Behaviour change and lifestyle pathway

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Information about Behaviour change and lifestyle pathway
Health & Medicine

Published on February 22, 2014

Author: jamesgmcmanus



A behaviour change and lifestyle pathway for discussion with agencies and stakeholders in b

Discussion draft for Hertfordshire Health Behaviour Change Care Pathway (Version 2.0, February 2013) The evidence base for changing health behaviour is developing quickly. Brief interventions in primary care (by practice nurses and GPs) can motivate people to change, providing referral onwards is speedy. This pathway seeks to join this up with community interventions people can be signposted into, and support primary and secondary prevention 1st Line – Brief Intervention 2nd Line – Behaviour Change Opportunistic brief advice by GP, pharmacist or practice nurse Discuss primary or main goal then refer appropriately 1. Identify health issue of concern (and follow appropriate pathway for that, e.g. obesity) 2. Assess motivation to change 3. If motivated, refer on 4. If not motivated,     Raise awareness of risks. Offer written information on healthy eating and physical activity. Raise again in 3 months. Offer information prescription Smoking is primary, main or only goal Refer to smoking cessation service Weight loss, healthy living or CVD risk is main or primary goal Refer to ifestyle Service 3rd Line - Activity 4th Line – Specialist If fall into 1st or subsequent line category of advice within Obesity Care Pathway refer to Healthy Adults Programme, provided there are no contraindications and if co-morbidities or person has BMI over 30, GP has assessed and supports referral. For patients with comorbidites Patients who are diabetic or have coronary heart disease or a history of heart problems must have referral from appropriate primary care team or secondary care to participate in programme. Behaviour change programme to be developed in partnership with specialist services Patients with highly complex psychological or emotional issues (e.g. depression or eating disorder.) If not already in contact with such services, refer to psychology or primary care mental health team If referral has come from such a service, Health Trainer to agree programme in consultation with that service.

Schematic of Behaviour Change/Health Trainer Support Source or referral to health support front line (e.g. health trainer/leisure service/health advocate) 1 Initial Contact with front line 2 Assessment – Goal Setting Primary Goal Agree communication with GP/Referrer and how often 3 Enabling the client Arrange referral Facilitate attendance Signposting / Providing information Work with Client HT activity Boosting Motivation Confidence Building Addressing Ambivalence Barriers Problem Solving Goal Setting “Secondary Goal” Specialist Service 4 5 Sustaining Change Encouragement, Understanding and Support Review against Primary Goal 6 1. 2. 3. 4. 5. 6. Sources of referral need to be identified Location of contact needs to be agreed Assessment forms and questionnaires to be completed Referrals to and from specialist services need to be in place HTs must record their work with clients using data capture system Progress reviews need to be supported by a practice supervisor and „time-bound‟ Hertfordshire Behaviour Change Pathwa

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