Healthy CHAT: The Opportunistic Advice Given to Individuals on Unhealthy Lifestyle Behaviours

Saturday, March 28, 2020: 8:50 AM

Karen Missen, PhD
Placement, Education, Research Unit, Latrobe Community Health Service, Morwell, VIC, Australia

Purpose:

Nurses play an important role in educating their clients about the health risks of smoking, inactivity, poor nutrition and alcohol consumption (Harris et al. 2013; Simerson & Hackbarth, 2018). A consultation can represent an opportunistic teachable moment where the nurse can give the client Very Brief Advice (VBA) on an unhealthy risk behaviour that they may have. VBA is defined as proactively raising awareness of, and assessing a person's willingness to engage in further discussion about unhealthy behaviours, traditionally using the three As: Ask, Assess, & Advise, in under three minutes (Hughes et al., 2013, NCSCT, n.d.)

Nurses evaluate a person’s willingness for change and deliver information concerning the significance of modifying their behaviours and provide them with resources to assist with this change (Simerson & Hackbarth, 2018; Webb, Foster & Poulter, 2016). The assumption is based on evidence that clients who have been provided with VBA regarding their unhealthy behaviours, will increase their motivation and intention to change, which in turn will sustain improvements in their health.

Evidence in the literature demonstrates the effectiveness of General Practitioners encouraging their patients to access support services or make lifestyle changes in relation to unhealthy risk behaviours in particular with smoking cessation (Greenhalgh et al. 2016; RACGP, 2015). However, there is limited research available on the delivery of VBA in the community setting by either Allied Health or nursing staff.

The aim of this project was to develop and evaluate a face-to-face and online learning module for the delivery of VBA about lifestyle risk behaviours for healthcare professionals.

Methods:

A co-design participatory approach was used in this study to engage nurses, allied healthcare workers and consumers to collaboratively assist in designing a learning module that meets the needs of both clinicians and consumers. Separate focus groups with clinicians and consumers were conducted at regional community healthcare organisations to understand their experiences in delivering and receiving VBA on unhealthy behaviours. Questions were asked about what works well and not so well when giving VBA, potential challenges, and the content, support resources and video clips that should be included in the learning module. An online survey was administered both prior and six weeks following the delivery of the face to face learning module at each regional community health setting.

Results:

An online and face to face learning module on how to deliver effective VBA was developed for nurses and Allied Health staff. The term VBA was deemed too formal by both consumers and clinicians and the term ‘Healthy CHAT’ was adopted with the acronym ‘CHAT’ representing the words- Check, Hear, Advise, Talk. Examples of this learning module will be presented at this conference as well as the evaluation results reporting on the increased knowledge base and confidence levels of participants.

Conclusion:

We have implemented and evaluated the Healthy CHAT training and support package, in which, we have found an increase in clinicians' confidence and knowledge in engaging in discussions around unhealthy lifestyle behaviours with their clients and an increase in the number of referrals to specialist services.

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