Changing behaviour usually involves taking a multifaceted approach, using a range of different interventions to target various elements of the environment.
The above is not something based on any quotations, but it is a commonplace of behaviour change. A wide body of evidence highlights the importance of employing a range of approaches to changing the behaviour of clinical staff (1, 2, 3, 4, 5 6, 7, 8, 9).
As such, multifaceted interventions have the benefit of targetting different components of the behavioural change environment as well as supporting different styles of learners (10). Organisational change is crucial to sustain change with greater impact than individualised interventions (11).
It is important to start somewhere and change what you can.
“I think it’s just actually doing it. It’s just having the conversation with all the staff involved. How you’re going to do it, when you’re going to do it, what you’re going to cover. It’s getting everybody to agree on that and, right, let’s trial it for two weeks, three weeks, a month, and see how it goes”. Cardiac Rehab Exercise Physiologist
Even small successes can help to motivate people to do more.
‘We enjoy seeing the progress that we can make with people. And I find this an outstanding thing. I never thought it would evolve as it has done. And it gives me such a buzz.’ Staff Nurse
- Warriner, H. P. (1976) ‘Let ’ s Get Moving Again *’, pp. 293–297.
2 Chatterjee, R. et al. (2017) ‘GPs’ knowledge, use, and confidence in national physical activity and health guidelines and tools: a questionnaire-based survey of general practice in England’, British Journal of General Practice, 67(663), pp. e668–e675. doi: 10.3399/bjgp17X692513.
3. Douglas, F., Torrance, N., et al. (2006b) ‘Primary care staff’s views and experiences related to routinely advising patients about physical activity. A questionnaire survey.’, BMC public health, 6(1), p. 138. doi: 10.1186/1471-2458-6-138.
4.Robertson, R. and Jochelson, K. (2006) ‘Interventions that change clinician behaviour: Mapping the literature’, King’s Fund, London, (November). Available at: https://www.nice.org.uk/media/default/about/what-we-do/into-practice/support-for-service-improvement-and-audit/kings-fund-literature-review.pdf (Accessed: 30 January 2018).
5.Gagliardi, A. R. et al. (2015) ‘Factors contributing to the effectiveness of physical activity counselling in primary care: a realist systematic review.’, Patient education and counseling. Elsevier, 98(4), pp. 412–9. doi: 10.1016/j.pec.2014.11.020.
6.Grimshaw, J. M. et al. (2012) ‘Knowledge translation of research findings.’, Implementation science : IS, 7, p. 50. doi: 10.1186/1748-5908-7-50.
7.Petzold, A. (2010) ‘Using the knowledge to action process model to incite clinical change’, Journal of Continuing …, 33(3), pp. 167–171. doi: 10.1002/chp.
8.Robertson, R. and Jochelson, K. (2006) ‘Interventions that change clinician behaviour: Mapping the literature’, King’s Fund, London, (November). Available at: https://www.nice.org.uk/media/default/about/what-we-do/into-practice/support-for-service-improvement-and-audit/kings-fund-literature-review.pdf (Accessed: 30 January 2018).
9.Sassen, B., Kok, G. and Vanhees, L. (2011) ‘Predictors of healthcare professionals’ intention and behaviour to encourage physical activity in patients with cardiovascular risk factors.’, BMC public health, 11(1), p. 246. doi: 10.1186/1471-2458-11-246.
10.Knox, E. C. L. et al. (2013) ‘Lack of knowledge of physical activity guidelines: can physical activity promotion campaigns do better?’, BMJ open, 3(12), p. e003633. doi: 10.1136/bmjopen-2013-003633.
11.Knox, E. C. L., Musson, H. and Adams, E. J. (2015) ‘Knowledge of physical activity recommendations in adults employed in England: associations with individual and workplace-related predictors.’, The international journal of behavioral nutrition and physical activity. BioMed Central, 12(1), p. 69. doi: 10.1186/s12966-015-0231-3.
12. Reid H (2018) Moving Medicine: the development of a web-based platform to facilitate good quality conversations on physical activity across clinical practice in the NHS Unpublished Master’s thesis, University of Oxford