Many health and social care staff are trained in brief health promotion interventions to ensure people’s lifestyles are assessed in relation to their overall health. Staff evaluations of health promotion training provided at Bolton Foundation Trust showed how it may prompt staff to evaluate their own lifestyles.
This supports NICE guidance on disability, dementia and frailty in later life, where recommendation 13 advises training on brief interventions for all health and social care staff, and that this this training should help participants change their own behaviour to reduce their own health risks if relevant. The recommendation also states that initial training and continuing professional development programmes should be provided for local authority staff, all health and social care professionals and community volunteers on how to reduce the risk factors for dementia, disability and frailty in later life. The guidance states that this training should help participants change their own behaviour to reduce their own health risks if relevant.
Aims and objectives
Our project had several aims:
• To assess any impact of attending training in health promotion and brief advice on health care staff’s evaluation of their own health.
• To capture any evidence of positive outcomes on staff themselves as a result of teaching them about lifestyle brief advice.
• To determine if this evidence can be used to further justify the investment in training on health promotion brief advice other than just equipping them to intervene in patients’ health?
• To determine if this evidence can be used to support any workplace health interventions?
• To determine if we can highlight which areas of lifestyle improvement support could be implemented in the workplace to support improved staff health and wellbeing?
Reasons for implementing your project
At the Royal Bolton Hospital a multi-topic patient health promotion training session was regularly being delivered to staff in order to support the introduction of a health promotion pathway within in an acute setting. It became apparent, from anecdotal feedback and some formal evaluation after the training was complete, that exposure to health promotion related advice, guidance and evidence was prompting staff to assess their own lifestyle health needs. We were keen to measure this impact along with the more routine training session evaluation.
How did you implement the project
The patient assessment aims to cover a variety of current health priorities including: smoking, alcohol use, diet, physical activity, weight management, mental health and sexual health.
As part of the ongoing process of designing and delivering the training and assessment pathway we decided to more robustly measure (though in as simple a way as possible) what, if any impact the training was having on staff lifestyles.
The training session and associated assessment form design needed to have initial and ongoing input from healthcare staff as the design evolved. At the end of each training session, evaluation forms were given to staff attending the training. The forms are to evaluate suitability, acceptability and relevance of the course content and delivery. It was important that they considered the training to be relevant and fit for their needs and created a belief in the usefulness of the lifestyle assessment.
There are questions on the form to assess if the training has made staff consider their own lifestyle; if so in what areas, and if they would like to access any of the support which is locally available support.
Attendees are assured that the answers will be anonymous as no identifiable information is required such as name or department of work. Answers are entered into an excel database for both a record of attendance and to be able to analyse the data.
The initial evaluation was focused on course content and appropriateness. It also measured the number of staff attending the Health Promotion Brief advice training session. To date more than 2000 members of staff have attended.
Questions on the impact on staff health were introduced at a later stage. This evaluation involves 403 staff to date.
Evaluation is done at the end of the training session. Attendees are assured that the evaluations are anonymous to encourage a more honest evaluation both of the training session and of its impact on their own lifestyle habits.
The results can be used help to decide which staff health promotion initiatives to support within theTrust.
The evaluation showed that: (n=403) 75% indicated that they felt they needed to make some changes to their lifestyle and 11% were unsure. Only 14% said they felt no change was necessary.
The main areas for change were identified as: exercise (86%), weight (67%), diet (63%), alcohol (40%), mental health (24%) and smoking (8%).
An article detailing our evaluation was published in Nursing Times.
Key learning points
• Staff training is the key to success of a patient health promotion pathway intervention.
• There is added value to training staff to complete a patient health promotion assessment. Staff are being given information on health improvement on which they base an assessment of their own lifestyle.
• Post training evaluations show that the training makes staff consider lifestyle changes themselves. In essence the training makes them more aware of their own health needs.
• Consider a method of measuring the longer term outcomes. What lifestyle change did staff make?
• One of the main barriers is the availability of staff to attend the training. It isn’t mandatory to attend these sessions and complete patient assessments, so we may need to offer extra incentives to staff.
• Consider what can be introduced into the workplace to help staff be healthier? Improved food environments, especially snack food. Measured walk routes through the grounds or adjoining roads and paths, mental wellbeing sessions, adopting a cycle purchase scheme etc.
• As most NHS trusts are keen to see their staff improve their health, this is an effective way of getting health improvement information and advice across to staff without it being specifically aimed at them. This adds to the case to train staff to intervene with patients to make every contact count.
• Keep the training in-house if you can. External trainers tend to be only available varying time-limited periods as funding is identified and offered. Training in health promotion needs to be a constant offer.