，通常要求收件人‘请致电诊所’。我们已将这一过程确定为有效预防医疗保健的主要障碍。它为患者预约设置了几个障碍：*“我不明白医生提供给我的是什么”*“我试着给全科医生打电话，但打不通”*“我从未收到邀请”*“提供的时间对我不起作用”通常会采取一刀切的方法，但往往会把人排除在外。**我们的创新是一场远离‘一刀切’的运动**Appt-Health是一家成熟的社会企业，有着成功的创新记录。在Appt已建立的患者互动平台的基础上，我们将推出一款“定位引擎”的原型。这将意味着不同类别的患者将收到不同的预约邀请工作流程。这一创新有两个目的。它允许我们：1。进行对照试验，比较哪种邀请策略效果最好。以最适合不同人群的邀请策略为目标。我们将使用这个原型目标定位引擎进行六项对照试验，以评估不同的邀请策略。这些战略将通过研究确定的用户需求来提供信息。通过了解哪些邀请策略最适合哪些患者，我们将彻底改变我们思考患者参与的方式。

**We know preventive healthcare is crucial for managing the common complaints of ageing**To manage the common complaints of ageing is to understand them. For long-term and chronic conditions (a major source of the common complaints of ageing) this is best achieved by attending NHS prevention programmes. These programmes identify these conditions early, allowing preventive action to be taken, or help individuals to self-manage an existing condition.**High public engagement in prevention is a structural and behavioural challenge**The problem is that not everyone benefits from these programmes. Older adults are increasingly likely to live with one or more long term or chronic condition. This means that need for these programmes is increasing every year as our population ages. But the preventive healthcare programmes that manage or screen for these conditions are underperforming.The causes for underperformance are both behavioural (how do you get a high proportion of individuals to participate?) and structural (how do you get care providers to prioritise prevention?).These causes intersect in the 'call and recall' process, which NHS GP practices follow to engage the public in preventive programmes. This includes outbound letters, SMS or emails typically asking the recipient to 'please call the practice'.We have identified this process as the major blocker to effective preventive healthcare. It creates several barriers for patients accessing appointments:* "I don't understand what I'm being offered"* "I try to call the GP but can't get through"* "I never received the invitation"* "The times offered don't work for me"A one-size-fits-all approach is usually taken but, too often, that leaves people out.**Our innovation is a movement away from 'one-size-fits-all'**Appt-Health (Appt) is an established social enterprise with a track-record of successful innovation. Building on top of Appt's established patient engagement platform, we will prototype a 'targeting engine'. This will mean that different cohorts of patients will receive different appointment invitation workflows.This innovation serves two purposes. It allows us to:1. carry out controlled trials, to compare which invitation strategies work best.2. target separate demographic cohorts with an invitation strategy that is most suited to them.We will use this prototype targeting engine to carry out six controlled trials to evaluate different invitation strategies. These strategies will be informed by user needs, identified by research. By understanding which invitation strategies work best for which patient cohorts, we will revolutionise the way we think about patient engagement.