scholarly journals Applying behavioural science to improve physicians’ ability to help people improve their own health behaviours

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
K Lavoie
Keyword(s):  
Behaviour Change ◽  
Health Behaviour ◽  
Healthcare Professionals ◽  
Assessment Tool ◽  
Health Behaviours ◽  
Poor Health ◽  
Behavioural Science ◽  
Effective Interventions ◽  
Physician Health ◽  
The Impact

Abstract Issue/problem Poor health behaviours are at the centre of most non-communicable chronic diseases and account for a significant amount of morbidity and mortality. Healthcare professionals, and especially physicians, are in a unique position to be able to positively influence their patients and aid them in changing poor health behaviours. However, most physicians report having low confidence or a lack of skills to effectively achieve this. Description of the problem The main approach that physicians take to influence their patients’ poor health behaviours is to provide them with advice and evidence about the impact of the poor health behaviours. This strategy has been shown to have limited impact on changing patient behaviour. As such, there is a need to develop effective interventions that target changing physician health behaviour counselling behaviours, effectively, a behaviour change intervention for physicians so that they are better at helping patients change their behaviour. Results Using a structured stakeholder-oriented approach (the ORBIT model for developing behavioural interventions) we have systematically developed a robust behaviour change-based continuing medical education curriculum (leveraging motivational communication), and online assessment tool to improve physician competency. These were developed by a pan-Canadian team with notable international input through the IBTN. Lessons The use of a structured stakeholder-driven process, we have developed an intervention which seems to have greater relevancy to the target audience, lead to greater engagement, and a higher probability of implementation than a researcher led approach. Whilst the studies are still ongoing, it is anticipated that this intervention will be able to dramatically improve the health of individuals through effective health behaviour change interventions by healthcare professionals.

scholarly journals Training physicians in motivational communication to improve behaviour change counselling competency: A behavioural medicine approach to NCD prevention and management

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
K Lavoie
Keyword(s):  
Behaviour Change ◽  
Skill Acquisition ◽  
Assessment Tool ◽  
Health Behaviours ◽  
Evidence Based ◽  
Training Dose ◽  
Face To Face ◽  
Behaviour Change Counselling ◽  
Communication Competencies ◽  
The Impact

Abstract Background Despite the importance of changing health behaviours in the context of preventing and managing non-communicable chronic diseases (NCD's), physician use of evidence-based behaviour change counselling (BCC) is low, and BCC skills competency is generally poor. Motivational communication (MC) is a patient-centred, evidence-based BCC approach used by healthcare providers, designed to increase patient motivation to adopt a healthy lifestyle. MC-based approaches improved a range of health behaviours (smoking, diet, physical activity) in patients with NCDs, leading to increased demand for physician training. Despite the widespread dissemination of training programs, data on their efficacy in achieving competency among physicians is limited. This is likely due to a lack of consensus on the core communication competencies to be achieved, and in the absence of acceptable, valid and reliable tools to measure skill acquisition. Results Using an integrated knowledge translation (iKT) approach that engaged 199 international physicians, behaviour change experts and health administrators, we have identified 11 core evidence-based communication competencies that physicians should acquire in the context of NCD prevention/management. They have been incorporated into a basic 4 hr face-to-face MC training program called “LEARN THE BASICs”. To assess MC competency, we have also developed a reliable, engaging, efficient, 'user-friendly' case-based digital assessment tool called the MC-Competency Assessment Test (MC-CAT). Conclusions Strategies for optimizing and tailoring this program, including finding the most cost-effective training dose, the impact of supplemental training components (e.g., in person vs. digital coaching; booster sessions), and delivery modes (e.g., face-to-face vs digital/online), will be discussed in the context of optimizing implementation success.

scholarly journals O7D.3 Working conditions and health behaviour as causes of educational inequalities in self-rated health: an inverse odds weighting approach

2019 ◽  
Vol 76 (Suppl 1) ◽  
pp. A67.1-A67
Author(s):  
Jolinda Schram ◽  
Joost Oude Groeniger ◽  
Merel Schuring ◽  
Karin Proper ◽  
Sandra van Oostrom ◽  
...  
Keyword(s):  
Working Conditions ◽  
Health Behaviour ◽  
Health Behaviours ◽  
Poor Health ◽  
Total Effect ◽  
Physical Work ◽  
Educational Inequalities ◽  
Self Rated Health ◽  
Increased Risk ◽  
Low Education

BackgroundThis study aims to estimate to what extent working conditions and health behaviours mediate the increased risk of low educated workers to report a poor health.MethodsRespondents of the longitudinal Survey of Health, Ageing, and Retirement in Europe (SHARE) in 18 European countries were selected aged between 50 years and 64 years, in paid employment at baseline and with information on education and self-rated health (n=15,126). Health behaviours and physical and psychosocial work characteristics were measured at baseline, while self-rated health was measured at 2 year follow up. We used loglinear regression models and Inverse Odds Weighting causal mediation analysis to estimate the total effect of low education on self-rated health and to decompose the effect into natural direct (NDE) and natural indirect effects (NIE).ResultsLower educated workers were more likely to be in poor health compared to higher educated workers. The total effect of low education on self-rated health was RR=1.81 [95% CI 1.66–1.97]. For work conditions, having a physical demanding job was the strongest mediator, followed by lack of job control and lack of job rewards. NIE through working conditions was RR=1.16 [95% CI 1.06–1.25], explaining about 30% of educational inequalities in self-rated health. For health behaviour, body mass index and alcohol were the strongest mediators, followed by smoking. NIE though health behaviour was RR=1.14 [95% CI 1.07–1.20], explaining about 27% of educational inequalities in self-rated health.ConclusionsPreventive interventions focusing on reducing physical work demands as well as improving health behaviour may contribute to reducing educational inequalities in self-rated health among workers in Europe.

scholarly journals The application of psychological theory to nutrition behaviour change

2009 ◽  
Vol 68 (2) ◽  
pp. 205-209 ◽  
Author(s):  
M. Barker ◽  
J. A. Swift
Keyword(s):  
Behaviour Change ◽  
Health Behaviour ◽  
Eating Behaviour ◽  
Health Behaviours ◽  
Psychological Theory ◽  
Theory And Practice ◽  
Behaviour Change Techniques ◽  
Attitudes And Beliefs ◽  
Psychological Determinants ◽  
Integrated Research

Changing individuals' health behaviour seems to be the key to solving many of the world's health problems. Although there is a multitude of potential influences, many interventions to improve health seek to change intrinsic psychological determinants of health behaviour. To date, most attention has been paid to cognitions, such as attitudes and beliefs, and a number of social cognition models (SCM) are in current use. SCM all describe cognitions as determinants of behaviour, thereby implying that changes in cognitions will lead to changes in behaviour. Although SCM are widely used to predict a range of health behaviours, they are associated with a number of important limitations, including poor levels of predictive power, particularly in relation to eating behaviour, and limited guidance about the operationalisation of theoretical constructs. These limitations may explain why very few interventions to change behaviour are explicitly theory-based, despite the widely-held view that having a clear theoretical underpinning will improve effectiveness. Ultimately, advances in understanding and changing health behaviour will come about only if psychological theory and practice are integrated. The recently-published taxonomy of behaviour-change techniques used in interventions is a good example of integrated research, but more work of this type is essential and will require respectful collaboration between researchers and practitioners working from a range of different disciplines such as health psychology, public health nutrition and health promotion.

scholarly journals The impact of nature-based interventions on public health: a review using pathways, mechanisms and behaviour change techniques from environmental social science and health behaviour change

2021 ◽  
Vol 9s7 ◽  
pp. 33-61
Author(s):  
Stephanie Wilkie ◽  
Nicola Davinson
Keyword(s):  
Public Health ◽  
Social Science ◽  
Health Outcomes ◽  
Behaviour Change ◽  
Health Behaviour ◽  
Behaviour Change Techniques ◽  
Change Models ◽  
Health Behaviour Change ◽  
The Impact ◽  
Environmental Social Science

The aim of this narrative review is to explore whether nature-based interventions improved individual public health outcomes and health behaviours, using a conceptual framework that included pathways and pathway domains, mechanisms, and behaviour change techniques derived from environmental social science theory and health behaviour change models. A two-stage scoping methodology was used to identified studies published between 2000 and 2021. Peer reviewed, English-language reports of nature-based interventions with adults (N = 9) were included if the study met the definition of a health�behaviour change intervention and reported at least one measured physical/mental health outcome. Interventions focused on the restoring or building capacities pathway domains as part of the nature contact/experience pathway; varied health behaviour change mechanisms and techniques were present but environmental social-science-derived mechanisms to influence health outcomes were used less. Practical recommendations for future interventions include explicit statement of the targeted level of causation, as well as utilisation of both environmental social science and health behaviour change theories and varied public health outcomes to allow simultaneously testing of theoretical predictions.

scholarly journals The Your COVID-19 Risk Assessment Tool and the Accompanying Open Access Data and Materials Repositories

2021 ◽  
Author(s):  
Gjalt - Jorn Ygram Peters ◽  
Dominika Kwasnicka ◽  
Rik Crutzen ◽  
Gill A. ten Hoor ◽  
Tugce Varol ◽  
...  
Keyword(s):  
Behaviour Change ◽  
Assessment Tool ◽  
Behavioural Science ◽  
Behavioural Determinants ◽  
Online Resource ◽  
Health Agencies ◽  
International Experts ◽  
Access Data ◽  
Initial Results ◽  
Behavioural Evidence

In March 2020, the Your COVID-19 Risk tool was developed in response to the global spread of SARS-CoV-2. The tool is an online resource based on key behavioural evidence-based risk factors related to contracting and spreading SARS-CoV-2. This article describes the development of the tool, the produced resources, the associated open repository, and initial results. This tool was developed by a multidisciplinary research team consisting of more than 150 international experts. This project leverages knowledge obtained in behavioural science, aiming to promote behaviour change by assessing risk and supporting individuals completing the assessment tool to protect themselves and others from infection. To enable iterative improvements of the tool, tool users can optionally answer questions about behavioural determinants. The data and results are openly shared to support governments and health agencies developing behaviour change interventions. Over 60 000 users in more than 150 countries have assessed their risk and provided data.

scholarly journals Systematic Review on the Effect of Training Interventions to Improve the Skills of Health Professionals in Promoting Health Behaviour Change, with Meta-Analysis of Behavioural Outcomes.

2020 ◽  
Author(s):  
Tom G Hatfield ◽  
Thomas Michael Withers ◽  
Colin J Greaves
Keyword(s):  
Systematic Review ◽  
High Risk ◽  
Healthcare Professional ◽  
Behaviour Change ◽  
Health Behaviour ◽  
Meta Analysis ◽  
Health Behaviours ◽  
Health Behaviour Change ◽  
Patient Health

Abstract Background We aimed to identify, synthesise and evaluate randomised control trial evidence on the effects of healthcare professional training on the delivery quality of health behaviour change interventions and, subsequently, on patient health behaviours.Methods Systematic review with narrative synthesis of effects on delivery quality and meta-analysis of health behaviour outcomes. We searched: Medline, EMBASE, PsychInfo, AMED, CINAHL Plus and the Cochrane Central Register of Control Trials up to March 2019. Studies were included if they were in English and included intervention delivery quality as an outcome. The systematic review was registered on PROSPERO (registration: CRD42019124502).Results Twelve-studies were identified as suitable for inclusion. All studies were judged as being high risk of bias with respect to training quality outcomes. However with respect to behavioural outcomes, only two of the six studies included in the meta-analysis had a high risk and four had some concerns. Educational elements (e.g. presentations) were used in all studies and nine included additional practical learning tasks. In eight studies reporting delivery quality, 54% of healthcare professional communication outcomes and 55% of content delivery outcomes improved in the intervention arm compared to controls. Training that included both educational and practical elements tended to be more effective. Meta-analysis of patient health behavioural outcomes in six-studies found significant improvements (Standardised mean difference (SMD): 0.20, 95% confidence interval: 0.11 to 0.28, P<0.0001, I 2 = 0%). No significant difference was found between short (≤6-months) and long-term (>6-months) outcomes (SMD: 0.25 vs 0.15; P=0.31).Conclusions Delivery quality of health behaviour change interventions appears to improve following training and consequently to improve health behaviours. Future studies should develop more concise /integrated measures of delivery quality and develop optimal methods of training delivery.

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

Gamification as Upper Limb Rehabilitation Process

2021 ◽  
pp. 243-257
Author(s):  
Vitor Simões-Silva ◽  
Ana Filipa Duarte Mesquita ◽  
Karla Lígia Santos Da Silva ◽  
Vanessa Solange Arouca Quental ◽  
António Marques
Keyword(s):  
Behaviour Change ◽  
Health Behaviour ◽  
Positive Impact ◽  
Health Behaviours ◽  
Well Being ◽  
User Participation ◽  
World Health ◽  
Upper Limb Rehabilitation ◽  
Health Behaviour Change ◽  
Limb Rehabilitation

In our modern life world, health and well-being strongly depend on the individual's health behaviours. Motivation is a major factor of health behaviour change, and intrinsically motivated behaviour change is desirable as it is both sustained and directly contributes to well-being. This raises the immediate question what kind of interventions are best positioned to intrinsically motivate health behaviour change. The current state of evidence supports that gamification can have a positive impact in health and wellbeing. In recent years, games and game technology have been used quite widely to investigate if they can help make rehabilitation more engaging for users. The underlying hypothesis is that the motivating qualities of games may be harnessed and embedded into a game-based rehabilitation system to improve the quality of user participation.

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