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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.

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.
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.

Background: Changing 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. Methods: HCS 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. Results: Sixty-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). Conclusions: Provision 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.

Behaviour change theory, Communication skills, Health promotion, Healthy Conversation Skills, Theoretical Domains Framework, Workforce development
1472-6963
Hollis, Jenna
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Kocanda, Lucy
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Seward, Kirsty
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Collins, Claire
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Tully, Belinda
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Foureur, Maralyn
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Lawrence, Wendy
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MacDonald-Wicks, Lesley
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Schumacher, Tracy
4960b193-046f-4a85-b71f-f76a79ff0b81
Hollis, Jenna
f2ff5d7f-70de-44ea-8e01-826fa11a28d0
Kocanda, Lucy
e2986157-edc7-4ff5-a80c-4195b8cc9afb
Seward, Kirsty
d0782bcd-1006-4e1a-81da-f2e1fbe907cd
Collins, Claire
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Tully, Belinda
c71db967-18cd-432d-81c4-8f36a1c0ded5
Foureur, Maralyn
65f79c34-4fea-4d87-9390-7aa09506665d
Lawrence, Wendy
e9babc0a-02c9-41df-a289-7b18f17bf7d8
MacDonald-Wicks, Lesley
3ce698d3-b66d-4b2b-a643-e1b7b05de062
Schumacher, Tracy
4960b193-046f-4a85-b71f-f76a79ff0b81

Hollis, Jenna, Kocanda, Lucy, Seward, Kirsty, Collins, Claire, Tully, Belinda, Foureur, Maralyn, Lawrence, Wendy, MacDonald-Wicks, Lesley and Schumacher, Tracy (2021) 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, 21 (1), [880]. (doi:10.1186/s12913-021-06893-4).

Record type: Article

Abstract

Background: Changing 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. Methods: HCS 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. Results: Sixty-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). Conclusions: Provision 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.

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HCS paper_v7_final published - Accepted Manuscript
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Accepted/In Press date: 12 August 2021
Published date: 27 August 2021
Keywords: Behaviour change theory, Communication skills, Health promotion, Healthy Conversation Skills, Theoretical Domains Framework, Workforce development

Identifiers

Local EPrints ID: 451895
URI: http://eprints.soton.ac.uk/id/eprint/451895
ISSN: 1472-6963
PURE UUID: 73372abd-60e7-48d8-99a1-31702cb269af
ORCID for Wendy Lawrence: ORCID iD orcid.org/0000-0003-1264-0438

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Date deposited: 02 Nov 2021 17:45
Last modified: 28 Apr 2022 01:49

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Contributors

Author: Jenna Hollis
Author: Lucy Kocanda
Author: Kirsty Seward
Author: Claire Collins
Author: Belinda Tully
Author: Maralyn Foureur
Author: Wendy Lawrence ORCID iD
Author: Lesley MacDonald-Wicks
Author: Tracy Schumacher

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