Equipping providers with principles, knowledge and skills to successfully integrate behaviour change counselling into practice: a primary healthcare framework

Public Health ◽  
2018 ◽  
Vol 154 ◽  
pp. 70-78 ◽  
Author(s):  
M. Vallis ◽  
D. Lee-Baggley ◽  
T. Sampalli ◽  
A. Ryer ◽  
S. Ryan-Carson ◽  
...  
Keyword(s):  
Behaviour Change ◽  
Primary Healthcare ◽  
Knowledge And Skills ◽  
Behaviour Change Counselling

scholarly journals A theory-based exploration of antibiotic use in primary healthcare in Gezira state, Sudan

2021 ◽  
Vol 2 (1) ◽  
Author(s):  
Anna-Leena Lohiniva ◽  
Einas Elwali ◽  
Duha Abuobaida ◽  
Ashwag Abdulrahim ◽  
Paul Bukuluki ◽  
...  
Keyword(s):  
Behaviour Change ◽  
Primary Healthcare ◽  
Theoretical Domains Framework ◽  
Antibiotic Use ◽  
Local Context ◽  
Change Strategy ◽  
Qualitative Research Study ◽  
Inappropriate Use ◽  
Healthcare Settings ◽  
Behaviour Change Wheel

Abstract Background Inappropriate use of antibiotics is a major contributing factor to the emergence of antimicrobial resistance globally, including in Sudan. Objectives The project aimed to develop a theory-driven behaviour change strategy addressing both prescribers and patients based on factors that are driving antibiotic use in primary healthcare settings in Gezira state in Sudan. Methods The strategy was designed based on the Theoretical Domains Framework (TDF) to identify behavioural domains and the Behaviour Change Wheel (BCW) to select appropriate intervention functions. The process included (1) a formative qualitative research study and (2) a knowledge co-production workshop that utilized the results of the qualitative study to design a salient, appropriate, and credible behaviour change strategy. Results The TDF domains related to prescribers that emerged from the study included knowledge, skills, and intention. The selected BCW intervention functions included education, training, modelling, and persuasion. The main TDF domains related to patients included social influences and intention. The selected BCW intervention functions included enablement and education. Conclusion Using the TDF and BCW intervention functions, the study identified behavioural domains that influence antibiotic prescription and consumption in rural primary healthcare settings in Gezira state in Sudan and appropriate intervention functions to modify these behaviours. Knowledge co-production ensured that the evidence-based strategy was acceptable and practical in the local context.

scholarly journals Adapted motivational interviewing for brief healthcare consultations: protocol for a systematic review and meta-analysis of treatment fidelity in real-world evaluations of behaviour change counselling

BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e028417 ◽  
Author(s):  
Alison K Beck ◽  
Erin Forbes ◽  
Amanda L Baker ◽  
Ben Britton ◽  
Christopher Oldmeadow ◽  
...  
Keyword(s):  
Behaviour Change ◽  
Health Behaviour ◽  
Real World ◽  
Treatment Effects ◽  
Random Effect ◽  
Treatment Fidelity ◽  
Systematic Evaluation ◽  
Complex Behaviour ◽  
Behaviour Change Counselling ◽  
The Impact

IntroductionTreatment fidelity is an important and often neglected component of complex behaviour change research. It is central to understanding treatment effects, especially for evaluations conducted outside of highly controlled research settings. Ensuring that promising interventions can be delivered adequately (ie, with fidelity) by real-world clinicians within real-world settings is an essential step in developing interventions that are both effective and ‘implementable’. Whether this is the case for behaviour change counselling, a complex intervention developed specifically for maximising the effectiveness of real-world consultations about health behaviour change, remains unclear. To improve our understanding of treatment effects, best practice guidelines recommend the use of strategies to enhance, monitor and evaluate what clinicians deliver during patient consultations. There has yet to be a systematic evaluation of whether and how these recommendations have been employed within evaluations of behaviour change counselling, nor the impact on patient health behaviour and/or outcome. We seek to address this gap.Methods and analysisMethods are informed by published guidelines. Ten electronic databases (Medline, PubMed, EMBASE, PsycINFO, CINAHL Complete, ScienceDirect, Taylor and Francis; Wiley, ProQuest and Open Grey) will be searched for published and unpublished articles that evaluate behaviour change counselling within real-world clinical settings (randomised and non-randomised). Eligible papers will be rated against the National Institute of Health fidelity framework. A synthesis, evaluation and critical overview of fidelity practices will be reported and linear regression used to explore change across time. Random-effect meta-regression is planned to explore whether fidelity (outcomes reported and methods used) is associated with the impact of behaviour change counselling. Standardised effect sizes will be calculated using Hedges’ g (continuous outcomes) and ORs (binary/dichotomous outcomes).Ethics and disseminationNo ethical issues are foreseen. Findings will be disseminated via journal publication and conference presentation(s).PROSPERO registration numberCRD42019131169

scholarly journals Assessing Adherence, Competence and Differentiation in a Stepped-Wedge Randomised Clinical Trial of a Complex Behaviour Change Intervention

Nutrients ◽  
2020 ◽  
Vol 12 (8) ◽  
pp. 2332
Author(s):  
Alison Kate Beck ◽  
Amanda L. Baker ◽  
Gregory Carter ◽  
Chris Wratten ◽  
Judith Bauer ◽  
...  
Keyword(s):  
Behaviour Change ◽  
Real World ◽  
Best Practice ◽  
Research Question ◽  
Randomised Clinical Trial ◽  
Routine Care ◽  
Stepped Wedge ◽  
Behaviour Change Intervention ◽  
Complex Behaviour ◽  
Behaviour Change Counselling

Background: A key challenge in behavioural medicine is developing interventions that can be delivered adequately (i.e., with fidelity) within real-world consultations. Accordingly, clinical trials should (but tend not to) report what is actually delivered (adherence), how well (competence) and the distinction between intervention and comparator conditions (differentiation). Purpose: To address this important clinical and research priority, we apply best practice guidelines to evaluate fidelity within a real-world, stepped-wedge evaluation of “EAT: Eating As Treatment”, a new dietitian delivered health behaviour change intervention designed to reduce malnutrition in head and neck cancer (HNC) patients undergoing radiotherapy. Methods: Dietitians (n = 18) from five Australian hospitals delivered a period of routine care and following a randomly determined order each site received training and began delivering the EAT Intervention. A 20% random stratified sample of audio-recorded consultations (control n = 196; intervention n = 194) was coded by trained, independent, raters using a study specific checklist and the Behaviour Change Counselling Inventory. Intervention adherence and competence were examined relative to apriori benchmarks. Differentiation was examined by comparing control and intervention sessions (adherence, competence, non-specific factors, and dose), via multiple linear regression, logistic regression, or mixed-models. Results: Achievement of adherence benchmarks varied. The majority of sessions attained competence. Post-training consultations were clearly distinct from routine care regarding motivational and behavioural, but not generic, skills. Conclusions: Although what level of fidelity is “good enough” remains an important research question, findings support the real-world feasibility of integrating EAT into dietetic consultations with HNC patients and provide a foundation for interpreting treatment effects.

Randomized clinical trial comparing the effectiveness of two dietary interventions for patients with hyperlipidaemia

1998 ◽  
Vol 95 (4) ◽  
pp. 479-487 ◽  
Author(s):  
Cliona NÍ MHURCHÚ ◽  
Barrie M. MARGETTS ◽  
Viv SPELLER
Keyword(s):  
Body Weight ◽  
Body Mass ◽  
Behaviour Change ◽  
Serum Cholesterol ◽  
Dietary Habits ◽  
Dietary Advice ◽  
Lipid Levels ◽  
Dietary Interventions ◽  
Dietary Knowledge ◽  
Behaviour Change Counselling

1.Intervention trials in free-living populations have shown relatively small reductions in risk factors for cardiovascular disease, including lipid levels, and have led some to question whether diet is an effective treatment for hyperlipidaemia. However, behaviour change is a complex process and it is possible that standard intervention methods fail to motivate people sufficiently to comply with dietary advice. 2.This study applied motivational interviewing, a style of behaviour change counselling, to dietary education for people with hyperlipidaemia. One-hundred and twenty-one patients with hyperlipidaemia who had been referred to a hospital dietetic department for dietary advice were randomized to receive either standard or motivational dietary interventions for a period of 3 months. Outcomes assessed included dietary knowledge, stage of change, dietary intakes, lipid levels and body mass indices. 3.From baseline, both methods of dietary intervention resulted in self-reported changes in dietary habits and knowledge, statistically significant reductions in intake of total fat (from 32.8% to 28.4%), saturated fat (from 11.4% to 9.2%) and energy intakes [-239 ;kcal (-999.98 ;kJ)/day], and in body mass indices (-0.45 ;kg/m2). Serum cholesterol did not change significantly in either intervention group. 4.Motivational and standard dietary interventions achieved statistically significant changes in reported dietary knowledge and behaviour, and led to a reduction in body weight, but not serum cholesterol. Whether this lack of effect is real or due to subjects overestimating true dietary change cannot be determined. Change in body weight was associated with a reported change in energy intake; this provides some support for there having been a real change in intake.

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