Individual user involvement at Healthy Life Centres: a qualitative study exploring the perspective of health professionals

Espen Sagsveen,Marit By Rise,Kjersti Grønning,Ola Bratås

doi:10.1080/17482631.2018.1492291

Abstract

ABSTRACTThe aim of this study was to explore how professionals experience user involvement at an individual level and how they describe involving users at Healthy Life Centres. Four focus group interviews were conducted with a total of 23 professionals. Data were analysed using systematic text condensation. Four themes were identified: (1) Involving users through motivational interviewing; (2) Building a good and trustful relation; (3) Assessing and adjusting to the user’s needs and life situation; and(4) Strengthening the user’s ownership and participation in the lifestyle change process. Motivational interviewing was described by the professionals as a way to induce and ensure user involvement. However, seeing motivational interviewing and user involvement as the same concept might reduce user involvement from being a goal in itself and evolve into a means of achieving lifestyle changes. The professionals might be facing opposing discourses in their practice and a dilemma of promoting autonomy and involvement and at the same time promoting change in a predefined direction. Greater emphasis should thus be put on systematic reflection among professionals about what user involvement implies in the local Healthy Life Centre context and in each user’s situation.Abbreviations: HLC: Healthy Life Centre; MI: Motivational Interviewing; NCD: Non-communicable diseases; STC: Systematic Text Condensation. SDT: Self-determination theory

Highlights

One of the major health challenges of the twentyfirst century, when it comes to human suffering, mortality and the negative impact on the socio-economic development of countries, is the increasing number of non-communicable diseases (NCDs) (Riley et al, 2016; Sommer et al, 2015; World Health Organization (WHO), 2009, 2013, 2014)
When asked what they understood by user involvement and how they involved users in the Healthy Life Centres (HLC), the professionals described four main themes: (1) Involving users through motivational interviewing; (2) Building a good and trustful relation with the user; (3) Assessing and adjusting to the user’s needs and life situation; and (4) Strengthening the user’s ownership and participation in the lifestyle change process
The aim of this study was to explore how HLC professionals experienced service user involvement at an individual level and how they describe involving the service users in individual- and group-based counselling and activities at HLCs. When asked what they understood by user involvement and how they involved users in the HLCs, the professionals described four main themes: (1) Involving users through motivational interviewing; (2) Building a good and trustful relation with the user; (3) Assessing and adjusting to the user’s needs and life situation; and (4) Strengthening the user’s ownership and participation in the lifestyle change process

Summary

Introduction

One of the major health challenges of the twentyfirst century, when it comes to human suffering, mortality and the negative impact on the socio-economic development of countries, is the increasing number of non-communicable diseases (NCDs) (Riley et al, 2016; Sommer et al, 2015; WHO, 2009, 2013, 2014). The rise of cardiovascular diseases, cancers, chronic respiratory diseases and diabetes is primarily caused by lifestyle-related behavioural risk factors: tobacco use, physical inactivity, unhealthy diet and harmful use of alcohol (Ding et al, 2016; Riley et al, 2016; WHO, 2014, 2015). To meet these challenges, national and international authorities have incorporated health-promoting strategies into public policies (Ministry of Health and Care Services, 2013b; OECD, 2015; United Nations, 2015; WHO, 2013). Many countries have developed policies to promote healthy eating (Capacci et al, 2012)

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