Margaret E Cupples1,2,3, Judith A Cole4,5, Nigel D Hart6,7, Neil Heron4,5,8, Michelle C McKinley9,10, Mark A Tully11,12. 1. Professor, Department of General Practice, Queen's University Belfast, Dunluce Health Centre, Belfast, UK. 2. Professor, Centre for Public Health, Queen's University Belfast, Belfast, UK. 3. Professor, UKCRC Centre of Excellence for Public Health (Northern Ireland), Queen's University, Belfast, Belfast, UK. 4. Research Fellow, Department of General Practice, Queen's University Belfast, Dunluce Health Centre, Belfast, UK. 5. Research Fellow, Centre for Public Health, Queen's University Belfast, Belfast, UK. 6. Senior Lecturer, Centre for Medical Education, Queen's University Belfast, Belfast, UK. 7. Senior Lecturer, Department of General Practice, Queen's University Belfast, Dunluce Health Centre, Belfast, UK. 8. Research Fellow, UKCRC Centre of Excellence for Public Health (Northern Ireland), Queen's University, Belfast, Belfast, UK. 9. Reader, Centre for Public Health, Queen's University Belfast, Belfast, UK. 10. Reader, UKCRC Centre of Excellence for Public Health (Northern Ireland), Queen's University, Belfast, Belfast, UK. 11. Senior Lecturer, Centre for Public Health, Queen's University Belfast, Belfast, UK. 12. Senior Lecturer, UKCRC Centre of Excellence for Public Health (Northern Ireland), Queen's University, Belfast, Belfast, UK.
Abstract
BACKGROUND: Effective interventions are needed to support health behaviour change for cardiovascular disease (CVD) prevention. Decision tools encourage behaviour change but their effectiveness when used in shared decision-making with health professionals (HPs) is unknown. AIM: To test the feasibility of using a novel, paper-based tool for shared decision-making in initiating behaviour change. DESIGN & SETTING: A feasibility study in five general practices in Northern Ireland. METHOD: Adults with, or at high risk of, CVD were invited to discuss their diet and physical activity (PA) with an HP. Using a paper-based decision aid in shared decision-making about behaviour change, their capabilities, opportunities, and motivation were considered. Diet and PA were assessed at baseline, 1, and 3 months using the Dietary Instrument for Nutritional Education (DINE) and the Recent Physical Activity Questionnaire (RPAQ); accelerometers measured PA at baseline and 3 months. Semi-structured interviews, analysed thematically, explored participants' and HPs' views of the process. RESULTS: The positive response rate to study invitation was 28% (45/162); 23 were recruited (aged 43-74 years; 50% male; <40% met diet or PA recommendations); and 87% (20/23) completed the study. All interviewees valued the tool's structure, succinct content, and facilitation of discussion. HPs' sharing of relevant personal experience encouraged behaviour change; social responsibilities, health conditions, and beliefs restricted change. HPs' workloads prohibited the tool's routine use. CONCLUSION: Recruitment and completion rates suggest that using a novel, paper-based tool in shared decision-making for behaviour change is feasible. HPs' workloads constrain its use in practice, but qualitative findings indicate its potential value. Cross-sector collaborative exploration of sustainable models to promote behaviour change is needed.
BACKGROUND: Effective interventions are needed to support health behaviour change for cardiovascular disease (CVD) prevention. Decision tools encourage behaviour change but their effectiveness when used in shared decision-making with health professionals (HPs) is unknown. AIM: To test the feasibility of using a novel, paper-based tool for shared decision-making in initiating behaviour change. DESIGN & SETTING: A feasibility study in five general practices in Northern Ireland. METHOD: Adults with, or at high risk of, CVD were invited to discuss their diet and physical activity (PA) with an HP. Using a paper-based decision aid in shared decision-making about behaviour change, their capabilities, opportunities, and motivation were considered. Diet and PA were assessed at baseline, 1, and 3 months using the Dietary Instrument for Nutritional Education (DINE) and the Recent Physical Activity Questionnaire (RPAQ); accelerometers measured PA at baseline and 3 months. Semi-structured interviews, analysed thematically, explored participants' and HPs' views of the process. RESULTS: The positive response rate to study invitation was 28% (45/162); 23 were recruited (aged 43-74 years; 50% male; <40% met diet or PA recommendations); and 87% (20/23) completed the study. All interviewees valued the tool's structure, succinct content, and facilitation of discussion. HPs' sharing of relevant personal experience encouraged behaviour change; social responsibilities, health conditions, and beliefs restricted change. HPs' workloads prohibited the tool's routine use. CONCLUSION: Recruitment and completion rates suggest that using a novel, paper-based tool in shared decision-making for behaviour change is feasible. HPs' workloads constrain its use in practice, but qualitative findings indicate its potential value. Cross-sector collaborative exploration of sustainable models to promote behaviour change is needed.
Entities:
Keywords:
cardiovascular disease; diet; general practice; physical activity
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