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Objective: High quality obstetric anaesthetic care is integral to reducing preventable maternal deaths in Low-and-Middle-Income-Countries (LMICs). We applied behavioural science to evaluate SAFE Obstetrics, a 3-day Continuing Professional Development (CPD) course, on physician and non-physician anaesthetists' practice behaviours across 3 LMICs.Methods: Seven anaesthetist Fellows from Bangladesh, Nepal and Tanzania were trained in qualitative methods and behavioural science. Structured interviews were undertaken by Fellows and two UK behavioural scientists with course participants. Interviews were based on the Theoretical Domains Framework: a comprehensive framework of influences on behaviour change. Interviews were recorded, transcribed and analysed using content and thematic analysis.Results: 78 physician and non-physician anaesthetists participated (n = 26 Bangladesh, n = 24 Nepal and n = 28 Tanzania). Participants reported positive improvements in patient-centered working, safety, teamwork and confidence. Across countries, we found similar barriers and facilitators: environmental resources, a strong professional identity and positive social influences were key facilitators of change.Conclusion: This multi-country theory-based evaluation highlighted the impact of SAFE Obstetrics on participants' clinical practice. A supportive work environment was crucial for implementing learning following training; CPD courses in LMICs must furnish participants with skills and equipment to address training implementation challenges. Building local behavioural science capacity can strengthen LMIC health intervention evaluations. [ABSTRACT FROM AUTHOR]

Background Scalable, positive, behaviourally informed interventions may help people remember to attend their primary care appointment or cancel in good time, but have not yet been implemented long term. Aim To examine effects of social norms and making active commitments on missed and cancelled appointments in primary care over 12 months and explore implementation factors. Design and setting A mixed-methods design evaluation and implementation study led by a Patient Participation Group (PPG) member in a large GP practice in the West Midlands. Methods Following a 6-month baseline, waiting room notices were redesigned to emphasise positive social norms for desired behaviours. When booking appointments, receptionists were trained to invite patients to (i) verbally actively commit to cancelling if needed; (ii) write down their own appointment details. Monthly missed appointments (MAs) and cancellations were statistically compared with baseline averages and seasonally equivalent months. To explore implementation, reception staff completed a knowledge, attitude, and behaviour questionnaire at 9 months, analysed descriptively. Study team field notes were thematically analysed. Results Across 12 intervention months there was a mean of 37.67 fewer MAs per month (20% reduction) and 102.66 more cancellations (21.07% increase) compared with 6-month baseline means [MAs t (11) = −6.15, P < 0.001; cancellations t (11) = 3.637, P = 0.004] with statistically significant differences in seasonally equivalent months [MAs t (5) = −4.65, P = 0.006; cancellations t (5) = 3.263, P = 0.022]. Receptionists (n = 12) reported implementing the strategies except when facing pressures; knowledge and attitudes varied. Conclusions Behaviourally informed interventions reduced primary care MAs longer term; PPGs and practice teams can work together on quality improvement projects with support from leaders to prioritise and embed new practices. [ABSTRACT FROM AUTHOR]

Objectives: To investigate the general public's source credibility attitudes towards health and social care professionals when giving advice associated with their 'traditional role' versus an 'expanded health behaviour change' role, to facilitate the implementation of the health behaviour change agenda. Design: A 3x3 experimental between‐subjects vignette questionnaire study with nine scenarios in which a general practitioner (GP), health visitor, or firefighter offered advice on either stopping smoking, preventing cot death, or fire safety. Combinations were either congruent with a traditional role (e.g., health visitor and cot death) or an expanded role (e.g., firefighter and stopping smoking). Methods: Adults were recruited from metropolitan locations in northern England. Participants were randomized to one scenario and complete a validated 18‐item source credibility questionnaire. Factor analysis explored source credibility components; ratings for traditional and expanded role scenarios were compared using Mann–Whitney tests. Results: 369 participants completed the questionnaire (49.3% women, 64% White British, age range: 16–83). Factor analysis confirmed three source credibility dimensions: competence, caring, and trustworthiness. Ratings were generally high across professions and scenarios; participants rated professionals as significantly more 'competent' where scenarios related to their traditional roles than expanded roles (U 9778.5, p <.001) but equally as caring (U = 14467.5, p<.485) and trustworthy (U 14250.5, p.348). Conclusions: GPs, health visitors, and firefighters were all perceived as credible sources of health behaviour change advice, but may be viewed as 'less competent' sources of messages associated with an expanded job role. Effective professional training and public engagement regarding the role expansion agenda are needed to support policy implementation. Statement of ContributionWhat is already known on this subject?Source credibility surrounds people's perceptions of the source of advice and includes competence, caring, and trustworthiness dimensions.This may have an important influence on people's attitudes and behaviour, especially when messages are complex or emotive.A wide range of public sector workers is now expected to routinely offer preventive health and safety advice, as part of role expansion.What does this study add?This experimental survey study compared source credibility perceptions of GPs, health visitors, and firefighters giving advice on topics associated with a traditional or expanded role.Professionals were perceived as less 'competent' when giving advice on 'expanded role' topics, such as a firefighter discussing smoking, with a small reduction in source credibility.This highlights that source credibility may be specific to professional identities.Policymakers may need to explore this further as part of implementing role expansion for prevention and self‐management in health and social care. [ABSTRACT FROM AUTHOR]

Community health and social care practitioners play an increasingly important role in the health promotion agenda, but lack confidence in having effective health behaviour change (HBC) conversations with members of the public. This study reports the development and evaluation of a training intervention based on health psychology to improve health and social care practitioner self‐rated confidence, competence and intention to use five behaviour change techniques (BCTs) in their HBC conversations. A 2‐day behavioural science interprofessional skills training course plus online learning module was designed for health and social care staff across North East Scotland, teaching five evidence‐based BCTs (e.g. Action Planning), plus person‐centred communication skills. Participants rated confidence, competence and future intention to use the BCTs on likert scales (1–10) pre‐course and post‐course, and provided acceptability data. 177 participants aged 20–64 took part, qualitative and quantitative data suggested that the course had high acceptability. Paired samples t tests (n = 120 with complete data) showed significant improvements in confidence, competence and intention following the course, which remained significant with a conservative analysis (n = 174) assuming no change for missing data. Perceived competence in Action Planning increased most during the course (mean change 3.09). In conclusion, health psychology‐based skills training can improve practitioner confidence, competence and intention to use evidence‐based BCTs; further evaluation is needed to assess practice change. [ABSTRACT FROM AUTHOR]

Health psychology is at the forefront of developing and disseminating evidence, theories, and methods that have improved the understanding of health behaviour change. However, current dissemination approaches may be insufficient for promoting broader application and impact of this evidence to benefit the health of patients and the public. Nevertheless, behaviour change theory/methods typically directed towards health behaviours are now used in implementation science to understand and support behaviour change in individuals at different health system levels whose own behaviour impacts delivering evidence-based health behaviour change interventions. Despite contributing to implementation science, health psychology is perhaps doing less to draw from it. A redoubled focus on implementation science in health psychology could provide novel prospects for enhancing the impact of health behaviour change evidence. We report a Health Psychology Review -specific review-of-reviews of trials of health behaviour change interventions published from inception to April 2020. We identified 34 reviews and assessed whether implementation readiness of behaviour change interventions was discussed. We then narratively review how implementation science has integrated theory/methods from health psychology and related discipline. Finally, we demonstrate how greater synergy between implementation science and health psychology could promote greater follow-through on advances made in the science of health behaviour change.