Manchester Centre for Health Psychology, Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Coupland 1 Building-Room G3, Oxford Road, Manchester, M13 9PL, UK.
Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, M13 9PL, Manchester, UK.
Prev Sci. 2020 Apr;21(3):319-331. doi: 10.1007/s11121-020-01087-6.
Opportunities for healthcare professionals to deliver health behavior change interventions are often missed, but understanding the barriers and enablers to this activity is limited by a focus on defined specialisms/health conditions. This systematic review of systematic reviews collates all the evidence across professional groups to provide guidance to policy makers for implementing healthcare professional delivery of behavior change interventions. Eight electronic databases were searched for systematic reviews reporting patient-facing healthcare professionals' (e.g., general practitioners, nurses) barriers and enablers to delivering behavior change interventions (diet, physical activity, alcohol reduction, smoking cessation, and weight management). A narrative synthesis was conducted. Thirty-six systematic reviews were included. Four themes emerged as both barriers and enablers: (1) perceptions of the knowledge or skills needed to support behavior change with patients, (2) perceptions of the healthcare professional role, (3) beliefs about resources and support needed, and (4) healthcare professionals' own health behavior. There were four cross-disciplinary barriers: (1) perceived lack of time, (2) perceived lack of prioritization of health behavior change, (3) negative attitudes towards patients and perceptions of patient risk, and (4) perceptions of patient motivation. The three enablers were as follows: (1) training, (2) context, and (3) attitudes towards delivering interventions. To enhance healthcare professionals' delivery of behavior change interventions, policy makers should (a) address perceptions about patient need for interventions, (b) support diverse professional groups to identify opportunities to deliver interventions, and (c) encourage professionals to focus on prevention and management of health conditions.
医疗保健专业人员提供健康行为改变干预措施的机会经常被错过，但由于专注于特定专业/健康状况，理解这一活动的障碍和促进因素的程度有限。本系统综述对系统综述进行了综合，汇集了所有专业群体的证据，为政策制定者实施医疗保健专业人员提供行为改变干预措施提供了指导。八个电子数据库被搜索了报告面向患者的医疗保健专业人员（例如，全科医生，护士）在提供行为改变干预措施（饮食，体育活动，减少饮酒，戒烟和体重管理）方面的障碍和促进因素的系统评价。进行了叙述性综合。共纳入 36 项系统评价。出现了四个主题，既是障碍也是促进因素：（1）对支持患者进行行为改变所需的知识或技能的看法，（2）对医疗保健专业人员角色的看法，（3）对所需资源和支持的看法，以及（4）医疗保健专业人员自己的健康行为。存在四个跨学科障碍：（1）缺乏时间的感觉，（2）缺乏对行为改变的优先考虑，（3）对患者的消极态度以及对患者风险的看法，以及（4）对患者动机的看法。有三个促进因素：（1）培训，（2）背景，以及（3）提供干预措施的态度。为了增强医疗保健专业人员提供行为改变干预措施的能力，政策制定者应（a）解决对干预措施的患者需求的看法，（b）支持不同的专业群体识别提供干预措施的机会，以及（c）鼓励专业人员专注于预防和管理健康状况。
