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By the end of the session: You should be able to: apply Make Every Contact Count within your role ask people about their lifestyle choices advise people.

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Presentation on theme: "By the end of the session: You should be able to: apply Make Every Contact Count within your role ask people about their lifestyle choices advise people."— Presentation transcript:


2 By the end of the session: You should be able to: apply Make Every Contact Count within your role ask people about their lifestyle choices advise people of facts and tips to help change unhealthy lifestyle behaviours be confident to deliver Brief Advice (and Brief Interventions) refer people to appropriate help and support record your contacts know where to go for more information

3 Making Every Contact Count Making Every Contact Count focuses on short, one-to-one opportunities with service users to advise and signpost to healthy lifestyle information on: stopping smoking drinking alcohol within recommended limits eating a healthy diet taking regular physical activity maintaining a healthy weight mental health and wellbeing

4 MECC approach MECC is about encouraging people to make healthier choices to achieve positive long-term behaviour change for better health and wellbeing among patients / service users and staff themselves MECC involves: Systematically promoting the benefits of healthy living across the organisation Asking an individual about their lifestyle and if they want to make a change Responding appropriately to the lifestyle issue/s once raised Taking the appropriate action to either give information, signpost or refer service users to the support they need

5 MECC pathway

6 An example of MECC Impact In East Midlands 288,000 staff Millions of patient contacts a year If staff MECC with just ten people Less than one hour a year for each staff member = 2.88 million opportunities to influence behaviour change.

7 Cost basis There are more than 5,500 alcohol related hospital admissions and more than 2,000 alcohol related recorded crimes a year in Bedfordshire. Research has shown that identifying hazardous drinkers and giving them brief advice can reduce alcohol consumption on average by a quarter. We want to encourage people to make healthier lifestyle choices in areas such as smoking, alcohol, diet and physical activity…Improved health and better health outcomes across all of these areas gives us an opportunity to make savings up to £1.9 million over the next four years.

8 Health profile Bedford

9 Health profile Luton

10 Health profile Central Beds

11 What makes you who you are? Education Culture Where you live Place of birth Community Family Religion Income Interests and hobbies Work Transport

12 Quiz ?????? ??????

13 Smoking FACT: Stopping smoking is the single biggest thing you can do to improve your health. TIPS: You are up to 4 times more likely to quit with the support of NHS Stop Smoking services and medication compared with going it alone.

14 Smoking in pregnancy FACT: Increased risk of miscarriage and stillbirth Increased chance of pre-term birth (premature babies) and low-birth weight TIPS: Even if the pregnant woman / new mother does not smoke, there may be partners or others in the household who smoke? Second-hand smoke can still damage an unborn baby or a new born baby.

15 NHS Stop Smoking services Smokefree Bedfordshire 0800 013 0553 Smokefree Luton 0800 013 0845 What do you think about stopping smoking?

16 Alcohol FACT: Men should not drink more than 3-4 units per day (1 pint of strong 5% beer or cider). Women should not drink more than 2-3 units per day (1 standard 175ml 12% glass of wine.) You should have at least 2 alcohol free days a week. TIPS: Find out how many units are in your favourite drink. Have drinks with mixers.

17 Alcohol units

18 Impacts on health:

19 Alcohol CALS (Community Alcohol Liaison Service) - Beds 07729 542381 or 07858 083944 JKP - Luton 01582 723434 Drinkline – national helpline 0800 917 8282 Can you tell me about how much alcohol you drink each week?

20 Healthy Eating FACT: You should aim to eat at least 5 portions of varied fruit and vegetables a day and cut back on sugar, salt and fat. Check the label and swap higher levels for lower ones ‘Swap it don’t Stop it’. TIPS: Aim for one third of the food you eat to be starchy foods like potatoes, cereal, pasta, rice and bread. Your 5-a-day can include unsweetened fruit juice for one portion, and try adding a handful of fresh, frozen or tinned veg into meals like pasta sauces.

21 Healthy Eating change4life 0300 123 4567 Weight Loss The only way to lose weight healthily, and keep it off, is to reduce your calorie intake and increase your physical activity. For more help ask your GP or Practice Nurse. How do you feel about healthy eating and your diet?

22 FACT: Adults should do at least 30 minutes of moderate physical activity 5 times a week (150 minutes per week). Children should do 60 minutes of moderate physical activity every day. TIPS: Moderate activity is where you raise your heart rate, get warm or break a sweat on a warm day Each 10 minutes counts towards your daily target. Physical Activity

23 If you have not undertaken recent physical activity, it is best to start gradually. If in doubt, check with your GP. Children: community is support available through your child’s school and your local council community physical activity department. Adults: Activity for health 12 week activity referral programme. Ask your GP or Practice Nurse. change4life 0300 123 4567 What physical activities do you do each day that raise your heart rate?

24 Mental Health FACT: 1 in 4 people experience emotional, psychological or mental wellbeing issues at some point in their lives and 1 in 6 adults experience such problems at any one time which can include stress, anxiety, panic attacks and depression. TIPS: Talking to others, being active, helping others / volunteering, learning something new and appreciating the things around you can lead to better mental wellbeing. If you are worried that someone is a danger to themselves or at risk then follow safeguarding procedures.

25 Mental Health Speak to your GP to discuss any issues, who can recommend appropriate help and support. Mind the national mental health charity, can provide practical advice and links to local services 0300 123 3393 How do you feel about your mood day to day?

26 Free NHS Health Checks If any service users are aged between 40-74 years old they may be eligible for a free NHS Health check to screen for heart disease, stroke, diabetes or kidney disease risk, if they do not already have a diagnosis. Please ask them to request one from their GP.

27 Activity in pairs – What does MECC mean to me? What does Making Every Contact Count mean to you in your role or at home? How can you use it in your everyday contacts? Do you think you already include MECC in your everyday work or home life, what do you cover? Is there anyone or anywhere else you think you could use it with? What issues particularly affect your user group / family? What might motivate them to make a change? Do you have any concerns?

28 © Health improvement Behavioural Change Educational Approach Social Change

29 © The Behavioural Change approach Aim: to help individuals adopt healthy behaviours Methods used in this approach are targeted at the individual One-to-One e.g. goal setting / action plans Education

30 © Brief Advice – Level 1 BRIEF ADVICE is pro-actively raising awareness of, and assessing a person’s willingness to engage in further discussion about, healthy lifestyle issues. It is usually given opportunistically. It normally takes between 30 seconds to 3 minutes ©

31 What to do? Remember: Ask open questions. Advise on how to make changes, ask service user to suggest how they might make changes. Act – help the service user to set their own goals or access further help (signpost). Remember to think about the environment – privacy, comfort

32 Considerations Time - it might only take 30 seconds to ask a question. You need to start from where the service user is, not where you think they are or where they should be. You need to be open minded not critical or judgemental. Brief advice is working with the individual on their health goals. You are not lecturing them or telling them what to do. You are providing simple, clear advice and signposting. You can’t always tell what is going on from outward appearances. You are not expected to be a counsellor.

33 Activity Where do you live? Do you have children? What is your job? Can you tell me about… What do you think about… How do you feel about… What happened next … Why do you think that… So what you’re saying is…

34 Where to start Ask – use open questions “How do you feel about your health and wellbeing today?” “What could you change to make your lifestyle healthier?” “On a scale of 1-10 how important is it for you to make your lifestyle healthier?” (1 being not important at all and 10 being very important) Listen to what the client tells you Reflect back “So what you’re saying is…”, “Can I just check…” Advise – give a fact, tip and know where to signpost to. If they are not interested don’t force the issue – leave the door open.

35 Spiral of Change pre-contemplation contemplation decision action maintenance termination Progression of change contemplation action maintenance lapse/ relaps e

36 Scaling 12345678910 How do you feel about your health and wellbeing? Not good Very good 12345678910 How important is it for you to make a change? Not importantVery important 12345678910 How confident do you feel to make a change? Not confidentVery confident

37 Challenges.... If the service user is: Not interested – leave the door open Aggressive or confrontational Under the influence of drink or drugs Too emotional Too ill or injured Consider privacy – if the client is in a busy waiting room they may be unwilling to engage. So think about when and where you raise the issue.

38 Dealing with resistance What if the person doesn’t want to talk? is defensive? is not fluent in English? is tearful? is in a hurry? is not telling you the truth?

39 Time to have a go

40 Activity - Elephants in the room What issues might prevent your trainees from delivering brief advice consider: Being a smoker Having a weight issue Drinking above the recommended limits Being physically unfit Experiencing mental health issues How would you address it?

41 Brief Interventions – Level 2 BRIEF INTERVENTIONS occur when a person responds positively to proactive brief advice or specifically asks for help with a health-related issue. Typically between 10 minutes and 30 minutes and includes: Giving simple opportunistic advice to change Assessing a person’s commitment to change Supplying self-help materials or resources Signpost to specialist support Offering a follow-up appointment if appropriate Recording the outcome of discussion

42 Motivational Interviewing Motivational interviewing is described as a process of exploring a person’s motivation to change through interview in order to assist them towards a state of action. The techniques used are adaptations of counselling skills and particular attention is paid to the listening skills of the interviewer. Motivational interviewing can be understood as an approach which can be adopted for delivering a brief intervention.

43 Pros and Cons Identifying success behaviour: Can you think of a time in the past where you set a goal and achieved it? (it doesn’t have to be health related) What made you successful – what skills and techniques did you use? How can you use these to achieve this new goal? Pros and Cons What are some benefits of changing? Personal, financial… What are some drawbacks of staying the same? What are the benefits of staying the same? What are the drawbacks of changing?

44 SMART Goals If the client wants to work on goal setting, it can be anything from making a phone call for a self-referral to losing weight. You can help them set goals in a structured way to improve their chances of success. Specific Measurable Achievable Relevant Timely What if things go wrong?

45 Time to have a go Think of something you want to change Think of a previous time you achieved a goal, what steps did you take, why was it a success? What are the pros and cons of making a change vs. staying the same? Write down your three main reasons for making a change? Is now a good time to start? Make yourself a SMART goal related to starting to change.

46 Repeat quiz! To see what you’ve learned

47 Summary Brief advice is short, simple and factual. You are raising awareness and motivating people to think about making a change. Ask and Advise – provide facts, tips and where to go for more help. If someone isn’t interested – leave the door open. Brief interventions build on brief advice to help equip service users to take action. Act – Eliciting service user to identify areas for change, their readiness to change, and facilitating them to set their own goals and a means to achieve them. This may include: scaling, SMART goal setting and signposting to further support.

48 We are all different…

49 The 5 groups: Health Conscious Realists Balanced Compensators Live for Today's Hedonistic Immortals Unconfident Fatalists

50 Health Conscious Realists Feel in control of their loves and their health Tend not to take risks and take a longer term view of life The least fatalistic about their health

51 Balanced Compensators Like to look and feel good about themselves A healthy lifestyle is generally easy and enjoyable If they take health risks they will use compensatory mechanisms to make up for this

52 Live for Todays Short term view of life Believe in fate Leading a healthy lifestyle doesn't sound like much fun, and think it would be difficult

53 Hedonistic Immortals Want to get the most from life Don't feel they will get ill anytime soon Intend to live healthily Anything that is enjoyable cant be all bad

54 Unconfident Fatalists Fairly negative about things, and don't feel good about themselves. A healthy lifestyle is not easy nor are they in control They know there health is bad and that they should do something about it but are demotivated.

55 Healthy Foundations55 Healthy Foundations55Healthy Foundations55 High Motivation Low Motivation - ve Environment + ve Environment FightingThriving DisengagedSurviving Segmentation- Cluster Map Balanced Compensators (17%) Health Conscious Realists (21%) Unconfident Fatalists (18%) Hedonistic Immortals (19%) Live for Today (25%)

56 East of England

57 Activity Make your own presentation from slides based on your trainee group

58 Recording contacts Tell us who you’ve trained Submit a monthly form

59 Using MECC could… Result in someone being grateful you took the time to take an interest Help someone to make links between their lifestyle and realising other life ambitions Make someone feel able to take control of their health Mean that someone could live a longer and healthier life as a result of what you did

60 Questions? ?????? ??????

61 We can’t do it without you Start Making Every Contact Count today. Further training: There are options to take the training further such as Alcohol IBA training, Smoking Brief Advice and stop smoking service level 2 training. On-going support: If you have any questions that arise following today’s training or want to feedback thoughts or experiences please contact me by calling 01234 276875 or emailing

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