The impact of Healthy Conversation Skills training on health professionals’ barriers to having behaviour change conversations: a pre-post survey using the Theoretical Domains Framework

BMC Health Services Research

Tracy Schumacher¹  Lesley MacDonald-Wicks²  Clare Collins²  Mandy Hunter³  Belinda Tully⁴  Jenna L. Hollis⁵  Wendy Lawrence⁶  Kirsty Seward⁷  Lucy Kocanda⁸  Maralyn Foureur⁹ 

[1] Hunter Medical Research Institute, Newcastle, New South Wales, Australia;Priority Research Centre for Health Behaviour, The University of Newcastle, Newcastle, New South Wales, Australia;Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle, Newcastle, New South Wales, Australia;Department of Rural Health, University of Newcastle, Tamworth, New South Wales, Australia;Hunter Medical Research Institute, Newcastle, New South Wales, Australia;Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle, Newcastle, New South Wales, Australia;School of Health Sciences, The University of Newcastle, Newcastle, New South Wales, Australia;Hunter New England Local Health District Nursing and Midwifery Services, Newcastle, New South Wales, Australia;Hunter New England Population Health, Hunter New England Local Health District, Newcastle, New South Wales, Australia;Hunter Medical Research Institute, Newcastle, New South Wales, Australia;Hunter New England Population Health, Hunter New England Local Health District, Newcastle, New South Wales, Australia;School of Medicine and Public Health, The University of Newcastle, Newcastle, New South Wales, Australia;Hunter Medical Research Institute, Newcastle, New South Wales, Australia;Priority Research Centre for Health Behaviour, The University of Newcastle, Newcastle, New South Wales, Australia;Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle, Newcastle, New South Wales, Australia;Medical Research Council Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK;NIHR, Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK;Priority Research Centre for Health Behaviour, The University of Newcastle, Newcastle, New South Wales, Australia;School of Health Sciences, The University of Newcastle, Newcastle, New South Wales, Australia;School of Medicine and Public Health, The University of Newcastle, Newcastle, New South Wales, Australia;Hunter Medical Research Institute, Newcastle, New South Wales, Australia;Priority Research Centre for Health Behaviour, The University of Newcastle, Newcastle, New South Wales, Australia;Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle, Newcastle, New South Wales, Australia;Department of Rural Health, University of Newcastle, Tamworth, New South Wales, Australia;School of Nursing and Midwifery, The University of Newcastle, Newcastle, New South Wales, Australia;Nursing and Midwifery Research Centre, Hunter New England Health, Newcastle, New South Wales, Australia;

关键词: Behaviour change theory;    Communication skills;    Health promotion;    Healthy Conversation Skills;    Theoretical Domains Framework;    Workforce development;   

DOI  :  10.1186/s12913-021-06893-4

来源: Springer

【 摘 要 】

BackgroundChanging people’s behaviour by giving advice and instruction, as traditionally provided in healthcare consultations, is usually ineffective. Healthy Conversation Skills (HCS) training enhances health professionals’ communication skills and ability to empower and motivate people in health behaviour change. Guided by the Theoretical Domains Framework (TDF), this study examined the impact of HCS training on health professional barriers to conducting behaviour change conversations in both clinical and non-clinical settings. Secondary aims were to i) identify health professionals’ barriers to having behaviour change conversations, and explore the ii) effect of HCS training on health professionals’ competence and attitudes to adopting HCS, iii) feasibility, acceptability and appropriateness of using HCS in their clinical and non-clinical roles, and iv) acceptability and quality of HCS training.MethodsHCS training was conducted in October-November 2019 and February 2020. Pre-training (T1), post-training (T2) and follow-up (T3; 6-10 weeks post-training) surveys collected data on demographics and changes in competence, confidence, importance and usefulness (10-point Likert scale, where 10 = highest score) of conducting behaviour change conversations. Validated items assessing barriers to having these conversations were based on eight TDF domains. Post-training acceptability and quality of training was assessed. Data were summarised using descriptive statistics, and differences between TDF domain scores at the specific time points were analysed using Wilcoxon matched-pairs signed-rank tests.ResultsSixty-four participants consented to complete surveys (97% women; 16% identified as Aboriginal), with 37 employed in clinical settings and 27 in non-clinical settings. The training improved scores for the TDF domains of skills (T1: median (interquartile range) = 4.7(3.3-5.3); T3 = 5.7(5.3-6.0), p < 0.01), belief about capabilities (T1 = 4.7(3.3-6.0); T3 = 5.7(5.0-6.0), p < 0.01), and goals (T1 = 4.3(3.7-5.0); T3 = 4.7(4.3-5.3), p < 0.01) at follow-up. Competence in using ‘open discovery questions’ increased post-training (T1 = 25% of responses; T2 = 96% of responses; T3 = 87% of responses, p < 0.001), as did participants’ confidence for having behaviour change conversations (T1 = 6.0(4.7-7.6); T2 = 8.1(7.1-8.8), p < 0.001), including an increased confidence in having behaviour change conversations with Aboriginal clients (T1 = 5.0(2.7-6.3); T2 = 7.6(6.4-8.3), p < 0.001).ConclusionsProvision of additional support strategies to address intentions; memory, attention and decision processes; and behavioural regulation may enhance adoption and maintenance of HCS in routine practice. Wider implementation of HCS training could be an effective strategy to building capacity and support health professionals to use a person-centred, opportunistic approach to health behaviour change.

【 授权许可】

CC BY