Block 2: Week 4- Making Every Contact Count

Question 1

LO: Understand the importance of the Making Every Contact Count initiative

MECC:

What is MECC?

Answer 1

Brief intervention = chat for change, encourage people to make healthier choices. A short conversation that may put someone on the 1st step to better health and wellbeing.

Dr will:

Encouraging people to make healthier choices for better health:

• 1) systematically promoting** *the benefits of healthy living
• 2) Asking individuals about their lifestyle,** *responding appropriately
• *3) taking appropriate action- give info, signpost, or refer to support service**

Question 2

LO: Understand the importance of the Making Every Contact Count initiative

MECC:

What is the philosophy

Answer 2

Philosophy: Support individuals to make positive changes to physical + MH + wellbeing . Opportunistic delivery of consistent + concise healthy lifestyle information that enables individuals to engage in conversations about their health.

Question 3

LO: Understand important of MECC:

What is the case for MECC? (Drs perspective)

Answer 3

Duty of care:

• NHS has a responsibilty to protect + improve health and wellbeing of staff/ service users
• prevents poor health, promotes healthy living which is essential to reduce health inequalities
• Most serious illnesses perpetuated by unhealthy lifestyles
• adopting healthier lifestyle can have huge positive effect on health
• brief advice/ intervention can be trigger to change.
• Cost benefit
• See improved and quicker outcome from treatment
• knowing you are making a difference to patient’s lifestyles

Question 4

Case for MECC: Patients perspective

Answer 4

• Most people want ot be healthy and improve own health (70% smokers want to quit)
• research finds patients welcome opportunity to talk about lifestyle issues but dont start conversation themselves

Question 5

LO: List the elements of lifestyle and behavioural choices important in the manifestation of common and important diseases

Lifestyle Issues covered by MECC?

Answer 5

1. Healthy eating and maintaining healthy weight
2. Regular physical activity
3. Stopping smoking
4. Drinking alcohol within recommended limits
5. MH and wellbeing
6. Sexual health

Question 6

LO: List the elements of lifestyle and behavioural choices important in the manifestation of common and important diseases

What are the limits/recommendations for the lifestyle behaviours:

Answer 6

• Healthy eating, weight –> Normal BMI between 18.5- 25.
• Physical activity (30 mins 5 days / week)
• Smoking -> Should not
• Alcohol -> no more than 14 units/ week for M and F. Binge drinking is 6 units or more in women, 8 units or more in men
• Mental health and wellbeing
• Sexual health

Question 7

List the steps of behavioural change - how would you implement a behaviour change in practise?

Answer 7

COM B model

Step 1) Define behaviour problem

Step 2) Target behaviour that’ll address problem

Step 3) Clear Plan, who is to perform the target behaviours - pt/ service support/ family etc…

Step 4) Assess using COM B framework -> do they have capability, motivation, and opportunity to engage in behavioural change.

Step 5) Reflect, evaluate, monitor and adapt if necessary.

Question 8

What are the benefits of brief advice/ interventions?

Answer 8

• ideal for most settings, skills needed are generic
• quick and cost effective
• evidence based -> estimated £10,000 investment in brief advice could save £43,000 in healthcare costs
• most serious illnesses causes/ perpetuated by unhealthy lifestyle
• adopting healthy lifestyle has huge positive effect on peoples health
• delivering brief advice can be the trigger to change

Question 9

What are the effectiveness of lifestyle services?

Some examples of health interventions

Answer 9

1) 30 second approach: 70% of smokers want to quit. 1/40 become long-term ex-smoker

£10,000 invested in brief advice could save £40,000

2) Alcohol brief advice changes drinking behaviour in 1/8 people -> reduced acute admission and A&E attendance.
3) Obesity: offered referral to weight loss group

Those who attended lost weight and 81% thought intervention helpful.

Question 10

What is the COM-B model?

Answer 10

COM-B model describes the phases of intervention:

Patients need to have the:

• Capability
• Opportunity
• Motivation

All three feed into behaviour change.

Question 11

What are the frameworks for implemeting MECC?

• Very brief advice: 3As
• Brief intervention advice: 5As

Answer 11

Very Brief Advice:

• Ask -> “how do you feel about your health today?”. “What could you change to make your lifestyle healthier?”
• Advice
• Act - provide information, sign post and refer

Brief Advice:

• Assess
• Advise
• Agree
• Assist
• Arrange- refer