IBA for alcohol… and diet…and physical activity…and smoking….and…

19 Jun

I have just had the pleasure of writing and delivering a one-day training course entitled ‘Brief Advice for Health Behaviour Change’ that aimed to enable practitioners to deliver brief interventions using a motivational approach on the four issues of alcohol, smoking, diet and physical activity. The target audience was frontline staff, not just in healthcare (hospital staff and those delivering NHS Health Checks) but also prisons and workplaces. It is not the first time we have written training on IBA for topics other than alcohol (try IBA for alcohol and drugs for youth workers, or for alcohol and sexual risk-taking) but combining four topics into one process for IBA is not easy.

Firstly, there are basic practical difficulties of how you build the knowledge and understanding of practitioners and address any prejudices or myths that may exist about not one but four issues, in a single day. This is by no means easy, but pre-course work helps.

Even more tricky is how to describe and teach the process of ‘IBA’ for such a broad range of ‘lifestyle’ issues.  Finally, the challenge is to design a process that can realistically be implemented in a 10 minute (max) conversation.

While the basic IBA skills remain the same, we designed a completely new framework or IBA process in which to present and teach them. The course included discussion not only of how and when to raise the issue of ‘lifestyle’ generally, but also how to narrow the conversation down to one or two topics which the individual is ready to discuss. We discussed stages of change in terms of just three stages to simplify thinking and decision-making. And the ‘Identification’ or ‘Screening’ process inherent in IBA was simplified to exploring the individual’s current behaviour and comparing it to national guidelines rather than using a formal screening tool.

The pilot went well, and I am confident that the challenges described can be met – but perhaps not for all of the people all of the time!  And one key question remains – are some issues harder to raise than others?  If you try to cover them all together, will practitioners avoid the issue they find most sensitive? And if so, which issue will be left out? In Scotland, I know that when Keep Well practitioners offering cardiovascular check ups (similar to NHS Health Checks in England) were trained on generic health behaviour change approaches, it was found that they avoided alcohol as an issue and separate training specifically on alcohol was provided. Was this a one-off? Or could we expect that diet and weight issues would be just as sensitive?

We will soon be training 18 people to roll out the Brief Advice for Health Behaviour Change course to others via a two-day training for trainers course… watch this space!

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2 Responses to “IBA for alcohol… and diet…and physical activity…and smoking….and…”

  1. Charles Aina June 20, 2012 at 9:42 am #

    Dear Niamh, I would be very intrested in attending the Training the Trainers course, please contact me with details.

    Take care

    Charles

    • Niamh Fitzgerald August 5, 2012 at 10:59 pm #

      The training for trainers course I mentioned was for an individual PCT, however there are a couple of ways you could access the course and training manual yourself:

      • Get together enough folk in your area/region to make it viable to deliver a course locally.
      • Wait until we have enough people interested from all over UK/elsewhere for us to run a course here in Glasgow.

      I’ll email you directly so that you can let me know if either of these options are of interest. You can also directly contact me through http://www.createconsultancy.com/contact.

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