The recent HPPHN Integrating Health Psychology with Health Education and Training event took place on the 21st September 2017 in Bedford at the University of Bedfordshire. The event, chaired by Dr Angel Chater, featured a number of thought-provoking talks and interactive workshop sessions from inspirational speakers including specialists in health psychology and public health. As part of the conference lunch, all attendees were invited for a group guided networking walk around the state-of-the-art teaching and research sport sciences laboratory facility, of the University’s School of Sport Science and Physical Activity.
Proceedings started with a welcome and introduction from the Chair of the HPPHN Committee, Dr Angel Chater who is Reader in health psychology and behaviour change at the University of Bedfordshire. The first speakers of the day were health psychologists Dr Jo Hart and Dr Lucie Byrne Davis from the University of Manchester, who delivered the first session as an interactive workshop. The central theme prevailing was the importance of systematically integrating behaviour change theory in healthcare, including medical education and training in order to improve health professionals’ effectiveness in achieving behaviour change. Feedback from the audience on the different purposes of training and what it is trying to change led to a lively discussion on the purpose and overlap between education, training and mentorship. Competence was considered important but not sufficient to change practice; opportunity and motivation were identified as two key active ingredients.
Dr Vivien Swanson, Reader in health psychology at the University of Stirling, presented a roadmap of the Scottish experience of training and education in health psychology. She provided a background setting to some of the key public health challenges that Scotland currently faces and described a number of behaviour change interventions that have or are being developed as part of students’ Stage II training in a variety of public health settings.
Dr Vicky Lawson discussed the opportunities and challenges of integrating approaches to mental and physical health in her dual role as a health psychologist and Public Health England Clinical Champion on Physical Activity. She spoke of the complexity of goal setting with patients who may not be ready to modify their behaviour and hence present a risk of disengaging. She gave examples of her work with GPs and practice nurses, which aimed at integrating physical health behaviour change to help patients with several long-term conditions to improve their self-management skills. Similarly, Alison Trout, senior public health specialist at Solihull County Council, spoke about embedding behaviour change training in public health initiatives and discussed the varying levels of patient activation. Using examples, she illustrated the three summary levels of the behaviour change competency framework, which describes the readiness of patients with a long-term condition to engage in self-management.
The event was concluded with a stimulating interactive workshop led by Dr Angel Chater who spoke of changing behaviour in the real world, using motivational interviewing as an effective conversation approach. Her session included a role play exercise of a client and health professional discussing a real-life health goal during a consultation. This was followed by a feedback session with the audience on some of the reasons which (de)motivate people from engaging with behaviour change and the challenges and skills required to conduct effective consultations. The role play was then repeated, applying the skills of motivational interviewing to support engagement with behaviour. Throughout the day, presentations from experts working in a variety of clinical, policy and academic research settings highlighted some of the challenges of changing behaviour. Speakers emphasized the importance of embedding health psychology, such as the BCT taxonomy, in health education, training and public health initiatives to promote healthier lifestyles. Integrating behaviour change in a systematic way across training and education can be an effective intervention to improve patient outcomes.
The content of the talks from today’s event can be applied to a number of contexts for both training and practice. As health psychologists Dr Jo Hart and Dr Lucie Byrne Davis illustrated during their workshop, theoretical models of behaviour change are being integrated into medical curricula. Behavioural science would benefit other health and social care, public health programmes and allied health curricula. One illustration of future training would be to integrate theoretically-underpinned smoking cessation training in the midwifery curriculum, or to promote healthy lifestyles within care home managers’ or firefighters’ training programme. In terms of future practice, one application would be to integrate a theoretical approach to goal setting such as motivational interviewing in a primary care setting. Notwithstanding the challenges of time constraints in this particular setting, a theoretically-underpinned approach to goal setting would help to reduce the risk of practice nurses and general practitioners disengaging their patient when trying to change a particular health behaviour.
Frederique Lamontagne-Godwin, PhD student - Allied Health Scholarship