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      ‘It's difficult, I think it's complicated’: Health care professionals’ barriers and enablers to providing opportunistic behaviour change interventions during routine medical consultations

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          Abstract

          Objectives

          Internationally, public health strategies encourage health care professionals to deliver opportunistic behaviour change interventions. The present study: (1) examines the barriers and enablers to delivering interventions during routine consultations, and (2) provides recommendations for the design of interventions to increase delivery of opportunistic behaviour change interventions.

          Design

          Qualitative interview study.

          Methods

          Twenty‐eight semi‐structured interviews were conducted with patient‐facing health care professionals. The Behaviour Change Wheel informed a framework analysis in which findings were mapped onto the Theoretical Domains Framework (TDF). Intervention functions and behaviour change techniques (BCTs) targeting each TDF domain were identified.

          Results

          Health care professionals understood the importance of opportunistic behaviour change interventions (beliefs about consequences), but were sceptical about their capabilities to facilitate behaviour change with patients (beliefs about capabilities). Some clinicians were unwilling to discuss behaviours perceived as unrelated to the patient's visit (social/professional role and identity). Discipline‐specific tasks were prioritized, and delivering interventions was perceived as psychologically burdensome. One‐to‐one contact was favoured over busy hospital settings (environmental context and resources). Seven intervention functions (training, restriction, environmental restructuring, enablement, education, persuasion, and modelling) and eight BCT groupings (antecedents, associations, comparison of outcomes, covert learning, feedback and monitoring, natural consequences, reward and threat, and self‐belief) were identified.

          Conclusions

          Across disciplines, health care professionals see the value of opportunistic behaviour change interventions. Barriers related to workload, the clinical environment, competence, and perceptions of the health care professional role must be addressed, using appropriate intervention functions and BCTs, in order to support health care professionals to increase the delivery of interventions in routine practice.

          Statement of contribution

          What is already known on this subject?

          • Brief, opportunistic interventions can be a cost effective way of addressing population health problems.

          • Public health policies compel health care professionals to deliver behaviour change interventions opportunistically.

          • Health care professionals do not always deliver interventions opportunistically during routine medical consultations; however the barriers and enablers are currently unclear.

          What does this study add?

          • This is the first study to examine cross‐disciplinary barriers and enablers to delivering opportunistic behaviour change interventions.

          • Across diverse professional groups, working in different medical professions, participants saw the value of delivering opportunistic behaviour change interventions.

          • Targeting key theoretical domains that are shared across professional groups may be useful for increasing the delivery of opportunistic behaviour change interventions.

          Related collections

          Most cited references23

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          • Article: not found

          Unrealistic optimism about susceptibility to health problems: conclusions from a community-wide sample.

          A mailed questionnaire was used to obtain comparative risk judgments for 32 different hazards from a random sample of 296 individuals living in central New Jersey. The results demonstrate that an optimistic bias about susceptibility to harm--a tendency to claim that one is less at risk than one's peers--is not limited to any particular age, sex, educational, or occupational group. It was found that an optimistic bias is often introduced when people extrapolate from their past experience to estimate their future vulnerability. Thus, the hazards most likely to elicit unrealistic optimism are those associated with the belief (often incorrect) that if the problem has not yet appeared, it is unlikely to occur in the future. Optimistic biases also increase with the perceived preventability of a hazard and decrease with perceived frequency and personal experience. Other data presented illustrate the inconsistent relationships between personal risk judgments and objective risk factors.
            Bookmark
            • Record: found
            • Abstract: not found
            • Article: not found

            Unique effects of setting goals on behavior change: Systematic review and meta-analysis.

              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Factors influencing European GPs' engagement in smoking cessation: a multi-country literature review.

              Smoking cessation advice by GPs is an effective and cost-effective intervention, but is not implemented as widely as it could be. This wide-ranging Europe-wide literature review, part of the European Union (EU) PESCE (General Practitioners and the Economics of Smoking Cessation in Europe) project, explored the extent of GPs' engagement in smoking cessation and the factors that influence their engagement. Two searches were conducted, one for grey literature, across all European countries, and one for academic studies. Data from eligible studies published from 1990 onwards were synthesised and reported under four categories of influencing factors: GP characteristics, patient characteristics, structural factors, and cessation-specific knowledge and skills. The literature showed that most GPs in Europe question the smoking status of all new patients but fewer routinely ask this of regular patients, or advise smokers to quit. The proportion offering intensive interventions or prescribing treatments is lower still. Factors influencing GPs' engagement in smoking cessation include GPs' own smoking status and their attitudes towards giving smoking cessation advice; whether patients present with smoking-related symptoms, are pregnant, or heavy smokers; time, training, and reimbursement are important structural factors; and some GPs lack knowledge and skills regarding the use of specific cessation methods and treatments, or have limited awareness of specialist cessation services. No single factor or category of factors explains the variations in GPs' engagement in smoking cessation. Strategies to improve the frequency and quality of GPs' engagement in smoking cessation need to address the multifaceted influences on GPs' practice and to reflect the widely differing contexts across Europe.
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                Author and article information

                Contributors
                chris.keyworth@manchester.ac.uk
                Journal
                Br J Health Psychol
                Br J Health Psychol
                10.1111/(ISSN)2044-8287
                BJHP
                British Journal of Health Psychology
                John Wiley and Sons Inc. (Hoboken )
                1359-107X
                2044-8287
                12 April 2019
                September 2019
                : 24
                : 3 ( doiID: 10.1111/bjhp.v24.3 )
                : 571-592
                Affiliations
                [ 1 ] Manchester Centre for Health Psychology Division of Psychology and Mental Health School of Health Sciences Faculty of Biology, Medicine and Health Manchester Academic Health Science Centre The University of Manchester UK
                [ 2 ] Manchester Centre for Health Psychology Division of Psychology and Mental Health School of Health Sciences Faculty of Biology, Medicine and Health Manchester Academic Health Science Centre and NIHR Manchester Biomedical Research Centre and Manchester University NHS Foundation Trust (MFT) and NIHR Greater Manchester Patient Safety Translational Research Centre The University of Manchester UK
                Author notes
                [*] [* ]Correspondence should be addressed to Chris Keyworth, Manchester Centre for Health Psychology, Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Coupland Building 1, Room G.3, Manchester, M13 9PL, UK (email: chris.keyworth@ 123456manchester.ac.uk ).
                Author information
                https://orcid.org/0000-0002-7815-6174
                Article
                BJHP12368
                10.1111/bjhp.12368
                6766974
                30977291
                127664bd-97dc-4e67-833f-2058c002beb0
                © 2019 The Authors. British Journal of Health Psychology published by John Wiley & Sons Ltd on behalf of British Psychological Society

                This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

                History
                : 18 July 2018
                : 15 February 2019
                Page count
                Figures: 2, Tables: 2, Pages: 22, Words: 9245
                Funding
                Funded by: NIHR Manchester Biomedical Research Centre
                Categories
                Original Article
                Original Articles
                Custom metadata
                2.0
                bjhp12368
                September 2019
                Converter:WILEY_ML3GV2_TO_NLMPMC version:5.6.9 mode:remove_FC converted:30.09.2019

                health care professionals,behaviour change wheel,theoretical domains framework,qualitative,behaviour change,com‐b

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