Are healthcare professionals delivering opportunistic behaviour change interventions? A multi-professional survey of engagement with public health policy

Keyworth, Chris; Epton, Tracy; Goldthorpe, Joanna; Calam, Rachel; Armitage, Christopher J.

doi:10.1186/s13012-018-0814-x

Cited by 65 publications

(101 citation statements)

References 33 publications

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“…11,13 In the same UK survey, providing behavior change interventions took 35.3% of the appointment time. 24 However, the women in our study considered the FIGO Nutrition Checklist to be a quick intervention that is appropriate for use within a typical antenatal appointment.…”

Section: Discussionmentioning

confidence: 95%

“…In a national survey in the UK completed in 2017, 50% of healthcare professionals said that they did not provide patients with opportunistic behavior change techniques even though they perceived there was a need to do so. 24 Other barriers such as lack of time, competing priorities during pregnancy assessments, and lack of training and resources have been reported by healthcare professionals. 11,13 In the same UK survey, providing behavior change interventions took 35.3% of the appointment time.…”

Section: Discussionmentioning

confidence: 99%

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“It only takes two minutes to ask”—a qualitative study with women on using the FIGO Nutrition Checklist in pregnancy

Killeen

Callaghan

Jacob

et al. 2020

Intl J Gynecology & Obste

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Objective To gain an in‐depth understanding of how the FIGO Nutrition Checklist could work in clinical practice, from the perspective of pregnant women. Methods This qualitative study was part of a pilot study of the FIGO Nutrition Checklist in the antenatal department of a tertiary‐level university maternity hospital in Dublin, Ireland. Individual semistructured phone interviews were conducted with pregnant women who had completed the FIGO Nutrition Checklist as part of the pilot. Interviews were transcribed verbatim and analyzed using content analysis after manual coding of transcripts. Themes and subthemes are described. Results Ten interviews were completed. Subthemes related to the FIGO Nutrition Checklist emerged including ease of use and comprehension. Participants discussed how the tool could add value to their appointment by supporting initiation of nutrition conversations and highlighting nutritional issues. The first trimester was identified as the highest priority for using the FIGO Nutrition Checklist. The convenience of having nutrition addressed as part of standard care, rather than a separate appointment, also emerged. Conclusion Women in this study had a desire for nutrition and weight to be addressed by clinicians during routine antenatal appointments. The findings support using the FIGO Nutrition Checklist to address this.

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

“It only takes two minutes to ask”—a qualitative study with women on using the FIGO Nutrition Checklist in pregnancy

Killeen

Callaghan

Jacob

et al. 2020

Intl J Gynecology & Obste

View full text Add to dashboard Cite

show abstract

“…The sample was heterogeneous, and we sought to explore a wide range of views from diverse professional groups working in different medical professions (Dicicco‐Bloom & Crabtree, ). Participants, initially recruited through a survey panel company (YouGov), had previously taken part in a large‐scale cross‐sectional survey examining the prevalence of, and extent to which, health care professionals delivered opportunistic behaviour change interventions as part of routine practice (Keyworth et al, ). Participants who expressed an interest were invited to supply their contact details, so a member of the research team could arrange a convenient time to conduct the interview.…”

Section: Methodsmentioning

confidence: 99%

“…Behaviour change interventions can be delivered by health care professionals in as few as 30-s (Aveyard et al, 2016;Public Health England, 2016) and are cost-effective (Vijay, Wilson, Suhrcke, Hardeman, & Sutton, 2016). However, health care professionals do not always deliver behaviour change interventions opportunistically during routine patient consultations, even in cases where they perceive patients would benefit from such interventions (Keyworth, Epton, Goldthorpe, Calam, & Armitage, 2018). The barriers and enablers to delivering interventions opportunistically, across specialisms, are currently unclear.…”

Section: Statement Of Contributionmentioning

confidence: 99%

‘It's difficult, I think it's complicated’: Health care professionals’ barriers and enablers to providing opportunistic behaviour change interventions during routine medical consultations

Keyworth

Epton

Goldthorpe

et al. 2019

British J Health Psychol

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Objectives Internationally, public health strategies encourage health care professionals to deliver opportunistic behaviour change interventions. The present study: (1) examines the barriers and enablers to delivering interventions during routine consultations, and (2) provides recommendations for the design of interventions to increase delivery of opportunistic behaviour change interventions. Design Qualitative interview study. Methods Twenty‐eight semi‐structured interviews were conducted with patient‐facing health care professionals. The Behaviour Change Wheel informed a framework analysis in which findings were mapped onto the Theoretical Domains Framework (TDF). Intervention functions and behaviour change techniques (BCTs) targeting each TDF domain were identified. Results Health care professionals understood the importance of opportunistic behaviour change interventions (beliefs about consequences), but were sceptical about their capabilities to facilitate behaviour change with patients (beliefs about capabilities). Some clinicians were unwilling to discuss behaviours perceived as unrelated to the patient's visit (social/professional role and identity). Discipline‐specific tasks were prioritized, and delivering interventions was perceived as psychologically burdensome. One‐to‐one contact was favoured over busy hospital settings (environmental context and resources). Seven intervention functions (training, restriction, environmental restructuring, enablement, education, persuasion, and modelling) and eight BCT groupings (antecedents, associations, comparison of outcomes, covert learning, feedback and monitoring, natural consequences, reward and threat, and self‐belief) were identified. Conclusions Across disciplines, health care professionals see the value of opportunistic behaviour change interventions. Barriers related to workload, the clinical environment, competence, and perceptions of the health care professional role must be addressed, using appropriate intervention functions and BCTs, in order to support health care professionals to increase the delivery of interventions in routine practice. What is already known on this subject? Brief, opportunistic interventions can be a cost effective way of addressing population health problems. Public health policies compel health care professionals to deliver behaviour change interventions opportunistically. Health care professionals do not always deliver interventions opportunistically during routine medical consultations; however the barriers and enablers are currently unclear. What does this study add? This is the first study to examine cross‐disciplinary barriers and enablers to delivering opportunistic behaviour change interventions. Across diverse professional groups, working in different medical professions, participants saw the value of delivering opportunistic behaviour change interventions. Targeting key theoretical domains that are shared across professional groups may be useful for increasing the delivery of opportunistic behaviour change...

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“…No systematic review to date has aimed to collate all of the available evidence in relation to the common barriers and enablers to healthcare professionals delivering behavior change interventions. A recent national survey showed that healthcare professionals deliver behavior change interventions in just 50% of cases where they thought patients would benefit from interventions (Keyworth et al 2018). The specific reasons as to why this is the case, particularly across diverse specialisms, is currently unclear.…”

Section: Introductionmentioning

confidence: 99%

Delivering Opportunistic Behavior Change Interventions: a Systematic Review of Systematic Reviews

et al. 2020

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Opportunities for healthcare professionals to deliver health behavior change interventions are often missed, but understanding the barriers and enablers to this activity is limited by a focus on defined specialisms/health conditions. This systematic review of systematic reviews collates all the evidence across professional groups to provide guidance to policy makers for implementing healthcare professional delivery of behavior change interventions. Eight electronic databases were searched for systematic reviews reporting patient-facing healthcare professionals' (e.g., general practitioners, nurses) barriers and enablers to delivering behavior change interventions (diet, physical activity, alcohol reduction, smoking cessation, and weight management). A narrative synthesis was conducted. Thirty-six systematic reviews were included. Four themes emerged as both barriers and enablers:(1) perceptions of the knowledge or skills needed to support behavior change with patients, (2) perceptions of the healthcare professional role, (3) beliefs about resources and support needed, and (4) healthcare professionals' own health behavior. There were four cross-disciplinary barriers: (1) perceived lack of time, (2) perceived lack of prioritization of health behavior change, (3) negative attitudes towards patients and perceptions of patient risk, and (4) perceptions of patient motivation. The three enablers were as follows: (1) training, (2) context, and (3) attitudes towards delivering interventions. To enhance healthcare professionals' delivery of behavior change interventions, policy makers should (a) address perceptions about patient need for interventions, (b) support diverse professional groups to identify opportunities to deliver interventions, and (c) encourage professionals to focus on prevention and management of health conditions.

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Are healthcare professionals delivering opportunistic behaviour change interventions? A multi-professional survey of engagement with public health policy

Cited by 65 publications

References 33 publications

“It only takes two minutes to ask”—a qualitative study with women on using the FIGO Nutrition Checklist in pregnancy

“It only takes two minutes to ask”—a qualitative study with women on using the FIGO Nutrition Checklist in pregnancy

‘It's difficult, I think it's complicated’: Health care professionals’ barriers and enablers to providing opportunistic behaviour change interventions during routine medical consultations

Delivering Opportunistic Behavior Change Interventions: a Systematic Review of Systematic Reviews

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