Impacts of the COVID-19 public health emergency on healthcare professional delivery of opportunistic behaviour change interventions: a retrospective cohort study.
Behaviour change interventions
COM-B
COVID-19
Healthcare professionals
Journal
BMC health services research
ISSN: 1472-6963
Titre abrégé: BMC Health Serv Res
Pays: England
ID NLM: 101088677
Informations de publication
Date de publication:
05 Feb 2024
05 Feb 2024
Historique:
received:
09
09
2022
accepted:
23
12
2023
medline:
6
2
2024
pubmed:
6
2
2024
entrez:
5
2
2024
Statut:
epublish
Résumé
The public health policy "Making Every Contact Count" (MECC) compels healthcare professionals to deliver health behaviour change interventions during routine consultations. As healthcare systems continue their recovery from the impacts of the COVID-19 public health emergency, supporting people to modify health behaviours is more important now than when the policy was introduced. The present study aims to: (a) examine changes in healthcare professionals' awareness of, and engagement with the policy over a five-year period, (b) examine the psychosocial drivers associated with delivering behaviour change interventions, and (c) identify targets to increase healthcare professionals' delivery of interventions. Comparison of data from two independent representative surveys of NHS healthcare professionals working in the UK. In both surveys (July-September 2017; N = 1387, and February-March 2022; N = 1008), participants were asked to report: (1) awareness of the MECC policy, (2) the prevalence of MECC-related practice (perceived patient benefit, how often interventions were delivered, and time spent delivering interventions), and (3) perceptions of capabilities, opportunities and motivations to deliver behaviour change interventions. T- tests (independent-samples), MANOVA, multiple linear regression, and chi-square analyses were used to generate comparisons between the surveys. Awareness of the policy increased from 2017 (31.4%) to 2022 (52.0%). However, in 2022 compared with 2017, healthcare professionals reported (a) fewer patients would benefit from behaviour change interventions (49.1% versus 55.9%), (b) they delivered behaviour change interventions to a lower proportion of patients (38.0% versus 50.0%), and (c) they spent a lower proportion of the consultation time delivering interventions (26.5% versus 35.3%). Further, in 2022, compared with 2017, healthcare professionals reported fewer physical opportunities, fewer social opportunities, and fewer psychological capabilities to deliver behaviour change interventions. In the 2022 survey, perceptions of patient benefit and delivery of interventions was associated with greater perceptions of opportunities and motivations. Health behaviour change interventions remain an important part of routine healthcare in the continued recovery from COVID-19 public health emergency, however reported engagement with MECC-related practices appears to have reduced over time. Future research should consider how healthcare professionals identify patients who might benefit from opportunistic behaviour change interventions, and to increase capabilities, opportunities, and motivations to deliver interventions during routine consultations.
Sections du résumé
BACKGROUND
BACKGROUND
The public health policy "Making Every Contact Count" (MECC) compels healthcare professionals to deliver health behaviour change interventions during routine consultations. As healthcare systems continue their recovery from the impacts of the COVID-19 public health emergency, supporting people to modify health behaviours is more important now than when the policy was introduced. The present study aims to: (a) examine changes in healthcare professionals' awareness of, and engagement with the policy over a five-year period, (b) examine the psychosocial drivers associated with delivering behaviour change interventions, and (c) identify targets to increase healthcare professionals' delivery of interventions.
METHODS
METHODS
Comparison of data from two independent representative surveys of NHS healthcare professionals working in the UK. In both surveys (July-September 2017; N = 1387, and February-March 2022; N = 1008), participants were asked to report: (1) awareness of the MECC policy, (2) the prevalence of MECC-related practice (perceived patient benefit, how often interventions were delivered, and time spent delivering interventions), and (3) perceptions of capabilities, opportunities and motivations to deliver behaviour change interventions. T- tests (independent-samples), MANOVA, multiple linear regression, and chi-square analyses were used to generate comparisons between the surveys.
RESULTS
RESULTS
Awareness of the policy increased from 2017 (31.4%) to 2022 (52.0%). However, in 2022 compared with 2017, healthcare professionals reported (a) fewer patients would benefit from behaviour change interventions (49.1% versus 55.9%), (b) they delivered behaviour change interventions to a lower proportion of patients (38.0% versus 50.0%), and (c) they spent a lower proportion of the consultation time delivering interventions (26.5% versus 35.3%). Further, in 2022, compared with 2017, healthcare professionals reported fewer physical opportunities, fewer social opportunities, and fewer psychological capabilities to deliver behaviour change interventions. In the 2022 survey, perceptions of patient benefit and delivery of interventions was associated with greater perceptions of opportunities and motivations.
CONCLUSIONS
CONCLUSIONS
Health behaviour change interventions remain an important part of routine healthcare in the continued recovery from COVID-19 public health emergency, however reported engagement with MECC-related practices appears to have reduced over time. Future research should consider how healthcare professionals identify patients who might benefit from opportunistic behaviour change interventions, and to increase capabilities, opportunities, and motivations to deliver interventions during routine consultations.
Identifiants
pubmed: 38317160
doi: 10.1186/s12913-023-10522-7
pii: 10.1186/s12913-023-10522-7
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
167Informations de copyright
© 2024. The Author(s).
Références
McPhail S, Schippers M. An evolving perspective on physical activity counselling by medical professionals. BMC Fam Pract. 2012;13:31.
doi: 10.1186/1471-2296-13-31
pubmed: 22524484
pmcid: 3438055
Whitlock EP, et al. Evaluating primary care behavioral counseling interventions: an evidence-based approach. Am J Prev Med. 2002;22(4):267–84.
doi: 10.1016/S0749-3797(02)00415-4
pubmed: 11988383
Keyworth C, et al. Perceptions of receiving behaviour change interventions from GPs during routine consultations: a qualitative study. PLoS ONE. 2020;15(5):e0233399.
doi: 10.1371/journal.pone.0233399
pubmed: 32437462
pmcid: 7241720
Keyworth C, et al. Patients’ experiences of behaviour change interventions delivered by general practitioners during routine consultations: a nationally representative survey. Health Expect. 2021;24(3):819–32.
doi: 10.1111/hex.13221
pubmed: 33662180
pmcid: 8235898
Keyworth C, et al. Are healthcare professionals delivering opportunistic behaviour change interventions? A multi-professional survey of engagement with public health policy. Implement Sci. 2018;13(1):122.
doi: 10.1186/s13012-018-0814-x
pubmed: 30241557
pmcid: 6151030
Keyworth C, et al. It’s difficult, I think it’s complicated’: Health care professionals’ barriers and enablers to providing opportunistic behaviour change interventions during routine medical consultations. Br J Health Psychol. 2019;24(3):571–92.
doi: 10.1111/bjhp.12368
pubmed: 30977291
pmcid: 6766974
Whitlock EP et al. Evaluating primary care behavioral counseling interventions: an evidence-based approach 2002. 22(4): p. 267–284.
(RACGP)., T.R.A.C.o.G.P., Standards for general practices: Health promotion and preventive care.
Meade O, O’Brien M, Noone C, Lawless A, McSharry J, Deely H, & Byrne, M. Exploring barriers and enablers to the delivery of Making Every Contact Count brief behavioural interventions in Ireland: A cross‐sectional survey study. British Journal of Health Psychology. 2023. https://doi.org/10.1111/bjhp.12652
de Normanville C et al. Making Every Contact Count: The Prevention and Lifestyle Behaviour Change Competence Framework 2011. 1(2).
England PHEJPH. Making every contact count (MECC): consensus statement 2016. 201.
Michie S, van Stralen MM, West R. The behaviour change wheel: a new method for characterising and designing behaviour change interventions. Implement Sci. 2011;6(1):42.
doi: 10.1186/1748-5908-6-42
pubmed: 21513547
pmcid: 3096582
Chronic hospital nurse understaffing meets COVID-19: an observational study BMJ Quality & Safety, 2021. 30(8): p. 639.
Liu Q, et al. The experiences of health-care providers during the COVID-19 crisis in China: a qualitative study. Lancet Glob Health. 2020;8(6):e790–8.
doi: 10.1016/S2214-109X(20)30204-7
pubmed: 32573443
pmcid: 7190296
Tabah A, et al. Personal protective equipment and intensive care unit healthcare worker safety in the COVID-19 era (PPE-SAFE): an international survey. J Crit Care. 2020;59:70–5.
doi: 10.1016/j.jcrc.2020.06.005
pubmed: 32570052
pmcid: 7293450
Hoernke K, et al. Frontline healthcare workers’ experiences with personal protective equipment during the COVID-19 pandemic in the UK: a rapid qualitative appraisal. BMJ Open. 2021;11(1):e046199.
doi: 10.1136/bmjopen-2020-046199
pubmed: 33472794
Al-Ghunaim TA, et al. Psychological and occupational impact of the COVID-19 pandemic on UK surgeons: a qualitative investigation. BMJ Open. 2021;11(4):e045699.
doi: 10.1136/bmjopen-2020-045699
pubmed: 33795311
Murphy M, et al. Implementation of remote consulting in UK primary care following the COVID-19 pandemic: a mixed-methods longitudinal study. Br J Gen Pract. 2021;71(704):e166–77.
doi: 10.3399/BJGP.2020.0948
pubmed: 33558332
pmcid: 7909923
Greenhalgh T, Koh GCH, Car J. Covid-19: a remote assessment in primary care. BMJ. 2020;368:m1182.
doi: 10.1136/bmj.m1182
pubmed: 32213507
Vogt KS et al. Barriers and enablers to delivering behavior change interventions during the COVID-19 pandemic: a qualitative study in healthcare professionals. Under review.
Mishra V, et al. Health inequalities during COVID-19 and their effects on Morbidity and Mortality. J Healthc Leadersh. 2021;13:19–26.
doi: 10.2147/JHL.S270175
pubmed: 33500676
pmcid: 7826045
Bu F, et al. Longitudinal changes in physical activity during and after the first national lockdown due to the COVID-19 pandemic in England. Sci Rep. 2021;11(1):17723.
doi: 10.1038/s41598-021-97065-1
pubmed: 34475465
pmcid: 8413348
Naughton F, et al. Health behaviour change during the UK COVID-19 lockdown: findings from the first wave of the C-19 health behaviour and well-being daily tracker study. Br J Health Psychol. 2021;26(2):624–43.
doi: 10.1111/bjhp.12500
pubmed: 33410229
pmcid: 9291054
Michie S, Atkins L, West R. The behaviour change wheel: a guide to designing interventions 2014.
NICE PJ. L.N.I.f.H. and C. Excellence, Behaviour change: Individual approaches 2014.
Keyworth C, et al. Acceptability, reliability, and validity of a brief measure of capabilities, opportunities, and motivations (COM-B). Br J Health Psychol. 2020;25(3):474–501.
doi: 10.1111/bjhp.12417
pubmed: 32314500
Wise J. Covid-19: One in 23 people in England had infection in early January 2022. 376: p. o222.
Cohen DJ, et al. Identifying teachable moments for health behavior counseling in primary care. Patient Educ Couns. 2011;85(2):e8–e15.
doi: 10.1016/j.pec.2010.11.009
pubmed: 21183305
Phelan S. Pregnancy: a teachable moment for weight control and obesity prevention. Am J Obstet Gynecol. 2010;202(2):135e1–8.
doi: 10.1016/j.ajog.2009.06.008
Loughran MT, Plack CJ, Armitage CJ. Identifying targets for interventions to increase uptake and use of hearing Protection in Noisy recreational settings. Int J Environ Res Public Health, 2021. 18(15).
Armitage CJ, et al. Identifying targets for interventions to support public adherence to government instructions to reduce transmission of SARS-CoV-2. BMC Public Health. 2021;21(1):522.
doi: 10.1186/s12889-021-10574-6
pubmed: 33731056
pmcid: 7967094
Greenhalgh T et al. Video consultations for covid-19 2020. 368: p. m998.
Iacobucci G. Covid-19: Staff absences are continuing to stretch NHS hospitals, say leaders 2022. 376: p. o350.
Executive NH. Lockdown messaging must be careful not to discourage patients. 2022 23 May 2022]; Available from: https://www.nationalhealthexecutive.com/articles/lockdown-messaging-general-practice-rcgp .
Axenhus M, et al. Changes in Dementia diagnoses in Sweden during the COVID-19 pandemic. BMC Geriatr. 2022;22(1):365.
doi: 10.1186/s12877-022-03070-y
pubmed: 35473668
pmcid: 9039601
Keyworth C, et al. What challenges do UK adults face when adhering to COVID-19-related instructions? Cross-sectional survey in a representative sample. Prev Med. 2021;147:106458.
doi: 10.1016/j.ypmed.2021.106458
pubmed: 33607123
pmcid: 7885673
Iqbal MR, Chaudhuri A. COVID-19: results of a national survey of United Kingdom healthcare professionals’ perceptions of current management strategy– A cross-sectional questionnaire study. Int J Surg. 2020;79:156–61.
doi: 10.1016/j.ijsu.2020.05.042
pubmed: 32447002
pmcid: 7241367