facilitating health behaviour change - arna€¦ · education in cardiac rehabilitation increase...
Post on 20-Jul-2020
1 Views
Preview:
TRANSCRIPT
Facilitating Health
Behaviour Change: the future of group
education
Brendon McDougall
Accredited Exercise Physiologist
Sutherland Heart & Lung Team (SHALT)
South Eastern Sydney Local Health District
Brendon.Mcdougall@sesiahs.health.nsw.gov.au
Education in Cardiac Rehabilitation
Increase knowledge of health condition
Improve awareness, recognition & self-management
ACRA Core Components of CVD Secondary Prevention and CR (2014)1
o “Core component 4: CR services should be tailored to provide education and skill development to motivate and enable patients to self-care and make changes in their lifestyle”
Cardiac rehabilitation for people with heart disease: an overview of Cochrane systematic reviews (2014)2
o “it is recommended that comprehensive cardiac rehabilitation programs also include education and psychological interventions”
o Substantial variation in how education is delivered
o Benefits depend on changing people’s behaviour
1. Woodruffe S, Neubeck L, Clark R, Gray K, Ferry C, Finan J, Sanderson S & Briffa T. Australian Cardiovascular Health and Rehabilitation Association (ACRA) Core
components of cardiovascular disease secondary prevention and cardiac rehabilitation 2014. Heart, Lung and Circulation 2015;24:430-441.
2. Anderson L & Taylor RS. Cardiac rehabilitation for people with heart disease: an overview of Cochrane systematic reviews (Review). Cochrane Database of Systematic
Reviews 2014, Issue 12, Art. No.:CD011273. DOI: 10.1002/14651858.CD011273.pub2.
Group Education
Positives of group education
o Time efficient and cost effective
o Stimulate group discussion
o Various ideas and points of view
o Supported by expert opinion
Negatives of group education
o Some queries and concerns require individual attention
o Can be harder to motivate and enable self-management
o Benefits of education are dependent on changing participants behaviour
How to change behaviour?
My doctor said I have a rare condition called “Good Health”
Reflection On Education
How?
Style of delivery?
Interaction?
Tools and techniques to take action?
Support to take action?
Is there room for improvement?
Is Health Coaching the Answer?
Training HealthChangeTM Methodology by Health Change Australia® (HCA)
HCA approach supported by evidence3
Framework to identify and address barriers to change3
Promotes self management & person centred care3
Successfully implemented in individual assessment and education
Can this approach be implemented into group education?
3. Gale J. A practical guide to health behaviour change using the HCA approach, expanded and updated. Health Change Australia; 2012.
Change towards the future
Review sessions
o Conducted fortnightly to supplement traditional education sessions
o what have participants learnt?
o What do they want to know?
Action plan list
o “Menu of Options” (© 2013, Health Change Australia®)
o List of suggested health behaviour changes
o Participants select 1-3 options for each topic
o Discussion at next “review” education session
Did it work?
Retrospective survey
o Assess impact of review education sessions and action plan list
o 44 surveys mailed to clients who completed the program in 2014
o 31 surveys returned (70% response rate)
Client satisfaction survey
o Assess outcomes of program and evaluate participant satisfaction
o Mailed twice yearly to client’s who completed the program in the prior six months
o Compared survey results from prior to and post change implementation
Results – Retrospective Survey
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Providedadditional benefit
Increasedknowledge
Increasedconfidence
Assisted lifestylechange
Maintainedlifestyle change
94% 94%
90%
77%
86%
Review Education Sessions and Action Plan Lists (n=31)
Results – Behaviour & Lifestyle Changes
Physical activity16%
Diet9%
CCF Management16%
Review with GP13%
Medications12%
Community services7%
Home & personal safety8%
Energy conservation5%
Psychological8%
Advance Care Planning6%
Results – Client Satisfaction Survey
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Improved physicalhealth
Increased healthknowledge &confidence
Confident to discusshealthcare needs
Physically active atend of program
Satisfied witheducation received
62%
75%
88%
94%
81%77%
86%
97% 97%100%
Outcomes & Satisfaction
March 2014 (n=32)
March 2015 (n=35)
Implications for Practice
Where to Next?
The approach can be combined with traditional education sessions and
personalised to the audience
Person-centred care can be achieved in a group setting
Where to next?
o Health coaching training for all staff involved
o Further research – improved methodology and more participants
o Integration with chronic disease services
Thank you
“Review & discussion very helpful”
“Chance to hear about others problems & solutions”
“Made me make a commitment to take positive actions”
“I found the revision most helpful to consolidate what I had learned”
“I have kept up something from all of the fortnightly homework plans”
“At first I didn't want to go but the benefits of going have helped me 100
fold. Plus I have enjoyed it”
Brendon.Mcdougall@sesiahs.health.nsw.gov.au
top related