Challenges of implementing routine behaviour change support in a children’s hospital setting
- Lifestyle behaviours, such as smoking, excessive drinking, poor diet and lack of physical activity are the main causes of mortality and morbidity worldwide.
- Evidence shows that brief advice during routine consultations produces modest but worthwhile improvements in lifestyle.
- In the UK, a policy has been introduced (Make Every Contact Counts) giving healthcare professionals responsibility to provide health advice routinely to during everyday contact.
- However, evidence suggests that changing staff practice requires more than official instruction and the advice in the case of young children is targeted at parents rather than patients.
- CLAHRC WM carried out a qualitative study to understand the barriers to the implementation of health behaviour change into routine practice in a children’s hospital setting.
- Semi-structured interviews with health professionals were conducted to explore their views on talking about health behaviour change with patients and their families.
- The majority of participants acknowledged that they had a professional duty to promote overall health and wellbeing and that parents’ behaviour affected children. However, barriers presented included low levels of confidence in instigating conversations and concern that families may feel criticised.
- Many participants were aware that such advice might appear gratuitous when targeted at parents, especially if it was not directly related to the child's presenting condition.
- Health professionals were receptive to training on how to provide health behaviour change brief advice and also wished to acquire skills in how to practically manage conversations.
- Informed by this research, a training video has been produced addressing barriers for staff delivering behaviour change advice. The video is used in all staff training and induction and is available on YouTube at: https://www.youtube.com/watch?v=6yF8YGfZmJQ