Influences on NHS Health Check behaviours: a systematic review [post]

2020 unpublished
National Health Checks were introduced in the English National Health Service (NHS) in 2009 to reduce cardiovascular disease (CVD) risks and events. Following Public Health England's (PHE's) 2017 Digital review, NHS Health Checks were identified as a Digital Exemplar for PHE forming part of the Predictive Prevention programme, setting out the government's vision for putting prevention at the heart of the nation's health. This study applied behavioural science frameworks to: i) identify
more » ... ) identify behaviours and actors relevant to uptake, delivery and follow up of NHS Health Checks and influences on these behaviours and; ii) signpost to example intervention content, with a focus on digital intervention development. Methods A systematic review of studies reporting NHS Health Check-related behaviours of patients, health care professionals (HCPs) and commissioners. Influences on behaviours were coded using theory-based models: COM-B and Theoretical Domains Framework (TDF). Potential intervention types and behaviour change techniques (BCTs) were suggested to target key influences. Results We identified 37 studies reporting nine behaviours and influences for eight of these. The most frequently identified influences were physical opportunity including HCPs having space and time to deliver NHS Health Checks and patients having money to adhere to recommendations to change diet and physical activity. Other key influences were motivational, such as beliefs about consequences about the value of NHS Health Checks and behaviour change, and social, such as influences of others on behaviour change. The following techniques are suggested for websites or smartphone apps: Adding objects to the environment, e.g. provide HCPs with electronic schedules to guide timely delivery of Health Checks to target physical opportunity, Social support (unspecified) , e.g. include text suggesting patients to ask a colleague to agree in advance to join them in taking the 'healthy option' lunch at work; Information about health consequences , e.g. quotes and/or videos from patients talking about the health benefits of changes they have made. Conclusions Through the application of behavioural science we identified key behaviours and their influences which informed recommendations for digital intervention content. To ascertain the extent to which this reflects existing interventions we recommend a review of relevant evidence. Background Opportunity and Motivation needed to perform a Behaviour (Fig. 1) . The TDF is an integrative framework synthesising key theoretical constructs used in relevant theories and was developed in a collaboration between psychologists and implementation researchers. The framework consists of 14 domains:
doi:10.21203/rs.3.rs-16576/v1 fatcat:skzfkc4pl5czdaff5n7saaliby