Behavior Change Training for Health Professionals: Evaluation of a 2-Hour Workshop.

BACKGROUND: Rates of noncommunicable diseases continue to rise worldwide. Many of these diseases are a result of engaging in risk behaviors. Without lifestyle and behavioral intervention, noncommunicable diseases can worsen and develop into more debilitating diseases. Behavioral interventions are an effective strategy to reduce the burden of disease. Behavior change techniques can be described as the "active ingredients" in behavior change and address the components that need to be altered in order for the target behavior to change. Health professionals, such as pharmacists and nurses, can engage in opportunistic behavior change with their patients, to encourage positive health behaviors. OBJECTIVE: We aimed to develop, implement, and evaluate a behavior change workshop targeted at health professionals in Australia, with the goal of increasing knowledge of behavior change techniques and psychological variables. METHODS: A prospective study design was used to develop and evaluate a 2-hour behavior change workshop targeted at health professionals. The workshop was developed based on the Capability, Opportunity, Motivation, and Behavior Model and had five core objectives: (1) to detail the role of health professionals in delivering optimal care, (2) to demonstrate opportunities to change behavior, (3) to describe principles of behavior change, (4) to explain behavior change techniques, and (5) to determine the most appropriate behavior change techniques to use and when to use them. A total of 10 workshops were conducted. To evaluate the workshops and identify any potential long-term changes in behavior, we collected pre- and postworkshop data on knowledge and psychological constructs from the attendees. RESULTS: A final sample of 41 health professionals comprising general practitioners, nurses, and pharmacists completed the pre- and postworkshop surveys. Following the workshops, there were significant improvements in knowledge of behavior change techniques (t40=-5.27, P<.001), subjective norms (t40=-3.49, P=.001), descriptive norms (t40=-3.65, P<.001), perceived behavioral control (t40=-3.30, P=.002), and intention (t36=-3.32, P=.002); each had a large effect size. There was no significant difference in postworkshop attitude (t40=0.78, P=.44). The participants also found the workshops to be highly acceptable. CONCLUSIONS: A 2-hour, theoretically informed workshop designed to facilitate the use of behavior change techniques by health professionals was shown to be largely effective. The workshops resulted in increases in knowledge, descriptive and subjective norms, perceived behavioral control, and intention, but not in attitude. The intervention was also shown to be highly acceptable, with the large majority of participants deeming the intervention to be needed, useful, appropriate, and applicable, as well as interesting and worth their time. Future research should examine the lasting impacts of the workshop on health professionals' practices

A call for action: Educating pharmacists and pharmacy students in behaviour change techniques.

The increasing impact of chronic disease, including cancer and heart disease on mortality signifies a need for the upskilling of health professionals in health behaviour change. Solely providing education and information to patients is generally not sufficient to change behaviour, and for any change to be sustained. The nature of pharmaceutical practice allows pharmacists to have frequent contact with patients in the community. Historically, pharmacists have often effectively engaged with patients to assist with behaviour change initiatives related to smoking cessation, weight loss or medication adherence. Unfortunately, such initiatives do not work for everyone, and more tailored and varied interventions are urgently needed to reduce the effects of chronic disease. In addition, with greater inaccessibility to hospitals and GP's (e.g., appointment wait times), it is imperative that pharmacists are upskilled in providing opportunistic health behaviour change techniques and interventions. Pharmacists need to practice to their full scope consistently and confidently, including the use of behavioural interventions. The following commentary therefore describes and provides recommendations for the upskilling of pharmacists and pharmacy students in opportunistic behaviour change. We outline nine key evidence-based behaviour change techniques, the active-ingredients of a behaviour change intervention, that are relevant to common encounters in professional practice by pharmacists, such as improving adherence to medications/treatments and health promotion initiatives. These include social support (practical and emotional), problem solving, anticipated regret, habit formation, behaviour substitution, restructuring the environment, information about others' approval, pros and cons, and monitoring and providing feedback on behaviour. Recommendations are then provided for how this upskilling can be taught to pharmacists and pharmacy students, as well as how they can use these techniques in their everyday practice

Annotating Whole Genome Sequencing in COSMIC (The Catalogue of Somatic Mutations in Cancer)

&#x22;COSMIC, the Catalogue Of Somatic Mutations In Cancer&#x22;:http://www.sanger.ac.uk/cosmic is designed to store and display somatic mutation information relating to human cancers, combining detailed information on publications, samples and mutation types. The information is curated both from the primary literature and the laboratories at the Cancer Genome Project, Sanger Institute, UK, and then semi-automatically entered into the COSMIC database. The v47 release (May 2010) contained the curation of 9202 papers describing 116,977 mutations across 466,851 samples. In order to provide consistent annotation of the data, COSMIC has developed a classification system for cancer histology and tissue ontology, and adapted HGVS mutation nomenclature recommendations to describe the multiple mutation types involved in cancer. &#xd;&#xa;&#xd;&#xa;Cancer genetics is moving from systematic screens of candidate gene sets to whole genome sequencing analyses, and COSMIC displays and navigates this new data; we have recently included systematic gene screens and whole genome sequencing studies. COSMIC will annotate and display somatic mutation data that will be emerging from the &#x22;International Cancer Genome Consortium (ICGC)&#x22;:http://www.icgc.org/ and &#x22;The Cancer Genome Atlas (TCGA)&#x22;:http://cancergenome.nih.gov/ projects. New tools are being developed to interpret this genomic data with coding mutation annotations. In addition COSMIC will be expanded to curate and display data from mouse insertional mutagenesis screening and mouse cancer model exome/genome sequencing in the future. The data within COSMIC is freely available without restriction via a website, in datasheets on the &#x22;FTP site&#x22;:ftp://ftp.sanger.ac.uk/pub/CGP/cosmic and through the &#x22;COSMIC Biomart&#x22;:http://www.sanger.ac.uk/genetics/CGP/cosmic/biomart/martview/, available from the &#x22;COSMIC homepage&#x22;:http://www.sanger.ac.uk/cosmic &#xd;&#xa