1. Presented by : Dr Vivien Swanson, NHS Education for Scotland ___________________________

2. Developing Sustainable Behaviour Change Training
Health professionals as implementers…
Developing Sustainable
Behaviour Change Training
Dr Vivien Swanson, Dr Deirdre Holly
NHS Education for Scotland

3. The intention – behaviour gap
50%
The intention – behaviour gap
“Bitter personal experience and meta-analysis converge on the conclusion that people do not always do the things that they intend to do”
(Sheeran & Webb 2016)

4. Why Health psychology…? What do health psychologists contribute?
‘Health is all about behaviour’
NHS needs more effective behaviour change interventions
and a ‘psychologically aware’ skilled workforce to work
collaboratively with patients to deliver better care
What do health psychologists contribute?
expertise in the science of health behaviour change
understanding mechanisms, complexities of barriers to change
added value (theory, evidence base, skills) to existing programmes
service improvement design and effectiveness of interventions
Behaviours have a major impact on health for all of us.
Although most people know what is healthy and understand health promoting messages, despite good intentions, it is difficult for all of us to make changes to our lifestyle and long standing habits.
The modern NHS needs to target patients and professionals’ behaviour as part of its focus on PREVENTION and SELF-MANAGEMENT
Health professionals need to be have psychological skills to EMPOWER patients and provide COLLABORATIVE PATIENT CENTRED CARE
Understanding and changing health behaviours are key skills for psychologists – using a psychological approach can add value to NES training programmes
Psychologists are behaviour change experts - can work with you to add a psychological perspective and to design EVIDENCE BASED INTERVENTIONS

5. What do we want to do?
develop state-of-the-art resources, build knowledge and skills for NHS staff in Scotland in changing health-related behaviour
develop generic and specific training adaptable to individual needs and contexts
ensure sustainability by developing follow-up coaching and mentoring

6. x x = Socially significant outcomes Implementation science:
Formula for success x x
Effective innovations
Effective implementation
Enabling contexts =
Socially significant outcomes

7. Implementation Stages
Exploration
Assess need
Decide intervention components
Consider implementation drivers
Assess fit
Installation Acquire resources
Prepare organisation
Prepare implementation drivers
Prepare staff
Initial Implementation
Adjust implementation drivers
Manage change
Deploy data systems
Initiate improvement cycles
Full Implementation
Monitor, manage implementation drivers
Fidelity and outcome benchmarks
Improve fidelity and outcomes
2-4 years

8. Develop evidence based intervention Develop coaching network
Needs assess-ment
Develop evidence based intervention
Test in different contexts
Gather Feedback
Develop and deliver on-line training, manualised support
Recruit and train trainers
Evaluate skills, fidelity
Develop coaching network
Evaluate impact
feedback, support
top-ups
Exploration
Installation
Implementation
Evidence into practice overview summary of process
Developing behaviour change training

9. Exploration

10. Exploration: what techniques?
93 BCTs take a behavioural approach to implementation science?

11. Exploration : mapping techniques to competencies

12. Strengthening Collaborative Practice: The MAP of Behaviour Change
Action Planning
Prompts, Cues
Motivation
Behaviour

13. Reflective, goal directed, rational
Automatic, habitual, unconscious, prompted, emotionally, environmentally cued route
Reflective, goal directed, rational
thinking of motivations, goals and values

14. Environmental Context Behaviour change techniques
Automatic
Rational / deliberate behaviours
Motivation
Action Planning
Behaviour
Prompts, Cues Habits Maintenance
Change- this is what we’re thinking of including in the online module – does it make sense? thoughts?/comments?
Automatic/cued behaviours
Behaviour change techniques
Environmental Context

15. BCT: Verbal persuasion about capability
“Tell the person that they can successfully perform the wanted behaviour, arguing against self-doubts and asserting that they can and will succeed”
Theme 1: Collaboration and Motivation
 Draw on collaborative care planning (needs of client and health professional are met).
 Identify values and goals, using these to encourage behaviour change
 Identify and address personal and environmental barriers to behaviour change

16. Theme 2: Planning, Action and Maintenance
Identify, agree goals
Set goals
Action plan (‘if … then’).
Self-monitoring (tailored, using diaries, apps)
Planning, identify barriers, problem solve, coping planning
Maintenance, re-evaluating goals, re-engaging with behaviour,
Support
Environmental restructuring
Theme 2: Planning, Action and Maintenance
BCT: Action planning
“Prompt detailed planning of performance of the behaviour (include context, frequency, duration and intensity)”

17. Theme 3: Prompts, Cues, and Habits
BCT : Restructure the Physical and Social Environment
“Change the environment to facilitate target behaviour…”
Understand the role of habits
Use environmental cues and prompts
Encourage rehearsal and repetition
Support long-term maintenance

18. Installation: WHO? Practice nurses FNP nurses Pharmacists Dentists
Public health practitioners
Health promotion specialists
Clinical psychologists
Knowledge is useful but need skills
Generic / Profession specific
Develop confidence
Change ‘fix-it’ mindset?

19. Installation: HOW? Face to face On-line Manual Soundbites
Coaching/mentoring
Webinars
Local events
Real life examples - videos, vignettes
Installation:

20. deliver
assess
monitor
improve
target
disseminate
coach
Implementation

21. Please contact us at: