Navigating the ‘MAP’ of behaviour change: developing effective training for health professionals working in diabetes

Abstract

Background: Improving self-management and associated health outcomes for people with diabetes is challenging due to the complexity of the condition. Behaviour change training for health professionals has focused on motivation and goal setting, but less on implementing planning and maintenance. We trained diabetes health professionals in action and coping planning techniques, employing reflective and automatic processes to build sustainable change in health outcomes for patients. Method: Competency Frameworks were used to develop and deliver face-to-face training in action planning and prompted/cued techniques to over 150 health practitioners, including GPs, practice nurses, consultants, dieticians and podiatrists working in diabetes care in nine areas in NHS Scotland. Training was over 1.5 days, two weeks apart. Mixed method evaluations included participant satisfaction ratings, and qualitative assessment of goals, action/coping plans post-training and at follow-up. Plans were rated for specificity, prompts, barrier identification and resolution and use of techniques after Reinwand et al, 2016. Findings: Participants rated training highly for enhancing confidence, work-related skills, understanding and applicability to practice. Many plans scored ‘excellent/moderate’ for specificity (47, 47%); prompts for the new behaviour (42, 89%) with most (31, 74%) specifying environmental restructuring prompts. Participants reported difficulty using techniques after session 1 and discussion of barriers to implementation as most helpful in session 2. Discussion: Training was very favourably received. Individuals reported introducing new techniques into their practice at follow-up. Detailed behavioural goals appear to be more difficult to generate than subsequent prompts and cues to action.