Health behaviour change in traditional acupuncture practice.

Abstract

Modifiable health behaviours cause multiple health conditions and incur substantial financial costs to society, making them a major public health priority. Development of behaviour change interventions and theory is a rapidly growing field but there remain significant gaps in understanding. The role of healthcare providers outside of mainstream health organisations, such as complementary medicine practitioners may be important in promoting behaviour change but research exploring the role of these practitioners is limited. A series of studies were undertaken to explore the potential role of one group of practitioners, traditional acupuncturists. A systematic critical interpretive synthesis of 40 original research articles identified gaps in knowledge on prevalence and patterns of support, and potential components, mediators and moderators of traditional acupuncture for supporting behaviour change outcomes. A mixed method survey study of 352 UK traditional acupuncturists found 57.7% (n=203) of consultations supported behaviour change. Support was more frequent in chronic conditions, for diet, physical activity and sleep hygiene. Key predictors of support were attitudes and confidence in ability. A longitudinal qualitative study of patient-acupuncturist dyads found variation in types of support needed by patients, including gaining control (by treatment of symptoms, explanations and strong therapeutic relationships) and help sustaining motivation. Trust in the practitioner, their explanations and the treatments was important. Decisions to enact a change were based both on reasoned understanding and changes in feelings and mood. Finally, the findings from all three studies were drawn together to produce a revised logic model of the process of health behaviour change in traditional acupuncture which provides a structure for future research. These studies suggest that traditional acupuncturists are already supporting behaviour change and that this support could be improved by developing training in areas identified within the revised logic model. It is recommended that public health bodies should explore the potential role of traditional acupuncturists and potentially other CM healthcare providers in supporting healthy behaviour targets. The methods, identified techniques and insights into mechanisms of change in this work could be applicable to wider contexts and models of behaviour change.

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Identifiers

ORCID for Jonquil Westwood Pinto: orcid.org/0000-0002-2237-6127

ORCID for Flis Bishop: orcid.org/0000-0002-8737-6662

ORCID for Katherine Bradbury: orcid.org/0000-0001-5513-7571

ORCID for Dave Newell: orcid.org/0000-0003-1462-3586

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