scholarly journals NHS Health Check Programme: a qualitative study of prison experience

2020 ◽  
Author(s):  
Marie Williams ◽  
Louise Thomson ◽  
Elizabeth Butcher ◽  
Richard Morriss ◽  
Kamlesh Khunti ◽  
...  
Keyword(s):  
Healthcare Services ◽  
Health Check ◽  
Healthcare Staff ◽  
Delivery Of Care ◽  
Health Checks ◽  
Key Policy ◽  
Prison Environment ◽  
Nhs Health Checks ◽  
Common Misconceptions ◽  
Nhs Health Check

Abstract Background NHS Health Checks began in England in 2009 and were subsequently introduced into English prisons. Uptake has been patchy and there is limited understanding about factors that may limit or enhance uptake in prison settings. Uptake of this programme is a key policy in reducing the risk of cardiovascular disease and death in these settings. Method Semi-structured focus groups were conducted with groups of prisoners (attendees and non-attendees to the health check), prison healthcare staff, custodial staff and ex-prisoners (n = 50). Participants were asked about their awareness and experiences of the NHS Health Check Programme in prison. Results All groups highlighted barriers for not attending a health check appointment, such as poor accessibility to the healthcare department, stigma and fear. The majority of participants expressed a lack of awareness and discussed common misconceptions regarding the health check programme. Methods of increasing the uptake of health checks through group-based approaches and accessibility to healthcare were suggested. Conclusions This study reports on prisoner, staff and ex-prisoner perspectives on the implementation of NHS Health Checks within a restrictive prison environment. These findings have potentially substantial implications for successful delivery of care within offender healthcare services.

scholarly journals NHS Health Checks for people with mental ill-health 2013–2017: an observational study

2020 ◽  
Vol 29 ◽  
Author(s):  
C. Garriga ◽  
J. Robson ◽  
C. Coupland ◽  
J. Hippisley-Cox
Keyword(s):  
Type 2 Diabetes ◽  
Cardiovascular Events ◽  
Health Check ◽  
Health Checks ◽  
Hazard Ratios ◽  
Nationally Representative ◽  
Nhs Health Checks ◽  
Nhs Health Check

Abstract Aims People living with serious mental ill-health experience adverse cardiovascular outcomes causing some of the greatest health inequality gaps in England, UK. We describe uptake of the NHS Health Check programme in people with mental ill-health, and rates of new diagnoses and management of cardiovascular risk factors in those who attend NHS Health Checks in comparison to those people without mental ill-health. Methods We used a large nationally representative database of people registered with general practitioners in England (QResearch). Between 2013 and 2017, we analysed attendance at NHS Health Checks and outcomes in the succeeding 12 months, in people with serious mental illness (SMI) including psychoses and in people prescribed long-term antidepressant medications (LTAD), with comparison to attendees who did not have these conditions. Hazard ratios (HR) were used to describe the association between outcomes and SMI and LTAD adjusting for sociodemographic variables. Results In those eligible for the NHS Health Check programme, we found a higher percentage of people with SMI attended an NHS Health Check (65 490, 19.8%) than those without SMI (524 728, 16.6%); adjusted HR 1.05 [95% confidence interval 1.02–1.08]. We also observed a higher percentage of attendance in people on LTAD (46 437, 20.1%) compared to people who were not prescribed LTAD (543 781, 16.7%); adjusted HR 1.10 (1.08–1.13). People with SMI were more likely to be identified with chronic kidney disease (CKD, HR 1.23, 1.12–1.34) and type 2 diabetes (HR 1.14, 1.03–1.25) within the 12 months following their NHS Health Check compared with those without SMI. People on LTAD were more likely to be identified with CKD (HR 1.55, 1.42–1.70) and type 2 diabetes (HR 1.45, 1.31–1.60) and also hypertension, cardiovascular disease, non-diabetic hyperglycaemia, familial hypercholesterolemia and dementia within the 12 months following their NHS Health Check. Statins were more likely to be prescribed to NHS Health Check attendees with SMI and those on LTAD than those without these conditions; HR 1.31 (1.25–1.38) and 1.91 (1.82–2.01), respectively. Antihypertensives were more likely to be prescribed to those on LTAD; HR 1.21 (1.14–1.29). Conclusions We found evidence that people with SMI or on LTAD treatment were 5–10% more likely to access NHS Health Checks than people without these conditions. People with SMI or on LTAD treatment who attended NHS Health Checks had higher rates of diagnosis of CKD, type 2 diabetes and some other relevant co-morbidities and increased treatment with statins and also anti-hypertensive medication in people on LTAD. This is likely to contribute to equitable reduction in adverse cardiovascular events for people with mental ill-health.

scholarly journals Reasons why people do not attend NHS Health Checks: a systematic review and qualitative synthesis

2017 ◽  
Vol 68 (666) ◽  
pp. e28-e35 ◽  
Author(s):  
Emma Harte ◽  
Calum MacLure ◽  
Adam Martin ◽  
Catherine L Saunders ◽  
Catherine Meads ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Management ◽  
Health Check ◽  
Cochrane Library ◽  
Inclusion Criteria ◽  
Qualitative Synthesis ◽  
Health Checks ◽  
The Impact ◽  
Nhs Health Checks ◽  
Nhs Health Check

BackgroundThe NHS Health Check programme is a prevention initiative offering cardiovascular risk assessment and management advice to adults aged 40–74 years across England. Its effectiveness depends on uptake. When it was introduced in 2009, it was anticipated that all those eligible would be invited over a 5-year cycle and 75% of those invited would attend. So far in the current cycle from 2013 to 2018, 33.8% of those eligible have attended, which is equal to 48.5% of those invited to attend. Understanding the reasons why some people do not attend is important to maximise the impact of the programmes.AimTo review why people do not attend NHS Health Checks.Design and settingA systematic review and thematic synthesis of qualitative studies.MethodAn electronic literature search was carried out of MEDLINE, Embase, Health Management Information Consortium, Cumulative Index to Nursing and Allied Health Literature, Global Health, PsycINFO, Web of Science, OpenGrey, the Cochrane Library, NHS Evidence, Google Scholar, Google, ClinicalTrials.gov, and the ISRCTN registry from 1 January 1996 to 9 November 2016, and the reference lists of all included papers were also screened manually. Inclusion criteria were primary research studies that reported the views of people who were eligible for but had not attended an NHS Health Check.ResultsNine studies met the inclusion criteria. Reasons for not attending included lack of awareness or knowledge, misunderstanding the purpose of the NHS Health Check, aversion to preventive medicine, time constraints, difficulties with access to general practices, and doubts regarding pharmacies as appropriate settings.ConclusionThe findings particularly highlight the need for improved communication and publicity around the purpose of the NHS Health Check programme and the personal health benefits of risk factor detection.

scholarly journals Influences on NHS Health Check behaviours: a systematic review

2020 ◽  
Author(s):  
Lou Atkins ◽  
Chryssa Stefanidou ◽  
Tim Chadborn ◽  
Katherine Thompson ◽  
Susan Michie ◽  
...  
Keyword(s):  
Systematic Review ◽  
Behaviour Change ◽  
National Health ◽  
Health Check ◽  
Behavioural Science ◽  
Health Checks ◽  
Digital Intervention ◽  
Intervention Content ◽  
Nhs Health Checks ◽  
Nhs Health Check

Abstract Background National Health Checks were introduced in the English National Health Service (NHS) in 2009 to reduce cardiovascular disease (CVD) risks and events. Following Public Health England’s (PHE’s) 2017 Digital review, NHS Health Checks were identified as a Digital Exemplar for PHE forming part of the Predictive Prevention programme, setting out the government’s vision for putting prevention at the heart of the nation’s health. This study applied behavioural science frameworks to: i) identify behaviours and actors relevant to uptake, delivery and follow up of NHS Health Checks and influences on these behaviours and; ii) signpost to example intervention content, with a focus on digital intervention development. Methods A systematic review of studies reporting NHS Health Check-related behaviours of patients, health care professionals (HCPs) and commissioners. Influences on behaviours were coded using theory-based models: COM-B and Theoretical Domains Framework (TDF). Potential intervention types and behaviour change techniques (BCTs) were suggested to target key influences. Results We identified 37 studies reporting nine behaviours and influences for eight of these. The most frequently identified influences were physical opportunity including HCPs having space and time to deliver NHS Health Checks and patients having money to adhere to recommendations to change diet and physical activity. Other key influences were motivational, such as beliefs about consequences about the value of NHS Health Checks and behaviour change, and social, such as influences of others on behaviour change. The following techniques are suggested for websites or smartphone apps: Adding objects to the environment, e.g. provide HCPs with electronic schedules to guide timely delivery of Health Checks to target physical opportunity, Social support (unspecified) , e.g. include text suggesting patients to ask a colleague to agree in advance to join them in taking the ‘healthy option’ lunch at work; Information about health consequences , e.g. quotes and/or videos from patients talking about the health benefits of changes they have made. Conclusions Through the application of behavioural science we identified key behaviours and their influences which informed recommendations for digital intervention content. To ascertain the extent to which this reflects existing interventions we recommend a review of relevant evidence.

scholarly journals Influences on NHS Health Check behaviours: a systematic review

2020 ◽  
Author(s):  
Lou Atkins ◽  
Chryssa Stefanidou ◽  
Tim Chadborn ◽  
Katherine Thompson ◽  
Susan Michie ◽  
...  
Keyword(s):  
Systematic Review ◽  
Behaviour Change ◽  
Health Care Professionals ◽  
Health Check ◽  
Behaviour Change Techniques ◽  
Behavioural Science ◽  
Health Checks ◽  
Intervention Content ◽  
Nhs Health Checks ◽  
Nhs Health Check

Abstract Background National Health Service Health Checks were introduced in 2009 to reduce cardiovascular disease (CVD) risks and events. Since then, national evaluations have highlighted the need to maximise the programme’s impact by improving coverage and outputs. To address these challenges it is important to understand the extent to which positive behaviours are influenced across the NHS Health Check pathway and encourage the promotion or minimisation of behavioural facilitators and barriers respectively. This study applied behavioural science frameworks to: i) identify behaviours and actors relevant to uptake, delivery and follow up of NHS Health Checks and influences on these behaviours and; ii) signpost to example intervention content. Methods A systematic review of studies reporting behaviours related to NHS Health Check-related behaviours of patients, health care professionals (HCPs) and commissioners. Influences on behaviours were coded using theory-based models: COM-B and Theoretical Domains Framework (TDF). Potential intervention types and behaviour change techniques (BCTs) were suggested to target key influences. Results We identified 37 studies reporting nine behaviours and influences for eight of these. The most frequently identified influences were physical opportunity including HCPs having space and time to deliver NHS Health Checks and patients having money to adhere to recommendations to change diet and physical activity. Other key influences were motivational, such as beliefs about consequences about the value of NHS Health Checks and behaviour change, and social, such as influences of others on behaviour change. The following techniques are suggested for websites or smartphone apps: Adding objects to the environment, e.g. provide HCPs with electronic schedules to guide timely delivery of Health Checks to target physical opportunity, Social support (unspecified), e.g. include text suggesting patients to ask a colleague to agree in advance to join them in taking the ‘healthy option’ lunch at work; Information about health consequences, e.g. quotes and/or videos from patients talking about the health benefits of changes they have made.Conclusions Through the application of behavioural science we identified key behaviours and their influences which informed recommendations for intervention content. To ascertain the extent to which this reflects existing interventions we recommend a review of relevant evidence.

scholarly journals NHS Health Checks: Equity and outcomes 2009-17: An observational study

2021 ◽  
pp. BJGP.2020.1021
Author(s):  
John Robson ◽  
Cesar Garriga ◽  
Carol Coupland ◽  
Julia Hippisley-Cox
Keyword(s):  
Type 2 Diabetes ◽  
Ethnic Groups ◽  
South Asian ◽  
Cardiovascular Prevention ◽  
Health Check ◽  
Cvd Risk ◽  
Health Checks ◽  
Nhs Health Checks ◽  
Nhs Health Check

Background: The NHS Health Check cardiovascular prevention programme is now 10 years old. Aim: We describe NHS Heath Check attendance, new diagnoses and treatment in relation to equity indicators. Design and Setting: Using a national general practice database 2009-17, we compared NHS Health Check attendance and new diagnoses and treatments, by age, gender, ethnic group and deprivation. Results: In 2013-17, 590,218 eligible people age 40-74 years attended an NHS Health Check (16.9%) and 2,902,598 (83.1%) did not attend. South Asian ethnic groups were most likely to attend and women more than men. New diagnoses were more likely in attendees than non-attendees; hypertension 25/1000 attendees vs 9/1000 in non-attendees; type 2 diabetes 8/1000 vs 3/1000; chronic kidney disease 7/1000 vs 4/1000. In people aged 65 or older, new atrial fibrillation was diagnosed in 5/1000 attendees and 3/1000 non-attendees and for dementia 2/1000 versus 1/1000 respectively. Type 2 diabetes, hypertension and CKD were more likely in more deprived groups, South Asian and black African/Caribbean ethnic groups. Attendees were more likely to be prescribed statins, 26/1000, than non-attendees 8/1000; and anti-hypertensive medicines, 25/1000 vs 13/1000 non-attendees. However, of the 117,963 people with 10% or greater CVD risk eligible for statins only 9,785 (8.3%) were prescribed them. Conclusions: NHS Health Checks uptake remains low. Attendees were more likely than non-attendees to be diagnosed with type 2 diabetes, hypertension and CKD and receive treatment with statins and antihypertensives. Most attendees received neither treatment nor referral. Of those eligible for statins, fewer than 10% were treated.

scholarly journals Influences on NHS Health Check behaviours: a systematic review

2020 ◽  
Author(s):  
Lou Atkins ◽  
Chryssa Stefanidou ◽  
Tim Chadborn ◽  
Katherine Thompson ◽  
Susan Michie ◽  
...  
Keyword(s):  
Systematic Review ◽  
Behaviour Change ◽  
Health Care Professionals ◽  
Health Check ◽  
Behaviour Change Techniques ◽  
Behavioural Science ◽  
Health Checks ◽  
Intervention Content ◽  
Nhs Health Checks ◽  
Nhs Health Check

Abstract Background National Health Service Health Checks were introduced in 2009 to reduce cardiovascular disease (CVD) risks and events. Since then, national evaluations have highlighted the need to maximise the programme’s impact by improving coverage and outputs. To address these challenges it is important to understand the extent to which positive behaviours are influenced across the NHS Health Check pathway and encourage the promotion or minimisation of behavioural facilitators and barriers respectively. This study applied behavioural science frameworks to: i) identify behaviours and actors relevant to uptake, delivery and follow up of NHS Health Checks and influences on these behaviours and; ii) signpost to example intervention content. Methods A systematic review of studies reporting behaviours related to NHS Health Check-related behaviours of patients, health care professionals (HCPs) and commissioners. Influences on behaviours were coded using theory-based models: COM-B and Theoretical Domains Framework (TDF). Potential intervention types and behaviour change techniques (BCTs) were suggested to target key influences. Results We identified 37 studies reporting nine behaviours and influences for eight of these. The most frequently identified influences were physical opportunity including HCPs having space and time to deliver NHS Health Checks and patients having money to adhere to recommendations to change diet and physical activity. Other key influences were motivational, such as beliefs about consequences about the value of NHS Health Checks and behaviour change, and social, such as influences of others on behaviour change. The following techniques are suggested for websites or smartphone apps: Adding objects to the environment, e.g. provide HCPs with electronic schedules to guide timely delivery of Health Checks to target physical opportunity, Social support (unspecified), e.g. include text suggesting patients to ask a colleague to agree in advance to join them in taking the ‘healthy option’ lunch at work; Information about health consequences, e.g. quotes and/or videos from patients talking about the health benefits of changes they have made.Conclusions Through the application of behavioural science we identified key behaviours and their influences which informed recommendations for intervention content. To ascertain the extent to which this reflects existing interventions we recommend a review of relevant evidence.

scholarly journals Influences on NHS Health Check behaviours: a systematic review

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Lou Atkins ◽  
Chryssa Stefanidou ◽  
Tim Chadborn ◽  
Katherine Thompson ◽  
Susan Michie ◽  
...  
Keyword(s):  
Systematic Review ◽  
Behaviour Change ◽  
Health Care Professionals ◽  
Health Check ◽  
Behaviour Change Techniques ◽  
Behavioural Science ◽  
Health Checks ◽  
Intervention Content ◽  
Nhs Health Checks ◽  
Nhs Health Check

Abstract Background National Health Service Health Checks were introduced in 2009 to reduce cardiovascular disease (CVD) risks and events. Since then, national evaluations have highlighted the need to maximise the programme’s impact by improving coverage and outputs. To address these challenges it is important to understand the extent to which positive behaviours are influenced across the NHS Health Check pathway and encourage the promotion or minimisation of behavioural facilitators and barriers respectively. This study applied behavioural science frameworks to: i) identify behaviours and actors relevant to uptake, delivery and follow up of NHS Health Checks and influences on these behaviours and; ii) signpost to example intervention content. Methods A systematic review of studies reporting behaviours related to NHS Health Check-related behaviours of patients, health care professionals (HCPs) and commissioners. Influences on behaviours were coded using theory-based models: COM-B and Theoretical Domains Framework (TDF). Potential intervention types and behaviour change techniques (BCTs) were suggested to target key influences. Results We identified 37 studies reporting nine behaviours and influences for eight of these. The most frequently identified influences were physical opportunity including HCPs having space and time to deliver NHS Health Checks and patients having money to adhere to recommendations to change diet and physical activity. Other key influences were motivational, such as beliefs about consequences about the value of NHS Health Checks and behaviour change, and social, such as influences of others on behaviour change. The following techniques are suggested for websites or smartphone apps: Adding objects to the environment, e.g. provide HCPs with electronic schedules to guide timely delivery of Health Checks to target physical opportunity, Social support (unspecified), e.g. include text suggesting patients to ask a colleague to agree in advance to join them in taking the ‘healthy option’ lunch at work; Information about health consequences, e.g. quotes and/or videos from patients talking about the health benefits of changes they have made. Conclusions Through the application of behavioural science we identified key behaviours and their influences which informed recommendations for intervention content. To ascertain the extent to which this reflects existing interventions we recommend a review of relevant evidence.

scholarly journals Fidelity of the delivery of NHS Health Checks in general practice: an observational study

BJGP Open ◽  
2020 ◽  
Vol 4 (4) ◽  
pp. bjgpopen20X101077
Author(s):  
Ben Paxton ◽  
Katie Mills ◽  
Juliet A Usher-Smith
Keyword(s):  
Risk Management ◽  
General Practice ◽  
Behaviour Change ◽  
Health Check ◽  
Health Checks ◽  
Dementia Risk ◽  
Fidelity Assessment ◽  
The Mean ◽  
Nhs Health Checks ◽  
Nhs Health Check

BackgroundThe NHS Health Check programme aims to reduce the risk of common preventable diseases by providing risk information and behaviour change advice. Failure to deliver the consultation appropriately could undermine its efficacy. To date, to the authors’ knowledge, there are no published data on the fidelity of delivery of NHS Health Checks.AimTo assess the fidelity of delivery of NHS Health Checks in general practice.Design & settingFidelity assessment of video and audio recordings of NHS Health Check consultations conducted in four GP practices across the East of England.MethodA secondary analysis of 38 NHS Health Check consultations, which were video or audio recorded as part of a pilot study of introducing discussions of cancer risk into NHS Health Checks. Using a checklist based on the NHS Health Check Best Practice Guidance, fidelity of delivery was assessed as the proportion of key elements completed during the consultations.ResultsThe mean number of elements of the NHS Health Check completed across all consultations was 14.5/18 (80.6%), with a range of 10 to 17 (55.6% to 94.4%). The mean fidelity for risk assessment, risk communication, and risk management sections was 8.7/10 (87.0%), 4.1/5 (82.0%), and 1.7/3 (56.7%), respectively. Clinically appropriate lifestyle advice was given in 34/38 consultations. Elements with the lowest fidelity were ethnicity assessment (n = 12/38; 31.6%), family history of cardiovascular disease (CVD) assessment (n = 25/38; 65.8%), AUDIT-C communication (n = 13/38; 34.2%), and dementia risk management (n = 6/38; 15.8%).ConclusionAlthough fidelity of delivery was high overall, important elements of the NHS Health Check were being regularly omitted. Opportunities for behaviour change, particularly relating to alcohol consumption and dementia risk management, may be being missed.

scholarly journals Patient experience of NHS health checks: a systematic review and qualitative synthesis

BMJ Open ◽  
2017 ◽  
Vol 7 (8) ◽  
pp. e017169 ◽  
Author(s):  
Juliet A Usher-Smith ◽  
Emma Harte ◽  
Calum MacLure ◽  
Adam Martin ◽  
Catherine L Saunders ◽  
...  
Keyword(s):  
Systematic Review ◽  
Behaviour Change ◽  
Lifestyle Changes ◽  
Qualitative Studies ◽  
Health Check ◽  
Cochrane Library ◽  
Inclusion Criteria ◽  
Health Checks ◽  
Nhs Health Checks ◽  
Nhs Health Check

ObjectiveTo review the experiences of patients attending NHS Health Checks in England.DesignA systematic review of quantitative and qualitative studies with a thematic synthesis of qualitative studies.Data sourcesAn electronic literature search of Medline, Embase, Health Management Information Consortium, Cumulative Index of Nursing and Allied Health Literature, Global Health, PsycInfo, Web of Science, OpenGrey, the Cochrane Library, National Health Service (NHS) Evidence, Google Scholar, Google, Clinical Trials.gov and the ISRCTN registry to 09/11/16 with no language restriction and manual screening of reference lists of all included papers.Inclusion criteriaPrimary research reporting experiences of patients who have attended NHS Health Checks.Results20 studies met the inclusion criteria, 9 reporting quantitative data and 15 qualitative data. There were consistently high levels of reported satisfaction in surveys, with over 80% feeling that they had benefited from an NHS Health Check. Data from qualitative studies showed that the NHS Health Check had been perceived to act as a wake-up call for many who reported having gone on to make substantial lifestyle changes which they attributed to the NHS Health Check. However, some had been left with a feeling of unmet expectations, were confused about or unable to remember their risk scores, found the lifestyle advice too simplistic and non-personalised or were confused about follow-up.ConclusionsWhile participants were generally very supportive of the NHS Health Check programme and examples of behaviour change were reported, there are a number of areas where improvements could be made. These include greater clarity around the aims of the programme within the promotional material, more proactive support for lifestyle change and greater appreciation of the challenges of communicating risk and the limitations of relying on the risk score alone as a trigger for facilitating behaviour change.

scholarly journals Influences on NHS Health Check behaviours: a systematic review

2020 ◽  
Author(s):  
Lou Atkins ◽  
Chryssa Stefanidou ◽  
Tim Chadborn ◽  
Katherine Thompson ◽  
Susan Michie ◽  
...  
Keyword(s):  
Systematic Review ◽  
Behaviour Change ◽  
National Health ◽  
Health Check ◽  
Behavioural Science ◽  
Health Checks ◽  
Digital Intervention ◽  
Intervention Content ◽  
Nhs Health Checks ◽  
Nhs Health Check

Abstract Background National Health Checks were introduced in the English National Health Service (NHS) in 2009 to reduce cardiovascular disease (CVD) risks and events. Following Public Health England’s (PHE’s) 2017 Digital review, NHS Health Checks were identified as a Digital Exemplar for PHE forming part of the Predictive Prevention programme, setting out the government’s vision for putting prevention at the heart of the nation’s health. This study applied behavioural science frameworks to: i) identify behaviours and actors relevant to uptake, delivery and follow up of NHS Health Checks and influences on these behaviours and; ii) signpost to example intervention content, with a focus on digital intervention development. Methods A systematic review of studies reporting NHS Health Check-related behaviours of patients, health care professionals (HCPs) and commissioners. Influences on behaviours were coded using theory-based models: COM-B and Theoretical Domains Framework (TDF). Potential intervention types and behaviour change techniques (BCTs) were suggested to target key influences. Results We identified 37 studies reporting nine behaviours and influences for eight of these. The most frequently identified influences were physical opportunity including HCPs having space and time to deliver NHS Health Checks and patients having money to adhere to recommendations to change diet and physical activity. Other key influences were motivational, such as beliefs about consequences about the value of NHS Health Checks and behaviour change, and social, such as influences of others on behaviour change. The following techniques are suggested for websites or smartphone apps: Adding objects to the environment, e.g. provide HCPs with electronic schedules to guide timely delivery of Health Checks to target physical opportunity, Social support (unspecified) , e.g. include text suggesting patients to ask a colleague to agree in advance to join them in taking the ‘healthy option’ lunch at work; Information about health consequences , e.g. quotes and/or videos from patients talking about the health benefits of changes they have made. Conclusions Through the application of behavioural science we identified key behaviours and their influences which informed recommendations for digital intervention content. To ascertain the extent to which this reflects existing interventions we recommend a review of relevant evidence.

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