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首页> 外文期刊>BMC Health Services Research >The impact of Healthy Conversation Skills training on health professionals’ barriers to having behaviour change conversations: a pre-post survey using the Theoretical Domains Framework
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The impact of Healthy Conversation Skills training on health professionals’ barriers to having behaviour change conversations: a pre-post survey using the Theoretical Domains Framework

机译：健康的谈话技能培训对健康专业人员对具有行为改变对话的障碍的影响：使用理论域框架的职前预测

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Changing people’s behaviour by giving advice and instruction, as traditionally provided in healthcare consultations, is usually ineffective. Healthy Conversation Skills (HCS) training enhances health professionals’ communication skills and ability to empower and motivate people in health behaviour change. Guided by the Theoretical Domains Framework (TDF), this?study examined the impact of HCS training on health professional barriers to conducting behaviour change conversations in both clinical and non-clinical settings. Secondary aims were to i) identify health professionals’ barriers to having behaviour change conversations, and explore the ii) effect of HCS training on health professionals’ competence and attitudes to adopting HCS, iii) feasibility, acceptability and appropriateness of using HCS in their clinical and non-clinical roles, and iv) acceptability and quality of HCS training. HCS training was conducted in October-November 2019 and February 2020. Pre-training (T1), post-training (T2) and follow-up (T3; 6-10?weeks post-training) surveys collected data on demographics and changes in competence, confidence, importance and usefulness (10-point Likert scale, where 10?=?highest score) of conducting behaviour change conversations. Validated items assessing barriers to having these conversations were based on eight TDF domains. Post-training acceptability and quality of training was assessed. Data were summarised using descriptive statistics, and differences between TDF domain scores at the specific time points were analysed using Wilcoxon matched-pairs signed-rank tests. Sixty-four participants consented to complete surveys (97% women; 16% identified as Aboriginal), with 37 employed in clinical settings and 27 in non-clinical settings. The training improved scores for the TDF domains of skills (T1: median (interquartile range)?=?4.7(3.3-5.3); T3?=?5.7(5.3-6.0), p??0.01), belief about capabilities (T1?=?4.7(3.3-6.0); T3?=?5.7(5.0-6.0), p??0.01), and goals (T1?=?4.3(3.7-5.0); T3?=?4.7(4.3-5.3), p??0.01) at follow-up. Competence in using ‘open discovery questions’ increased post-training (T1?=?25% of responses; T2?=?96% of responses; T3?=?87% of responses, p??0.001), as did participants’ confidence for having behaviour change conversations (T1?=?6.0(4.7-7.6); T2?=?8.1(7.1-8.8), p??0.001), including an increased confidence in having behaviour change conversations with Aboriginal clients (T1?=?5.0(2.7-6.3); T2?=?7.6(6.4-8.3), p??0.001). Provision of additional support strategies to address intentions; memory, attention and decision processes; and behavioural regulation may enhance adoption and maintenance of HCS in routine practice. Wider implementation of HCS training could be an effective strategy to building capacity and support health professionals to use a person-centred, opportunistic approach to health behaviour change.
机译：传统上在医疗保健咨询中提供建议和指导，通过提供建议和指导来改变人们的行为通常是无效的。健康的谈话技能（HCS）培训提高了卫生专业人员的沟通技巧和能力，赋予卫生行为的人们的变化。由理论域名框架（TDF）为指导，这是研究？研究HCS对临床和非临床环境中的行为改变对话的影响对健康专业障碍的影响。次要目标是i）确定卫生专业人员对具有行为变化对话的障碍，并探索HCS对卫生专业人员培训和态度采用HCS，III）在其临床中使用HCS的可行性，可接受性和适当性的影响的II）效应和非临床角色，和IV）可接受性和HCS培训的质量。 HCS培训于2019年10月至2019年11月和2月20日进行。预培训（T1），培训后（T2）和随访（T3; 6-10次？训练后6-10周）调查收集了人口统计数据的数据和变化能力，信心，重要性和有用性（10点李克特量表，其中10个？=？最高分）进行行为改变对话。评估具有这些对话的障碍的验证项目基于八个TDF域。培训后可接受性和培训质量得到评估。使用描述性统计来概述数据，使用Wilcoxon匹配对签名 - 等级测试分析了特定时间点的TDF域分数之间的差异。六十四名参与者同意完成调查（97％妇女; 16％鉴定为土着），37名在临床环境中使用，27例在非临床环境中。培训改进了技能TDF领域的分数（T1：中位数（四分位数范围）？=？4.7（3.3-5.3）; t3？=？5.7（5.3-6.0），p？＆？0.01），关于能力的信念（T1？= 4.7（3.3-6.0）; t3？=？5.7（5.0-6.0），p？0.01）和目标（t1？=？4.3（3.7-5.0）; t3？=？4.7 （4.3-5.3），p？＆lt ;? 0.01）在随访时。使用“开放发现问题”的能力增加训练后（T1？=？25％的回应; T2？= 96％的回应; T3？=？87％的回应，P？＆ <0.001），如下参与者对具有行为改变对话的信心（t1？=？6.0（4.7-7.6）; t2？=？8.1（7.1-8.8），p？＆ 0.001），包括增加行为与原住民的行为交谈增加的信心客户（T1？=？5.0（2.7-6.3）; t2？=α= 7.6（6.4-8.3），p？0.001）。提供额外的支持策略来解决意图;记忆，关注和决策过程;行为调节可以增强常规实践中HCS的采用和维护。更广泛实施HCS培训可能是建立能力和支持卫生专业人员使用以人为本的机会的健康行为变革的能力和支持卫生专业人员的有效策略。

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