Public health practitioners’ views of the ‘Making Every Contact Count’ initiative and standards for its evaluation

Chisholm, Anna; Ang-Chen, P; Peters, Sarah; Hart, Jo; Beenstock, Jane

doi:10.1093/pubmed/fdy094

Cited by 27 publications

(40 citation statements)

References 11 publications

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“…Further an initiative, Make Every Contact Count (MECC) (30), provides HCPs with online resources to improve clinical communications skills around exercise. However these approaches have varied in implementation success (31) and are yet to be fully evaluated. In addition, they lack a whole multi-disciplinary clinical team approach to training and do not provide links with an exercise referral scheme, something HCPs report as a barrier to broaching exercise with patients, as they want to be able to offer something tangible to patients (26).…”

Section: Trial Registration N/a Backgroundmentioning

confidence: 99%

Towards Implementing Exercise Into the Prostate Cancer Care Pathway: Development of a Theory and Evidence-Based Intervention to Change Healthcare Professional Behaviour

Turner¹,

Arden²,

Reale³

et al. 2021

Preprint

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BackgroundTwice-weekly supervised aerobic and resistance exercise for 12 weeks reduces fatigue and improves quality of life in men on Androgen Deprivation Therapy for prostate cancer. Despite the National Institute for Health and Care Excellence (NICE) proposing this as standard of care, it does not routinely take place in practice. Healthcare professionals are in a prime position to deliver and integrate these recommendations. A change in the behaviour of clinical teams is therefore required.In this paper, we describe the development of a training package for healthcare professionals using theory and evidence to promote delivery of such recommendations as standard care.MethodsThe intervention development process was guided by the Medical Research Council guidance for complex interventions and the Behaviour Change Wheel. Target behaviours were identified from the literature and thirty-five prostate cancer care healthcare professionals were interviewed to understand influences on these behaviours. The Theoretical Domains Framework was used to identify theoretical constructs for change. Behaviour change techniques were selected based on theory and evidence and were translated into intervention content. The intervention was refined with the input of stakeholders including healthcare professionals, patients, and exercise professionals in the form of rehearsal deliveries, focus groups and a workshop.ResultsSeven modifiable healthcare professional target behaviours were identified to support the delivery of the NICE recommendations including identifying eligible patients suitable for exercise, recommending exercise, providing information, exercise referral, providing support and interpret and feedback on progress. Ten domains from the Theoretical Domain’s Framework were identified as necessary for change, including improving knowledge and skills, addressing beliefs about consequences, and targeting social influences. These were targeted through twenty-two behaviour change techniques delivered in a half-day, interactive training package. Based on initial feedback from stakeholders, the intervention was refined in preparation for evaluation.ConclusionsWe designed an intervention based on theory, evidence, and stakeholder feedback to promote and support the delivery of NICE recommendations. Future work will aim to test this training package in a multi-centre randomised trial. If proven effective, the development and training package will provide a template for replication in other clinical populations, where exercise has proven efficacy but is insufficiently implemented.Trial registrationN/A

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Section: Trial Registration N/a Backgroundmentioning

confidence: 99%

Towards Implementing Exercise Into the Prostate Cancer Care Pathway: Development of a Theory and Evidence-Based Intervention to Change Healthcare Professional Behaviour

Turner¹,

Arden²,

Reale³

et al. 2021

Preprint

View full text Add to dashboard Cite

show abstract

“…Further an initiative, Make Every Contact Count (MECC) [ 32 ], provides HCPs with online resources to improve clinical communications skills around exercise. However these approaches have varied in implementation success [ 33 ] and are yet to be fully evaluated. In addition, they lack a whole multi-disciplinary clinical team approach to training and do not provide links with an exercise referral scheme, something HCPs report as a barrier to broaching exercise with patients, as they want to be able to offer something tangible to patients [ 28 ].…”

Section: Introductionmentioning

confidence: 99%

The development of a theory and evidence-based intervention to aid implementation of exercise into the prostate cancer care pathway with a focus on healthcare professional behaviour, the STAMINA trial

Turner

Arden

Reale

et al. 2021

BMC Health Serv Res

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Background Twice-weekly supervised aerobic and resistance exercise for 12 weeks reduces fatigue and improves quality of life in men on Androgen Deprivation Therapy for prostate cancer. Despite the National Institute for Health and Care Excellence (NICE) proposing this as standard of care, it does not routinely take place in practice. Healthcare professionals are in a prime position to deliver and integrate these recommendations. A change in the behaviour of clinical teams is therefore required. In this paper, we describe the development of a training package for healthcare professionals using theory and evidence to promote delivery of such recommendations as standard care. Methods The intervention development process was guided by the Medical Research Council guidance for complex interventions and the Behaviour Change Wheel. Target behaviours were identified from the literature and thirty-five prostate cancer care healthcare professionals (including oncologists, consultant urologists, clinical nurse specialists, physiotherapists, general practitioners and commissioners) were interviewed to understand influences on these behaviours. The Theoretical Domains Framework was used to identify theoretical constructs for change. Behaviour change techniques were selected based on theory and evidence and were translated into intervention content. The intervention was refined with the input of stakeholders including healthcare professionals, patients, and exercise professionals in the form of rehearsal deliveries, focus groups and a workshop. Results Seven modifiable healthcare professional target behaviours were identified to support the delivery of the NICE recommendations including identifying eligible patients suitable for exercise, recommending exercise, providing information, exercise referral, providing support and interpret and feedback on progress. Ten domains from the Theoretical Domain’s Framework were identified as necessary for change, including improving knowledge and skills, addressing beliefs about consequences, and targeting social influences. These were targeted through twenty-two behaviour change techniques delivered in a half-day, interactive training package. Based on initial feedback from stakeholders, the intervention was refined in preparation for evaluation. Conclusions We designed an intervention based on theory, evidence, and stakeholder feedback to promote and support the delivery of NICE recommendations. Future work will aim to test this training package in a multi-centre randomised trial. If proven effective, the development and training package will provide a template for replication in other clinical populations, where exercise has proven efficacy but is insufficiently implemented.

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“…There is, however, no universal or consistent approach to MECC, as organisations adopt different strategies to meet NICE guidelines (Wills and Ion 2014;Nelson et al 2013). Variation between models of MECC is thought, by some, to contribute to the paucity of evidence supporting its effectiveness and discrepancies in implementation success (Chisholm et al 2020;Chisholm et al 2019).…”

Section: Introductionmentioning

confidence: 99%

Making Every Contact Count and Healthy Conversation Skills as very brief or brief behaviour change interventions: a scoping review

Parchment

Lawrence

Perry

et al. 2021

J Public Health (Berl.)

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Aim To identify and map the available evidence regarding the implementation of Making Every Contact Count and/or Healthy Conversation Skills for both staff delivering and service users receiving the brief or very brief intervention/s. Methods A scoping review approach was used to rapidly map and provide an overview of the relevant literature, identify gaps in knowledge, and inform further, related research. Articles investigating experiences, perceptions and impact of Making Every Contact Count and/or Healthy Conversation Skills were included. Quantitative, qualitative, and mixed methods studies were eligible for inclusion, as were reviews and reports. Results Twenty-two articles were included in total. Healthy Conversation Skills training was found to be acceptable, and had a positive impact on staff confidence and competence in supporting behaviour change, across studies. Some positive effects of intervention exposure on the sedentary behaviour and dietary quality of service users were evidenced. Changes in confidence following Making Every Contact Count training were varied, as was perceived acceptability of the intervention for staff. Two studies highlighted positive impacts of the intervention on service user health; however, statistical significance was not reported. The perceived barriers and facilitators of implementation for both interventions mapped mostly to ‘Environmental Context and Resources’ on the Theoretical Domains Framework. Conclusion Healthy Conversation Skills is an acceptable and effective behaviour change intervention that could provide a consistent approach to Making Every Contact Count training and evaluation. Further research is warranted to evaluate this approach for more staff and service user groups.

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Public health practitioners’ views of the ‘Making Every Contact Count’ initiative and standards for its evaluation

Cited by 27 publications

References 11 publications

Towards Implementing Exercise Into the Prostate Cancer Care Pathway: Development of a Theory and Evidence-Based Intervention to Change Healthcare Professional Behaviour

Towards Implementing Exercise Into the Prostate Cancer Care Pathway: Development of a Theory and Evidence-Based Intervention to Change Healthcare Professional Behaviour

The development of a theory and evidence-based intervention to aid implementation of exercise into the prostate cancer care pathway with a focus on healthcare professional behaviour, the STAMINA trial

Making Every Contact Count and Healthy Conversation Skills as very brief or brief behaviour change interventions: a scoping review

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