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

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

2. Developing Sustainable Behaviour Change Training Dr Vivien Swanson, Dr Deirdre Holly NHS Education for Scotland

3. 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…? • ‘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 improvementdesign and effectiveness of 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. Implementation science: Formula for success x • x Effective innovations Effective implementation Enabling contexts = Socially significant outcomes

7. Implementation Stages 2-4 years

8. Exploration Installation Implementation Developing behaviour change training

9. Exploration

10. Exploration: what techniques?

11. Exploration : mapping techniques to competencies

12. Strengthening Collaborative Practice: The MAP of Behaviour Change Behaviour

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

14. Action Planning Motivation Environmental Context Behaviour change techniques Automatic Rational / deliberate behaviours Prompts, Cues Habits Maintenance Behaviour 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 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

20. Implementation

21. Please contact us at: Vivien.swanson@nes.scot.nhs.uk Deirdre.holly@nes.scot.nhs.uk