Purpose -There is growing evidence that health behaviour change interventions are associated with mental health and wellbeing improvements. This paper aims to examine the effect of healthy lifestyle interventions on mental wellbeing. Design/methodology/approach -Six databases (Medline, Evidence Based Medicine Cochrane Registered Controlled Trials, Evidence Based Medicine Full Text Reviews, British Nursing Index, Embase, PsycINFO) were searched from database commencement up to April 2013. A broad focus on lifestyle interventions and mental health and wellbeing outcomes was chosen. Papers were systematically extracted by title then abstract according to predefined inclusion and exclusion criteria. Inclusion criteria: any individual population (non-couple/family); any health behaviour change interventions; mental health and wellbeing outcomes; and a one-two level of evidence. Interventions aimed at workers were excluded, as were articles assessing cognitive functioning rather than mental health or wellbeing, or those using medications in interventions. Findings -Two authors reviewed 95 full papers. In total, 29 papers met inclusion criteria, representing a range of interventions spanning physical activity, diet, alcohol intake, drug use and smoking. A range of measures were used. The majority (n ¼ 25) of studies demonstrated improvements on at least one indicator of mental health and wellbeing. Limitations include the broad range of outcome measures used, varied follow-up times and the lack of detail in reporting interventions. Originality/value -Health behaviour change interventions targeting physical outcomes appear to have benefits to mental health and wellbeing spanning healthy populations and those with physical or mental health problems. Evidence is strongest for interventions targeting exercise and diet, particularly in combination and the actual lifestyle changes made and adherence appear to be important. However, it is not clear from this review which specific components are necessary or essential for improvements in mental health and wellbeing.

This systematic review and meta-analysis reports the efficacy of post-natal physical activity change interventions with content coding of behaviour change techniques (BCTs). Electronic databases (MEDLINE, CINAHL and PsychINFO) were searched for interventions published from January 1980 to July 2013. Inclusion criteria were: (i) interventions including ≥1 BCT designed to change physical activity behaviour, (ii) studies reporting ≥1 physical activity outcome, (iii) interventions commencing later than four weeks after childbirth and (iv) studies including participants who had given birth within the last year. Controlled trials were included in the meta-analysis. Interventions were coded using the 40-item Coventry, Aberdeen & London - Refined (CALO-RE) taxonomy of BCTs and study quality assessment was conducted using Cochrane criteria. Twenty studies were included in the review (meta-analysis: n = 14). Seven were interventions conducted with healthy inactive post-natal women. Nine were post-natal weight management studies. Two studies included women with post-natal depression. Two studies focused on improving general well-being. Studies in healthy populations but not for weight management successfully changed physical activity. Interventions increased frequency but not volume of physical activity or walking behaviour. Efficacious interventions always included the BCTs 'goal setting (behaviour)' and 'prompt self-monitoring of behaviour'.

Effectiveness of interventions was difficult to assess as, while all had benefits, their generalisability was limited due to methodological and reporting limitations. Improved reporting procedures are required to allow for replication.

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BackgroundSignificant challenges exist within primary care services in the United Kingdom (UK). These include meeting current demand, financial pressures, an aging population and an increase in multi-morbidity. Psychological services also struggle to meet waiting time targets and to ensure increased access to psychological therapies. Innovative ways of delivering effective primary care and psychological services are needed to improve health outcomes.SummaryIn this article we argue that integrated care models that incorporate behavioural health care are part of the solution, which has seldom been argued in relation to UK primary care. Integrated care involves structural and systemic changes to the delivery of services, including the co-location of multi-disciplinary primary care teams. Evidence from models of integrated primary care in the United States of America (USA) and other higher-income countries suggest that embedding continuity of care and collaborative practice within integrated care teams can be effective in improving health outcomes. The Behavioural Health Consultant (BHC) role is integral to this, working psychologically to support the team to improve collaborative working, and supporting patients to make changes to improve their health across management of long-term conditions, prevention and mental wellbeing. Patients’ needs for higher-intensity interventions to enable changes in behaviour and self-management are, therefore, more fully met within primary care. The role also increases accessibility of psychological services, delivers earlier interventions and reduces stigma, since psychological staff are seen as part of the core primary care service. Although the UK has trialled a range of approaches to integrated care, these fall short of the highest level of integration. A single short pilot of integrated care in the UK showed positive results. Larger pilots with robust evaluation, as well as research trials are required. There are clearly challenges in adopting such an approach, especially for staff who must adapt to working more collaboratively with each other and patients. Strong leadership is needed to assist in this, particularly to support organisations to adopt the shift in values and attitudes towards collaborative working.ConclusionsIntegrated primary care services that embed behavioural health as part of a multi-disciplinary team may be part of the solution to significant modern day health challenges. However, developing this model is unlikely to be straight-forward given current primary care structures and ways of working. The discussion, developed in this article, adds to our understanding of what the BHC role might consist off and how integrated care may be supported by such behavioural health expertise. Further work is needed to develop this model in the UK, and to evaluate its impact on health outcomes and health care utilisation, and test robustly through research trials.

Looked after young people require support to bridge the gap between knowledge and behaviour and several theories relevant to the findings have been identified. Participants desired more support around a range of health issues, which may come from school, workers and carers, as well as health professionals. Further research examining effective interventions with this group is crucial to improve outcomes.

The objective of the study was to examine the desire for spiritual and religious treatment options in chronically ill adults. Email interview data (N = 12) generated themes for religion, spirituality, and desired treatments. The resultant questionnaire data (N = 83) analysed the popularity of treatments. Thirty-five wide-ranging spiritual and religious treatment options were identified for use in the questionnaire; 47 per cent of the sample was interested in spiritual or religious treatments. There is a need for spiritual and religious treatment options, and translation of treatments into practice would assist coping for many people.

Purpose – The purpose of this paper is to examine a national sexual health and relationships education (SHARE) educational package for behaviour change techniques (BCTs) utilised in order to make recommendations for further improvements. Design/methodology/approach – Using BCTs taxonomy (BCT V1), two coders independently examined the 22 session plans within SHARE for their utilisation of BCTs. All three authors then examined the results, and agreed on any discrepancies. Findings – The SHARE package utilises only a small range of BCTs detailed in BCT V1. SHARE makes use of a range of techniques which may impact on the distal factors that influence sexual risk taking, such as self-esteem and building confidence to say “no” to sex. Practical implications – SHARE – and perhaps other sexual health education programmes – may need to draw on more BCTs, particularly those supported by evidence, in order to effectively reduce risky sexual behaviours among young people. Programmes may also benefit from including broader elements around pleasure, self-examination and screening behaviour. Originality/value – Sexual health packages rarely encounter such scrutiny, particularly being examined in relation to the BCTs. The new and rigorous way of rating the SHARE package has enabled a range of recommendations relating to BCTs to be made both for improving the package and other sexual health education programmes.