Enhancing delivery of health behaviour change interventions in primary care: a meta-synthesis of views and experiences of primary care nurses

Objective To systematically find and synthesise qualitative studies that elicited views and experiences of nurses involved in the delivery of health behaviour change (HBC) interventions in primary care, with a focus on how this can inform enhanced delivery and adherence to a structured approach for HBC interventions. Methods Systematic search of five electronic databases and additional strategies to maximise identification of studies, appraisal of studies and use of meta-synthesis to develop an inductive and interpretative form of knowledge synthesis. Results Nine studies met the inclusion criteria. Synthesis resulted in the development of four inter-linking themes; (a) actively engaging nurses in the process of delivering HBC interventions, (b) clarifying roles and responsibilities of those involved, (c) engaging practice colleagues, (d) communication of aims and potential outcomes of the intervention. Conclusion The synthesis of qualitative evidence resulted in the development of a conceptual framework that remained true to the findings of primary studies. This framework describes factors that should be actively promoted to enhance delivery of and adherence to HBC interventions by nurses working in primary care. Practice implications The findings can be used to inform strategies for researchers, policymakers and healthcare providers to enhance fidelity and support delivery of HBC interventions.

Behaviour change at population, community and individual levels: NICE Public Health Guidance 6

This guidance is aimed at those responsible for helping people to change their behaviour to improve their health. This includes policy makers and those working in local authorities and the community and voluntary sectors. It gives advice on how to plan and run relevant initiatives. The recommendations include the following advice: base interventions on a proper assessment of the target group, where they are located and the behaviour which is to be changed: careful planning is the cornerstone of success  work with other organisations and the community itself to decide on and develop initiatives build on the skills and knowledge that already exists in the community, for example, by encouraging networks of people who can support each other take account of and resolve problems that prevent people changing their behaviour (for example, the costs involved in taking part in exercise programmes or buying fresh fruit and vegetables, or lack of knowledge about how to make changes) base all interventions on evidence of what works train staff to help people change their behaviour evaluate all interventions.This resource was contributed by The National Documentation Centre on Drug Use.

Low-income Groups and Behaviour Change Interventions: A review of intervention content and effectiveness

This is the second paper in a series, Kicking Bad Habits, on how people can be encouraged to adopt healthy behaviour. Looking at interventions targeted specifically at low-income groups, this paper asks which interventions are effective in getting people to quit smoking, eat healthily and exercise. It reveals that the most frequently used techniques are providing information and encouraging people to set goals, which can be particularly effective at changing behaviour in disadvantaged groups.

Behaviour Change Wheel (BCW): Guia para Intervenções de Mudança de Comportamento

RESUMO Trata-se da resenha da obra The behaviour change wheel: a guide to designing interventions, de Michie, Atkins e West, publicada no Reino Unido pela Silverback Publishing em 2014.

Individuals, Behaviour Change and the Web

A psychologist's description of the Web as an effective channel for inducing and promoting changes of behaviour in individuals. Demonstrates an experimental system called "LifeGuide".

Behaviour change in the UK climate debate : an assessment of responsibility, agency and political dimensions

This paper explores the politics around the role of agency in the UK climate change debate. Government interventions on the demand side of consumption have increasingly involved attempts to obtain greater traction with the values, attitudes and beliefs of citizens in relation to climate change and also in terms of influencing consumer behaviour at an individual level. With figures showing that approximately 40% of the UK’s carbon emissions are attributable to household and transport behaviour, policy initiatives have progressively focused on the facilitation of “sustainable behaviours”. Evidence suggests however, that mobilisation of pro-environmental attitudes in addressing the perceived “value-action gap” has so far had limited success. Research in this field suggests that there is a more significant and nuanced “gap” between context and behaviour; a relationship that perhaps provides a more adroit reflection of reasons why people do not necessarily react in the way that policy-makers anticipate. Tracing the development of the UK Government’s behaviour change agenda over the last decade, we posit that a core reason for the limitations of this programme relates to an excessively narrow focus on the individual. This has served to obscure some of the wider political and economic aspects of the debate in favour of a more simplified discussion. The second part of the paper reports findings from a series of focus groups exploring some of the wider political views that people hold around household energy habits, purchase and use of domestic appliances, and transport behaviour-and discusses these insights in relation to the literature on the agenda’s apparent limitations. The paper concludes by considering whether the aims of the Big Society approach (recently established by the UK’s Coalition Government) hold the potential to engage more directly with some of these issues or whether they merely constitute a “repackaging” of the individualism agenda.

The national dialogue on behaviour change in UK climate policy: some observations on responsibility, agency and political dimensions

This chapter explores the politics around the role of agency in the UK climate change debate. Government interventions on the demand side of consumption have increasingly involved attempts to obtain greater traction with the values, attitudes and beliefs of citizens in relation to climate change and also in terms of influencing consumer behaviour at an individual level. With figures showing that approximately 40% of the UK’s carbon emissions are attributable to household and transport behaviour, policy initiatives have progressively focused on the facilitation of “sustainable behaviours”. Evidence suggests however, that mobilisation of pro-environmental attitudes in addressing the perceived “value-action gap” has so far had limited success. Research in this field suggests that there is a more significant and nuanced “gap” between context and behaviour; a relationship that perhaps provides a more adroit reflection of reasons why people do not necessarily react in the way that policy-makers anticipate. Tracing the development of the UK Government’s behaviour change agenda over the last decade, we posit that a core reason for the limitations of this programme relates to an excessively narrow focus on the individual. This has served to obscure some of the wider political and economic aspects of the debate in favour of a more simplified discussion. The second part of the chapter reports findings from a series of focus groups exploring some of the wider political views that people hold around household energy habits, purchase and use of domestic appliances, and transport behaviour-and discusses these insights in relation to the literature on the agenda’s apparent limitations. The chapter concludes by considering whether the aims of the Big Society approach (recently established by the UK’s Coalition Government) hold the potential to engage more directly with some of these issues or whether they merely constitute a “repackaging” of the individualism agenda.

Promoting behaviour change through personalized energy feedback in offices

A body of research suggests that the provision of energy feedback information to building users can elicit significant energy reductions through behaviour change. However, most studies have focused on energy use in homes and the assessment of interventions and technologies, to the neglect of the non-domestic context and broader issues arising from the introduction of feedback technologies. To address this gap, a non-domestic case study explores the delivery of personalized energy feedback to office workers through a novel system utilizing wireless technologies. The research demonstrates advantages of monitoring occupancy and quantifying energy use from specific behaviours as a basis for effective energy feedback; this is particularly important where there are highly disaggregated forms of energy use and a range of locations for that activity to take place. Quantitative and qualitative data show that personalized feedback can help individuals identify energy reduction opportunities. However, the analysis also highlights important contextual barriers and issues that need to be addressed when utilizing feedback technologies in the workplace. If neglected, these issues may limit the effective take-up of feedback interventions.

Behaviour change counselling for tobacco use cessation and promotion of healthy lifestyles: a systematic review

AIM To systematically assess the efficacy of oral health behaviour change counselling for tobacco use cessation (TUC) and the promotion of healthy lifestyles. MATERIALS AND METHODS Systematic Reviews, Randomized (RCTs), and Controlled Clinical Trials (CCTs) were identified through an electronic search of four databases complemented by manual search. Identification, screening, eligibility and inclusion of studies were performed independently by two reviewers. Quality assessment of the included publications was performed according to the AMSTAR tool for the assessment of the methodological quality of systematic reviews. RESULTS A total of seven systematic reviews were included. With the exception of inadequate oral hygiene, the following unhealthy lifestyles related with periodontal diseases were investigated: tobacco use, unhealthy diets, harmful use of alcohol, physical inactivity, and stress. Brief interventions for TUC were shown to be effective when applied in the dental practice setting while evidence for dietary counselling and the promotion of other healthy lifestyles was limited or non-existent. CONCLUSIONS While aiming to improve periodontal treatment outcomes and the maintenance of periodontal health current evidence suggests that tobacco use brief interventions conducted in the dental practice setting were effective thus underlining the rational for behavioural support.