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

Abstract

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.

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

“…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. 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.…”

“…10 Previous work identified lack of resources and relevant training as barriers to addressing nutrition in practice. [11][12][13] The FIGO (International Federation of Gynecology and Obstetrics) Nutrition Checklist is designed to facilitate brief and relevant nutrition discussions between women and their healthcare professional, in a personalized and consistent manner. Our survey-based study evaluating the acceptability and feasibility of the Checklist in clinical practice suggested that women were receptive to discussing nutrition during pregnancy.…”

Research priorities for the COVID‐19 pandemic and beyond: A call to action for psychological science

“…The inclination of many psychological scientists is to begin designing a new study or conducting a systematic review following Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines, but this does not meet the needs of policymakers. It would be valuable for psychological scientists providing expert advice to acquaint themselves with the terminology and procedures that are familiar to civil servants who are more likely to have use for a quick scoping review or rapid evidence assessment (Collins, Coughlin, Miller, & Kirk, 2015) rather than embarking on a time-consuming systematic review of systematic reviews (Keyworth, Epton, Goldthorpe, Calam, & Armitage, 2020).…”

Measuring fidelity to delivery of a new smoking cessation intervention integrated into routine tuberculosis care in Pakistan and Bangladesh: Contextual differences and opportunities

“…Training healthcare providers to deliver an additional behavioral change intervention within routine care is a promising approach considering pre-established trust, authority, access to the intervention recipients and knowledge of the additional behavioral changes required to best deal with the health condition 43 , 44 . On the other hand, healthcare providers may not be experts in behavior change techniques (BCT), may have limited time and could view the added tasks as minor, or as a distraction to their main task of providing care 38 , 45 . Few studies have assessed the effect of healthcare provider training on the delivery of different BCTs 18 .…”