• Put patients at ease by letting them know you’re having lifestyle conversations with all your patients.

• Gently gauge your patient’s interest in having the conversation to assess if they are ready for change.

• Focus on the positives from the patient’s point of view to foster a constructive, two-way conversation.

• If patients are not interested, invite them to make a follow-up appointment when they are ready to chat.

BMC Family Practice

Insights

• Be mindful of linking patient’s current health concern with their health behaviour, it may make them resistant.

• Build well received, collaborative conversations by inviting patient’s views using a question and answer format.

Albury C, Hall A, Syed A, Ziebland S, Stokoe E, Roberts N, Webb H, & Aveyard P (2019). Communication practices for delivering health behaviour change conversations in primary care: a systematic review and thematic synthesis. BMC Family Practice, 20: 111. Link to journal article

When patients feel they have been listened to with empathy, they are more receptive to nutrition recommendations.

• Encourage patients by letting them know that any positive changes to diet will help, no matter how small.

• Make change more achievable by reiterating the importance of starting small and working up to bigger goals.

• Make patients open to change by letting them know that even a small change to their diet can improve their health.

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Identify your patient’s barriers and enablers to a better diet within their social and physical environments, to support a conversation about potential strategies and improve their potential for success.

Potential barriers to an improved diet might include:

• Limited time, fatigue, family obligations or other competing priorities

• Limited access to fresh fruit, vegetables and good quality produce

• Cultural traditions that affect the types of foods consumed

Potential enablers of an improved diet include:

• Simple and easy to use self-tracking tools like Healthy Habits to foster motivation

• Supportive friends and family to help with food purchase, preparation and consumption

• Virtual support groups to challenge, motivate and encourage adherence to goals

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• Make change more achievable by reiterating the importance of starting small and working up to bigger goals.

• Encourage patients that any positive changes to their diet and nutrition they make will help, no matter how small.

• Motivate patients by letting them know that even a modest weight loss of just 5-10% can have a positive impact on health, even if they remain overweight.

• Patients may have unrealistic expectations about how much they need to change their diet. Reassure them by letting them know that even small changes can improve their health.

Journal of Human Hypertension

Insight

• Meta-analysis demonstrates that a modest reduction in salt intake has a significant effect on blood pressure in both hypertensive and normotensive individuals.

He F, MacGregor GA (2002). Effect of modest salt reduction on blood pressure: a meta-analysis of randomized trials. Implications for public health. Journal of Human Hypertension 16, 761–770. Link to journal article

• Get an idea of your patient’s current diet and suggest some small changes.

• Know your patient’s motivations, and work together to set achievable goals. Do they want to get physically stronger? Feel less fatigued? Lose weight?

The Healthy Habits app is a simple and easy way to get your patients started

• It guides patients to set small, achievable physical activity and nutrition goals

• Your patient can choose their own goals and increase their goals over time

• The app gives your patients simple tips and tricks to help them stay on track

The Healthy Habits app allows patients to link their data to your dashboard

• You will be able to see how your patients have been tracking

• Discuss behaviours and revise goals at their next appointment

American Journal of Clinical Nutrition

Insight

• Research shows that eating more fruit and vegetables reduces the risks associated with stroke incidence, stroke mortality, ischemic heart disease mortality, cardiovascular disease mortality, and all-cause mortality.

Bazzano LA, He J, Ogden LG, Loria CM, Vupputuri S, Myers L, & Whelton K (2002). Fruit and vegetable intake and risk of cardiovascular disease in US adults: the first National health and nutrition examination survey epidemiologic follow-up study. American Journal of Clinical Nutrition, 76: 93-99. Link to journal article

Annals of Family Medicine

Insight

Clinicians reported using 5 key strategies to support patient behaviour change.

1. Emphasising and encouraging patient ownership

2. Partnering with patients to identify small steps

3. Frequent follow-up visits to cheer successes

4. Listening and problem solving together

5. Showing caring and concern for patients

Greene J, Hibbard JH, Alvarez C, & Overton V (2016). Supporting patient behaviour change: approaches used by primary care clinicians whose patients have an increase in activation levels. Annals of Family Medicine, 14(2), 148-154. Link to journal article

Frontiers in Public Health

Insight

• Self-tracking apps, which track activities like exercise, eating and heart rate, help users to better understand their health and make improvements in their behaviours.

Sullivan AN and Lachman ME (2017). Behaviour change with fitness technology in sedentary adults: a review of the evidence for increasing physical activity. Frontiers in Public Health 4:289. Link to journal article