Contact Count Research Articles

Theoretically informed codesign of a tailored intervention to support pressure ulcer prevention behaviours by older people living in their own homes in the UK and their lay carers: an intervention codesign study (C-PrUP)

ObjectiveTo codesign a theoretically underpinned, healthcare practitioner-mediated, tailored intervention to support housebound older patients and their lay carers to adopt pressure ulcer prevention behaviours.DesignTheoretical domains framework informed codesign.SettingOne geographical area...

The effectiveness of integrating making every contact count into an undergraduate medical curriculum

The effectiveness of integrating making every contact count into an undergraduate medical curriculum

Predicting Athlete Workload in Women's Rugby Sevens Using GNSS Sensor Data, Contact Count and Mass.

The use of session rating of perceived exertion (sRPE) as a measure of workload is a popular athlete load monitoring tool. However, the nature of sRPE means the contribution of salient, sport-specific factors to athlete load in field sports is challenging to isolate and quantify. In rugby sevens, drivers of load include high-speed running and physical contact. In soccer and men's rugby, union acceleration/deceleration also influences load. These metrics are evaluated using data from global navigation satellite system (GNSS) sensors worn by athletes. Research suggests that sensor data methods for identifying load in men's rugby do not accurately quantify female athlete loads. This investigation examined how mass, contact, and accelerations and decelerations at different speeds contribute to load in women's rugby sevens. The study evaluated 99 international matches, using data from 19 full-time athletes. GNSS measures, RPE, athlete mass, and contact count were evaluated using a linear mixed-model regression. The model demonstrated significant effects for low decelerations at low and high speeds, mass, distance, and contact count explaining 48.7% of the global variance of sRPE. The use of acceleration/deceleration and speed from GNSS sensors alongside mass, as well as contact count, presents a novel approach to quantifying load.

Domiciliary Carers' Perspectives on Alcohol Use by Older Adults in Their Care: A Systematic Review and Thematic Synthesis of Qualitative Studies.

As global populations continue to age, alcohol consumption rises, and we strive to age in place, it is important to have an up-to-date understanding of domiciliary carers' perspectives on older adults' alcohol use in their care. Therefore, a systematic review and thematic synthesis of qualitative studies of the unique challenges faced by domiciliary care workers in front line roles regarding older adults' alcohol use was conducted (PROSPERO registration number: CRD42024516660). Eight databases were searched on 22 February 2024 for qualitative studies focusing on older adults' (defined as aged 50 or over) alcohol consumption and domiciliary care. The Critical Appraisal Skills Programme checklist was utilised for quality appraisal. Twenty articles reporting 14 unique studies of mainly medium to low quality were included. Three overarching themes (and associated subthemes) were identified as follows: identification (alcohol problems are common, no assessment for alcohol problems, and additional overt signs of excessive alcohol use), management (to buy or not to buy that is the question, balancing rights and risks, monitor and report but do not intervene, maintaining the vicious circle, home as a barrier to accessing support and services, and more support needed from healthcare professionals), and training (lack of alcohol education). Domiciliary carers are well placed to make every contact count to target alcohol consumption but would benefit from support and resources for alcohol consumption identification and management. Clear guidance on how to manage alcohol consumption to harmoniously balance rights and risks is crucial, particularly when caring for older adults with cognitive difficulties.

Making Every Contact Count: health professionals’ experiences of integrating conversations about Snacktivity to promote physical activity within routine consultations – a qualitative study

ObjectiveHelping people to change their health behaviours is becoming a greater feature within the role of health professionals, including through whole system initiatives such as Making Every Contact Count. Health...

Making every contact count

Nabeela Caratela explores a new initiative which will help show how dental nurses can help support patients with their oral and general health. Aim To improve knowledge and awareness of the ‘Making Every Contact Count’ (‘MECC’) initiative amongst dental nurses. To highlight the importance of the dental nurses' role in facilitating improvements to patients' overall health and wellbeing. Objectives Understand the importance and relevance of the ‘MECC’ initiative for dental teams. Support patients by providing ‘very brief advice’ and signposting to key resources.

Enhancing making every contact count (MECC) training and delivery for the third and social economy (TSE) sector: a strategic behavioural analysis

Objective To enhance Making Every Contact Count (MECC, an opportunistic approach to health promotion), training in the Third and Social Economy (TSE, all groups and organisations primarily working towards social justice, outside of the government or household) by examining the degree to which the behavioural content of MECC training tackled significant factors influencing MECC delivery. Methods and Measures A strategic behavioural analysis design. Semi-structured interviews with service providers (n = 15) and users (n = 5) were coded for barriers and facilitators of MECC delivery using the Theoretical Domains Framework (TDF). Existing MECC training was coded for behaviour change techniques (BCTs) and intervention functions (IFs). The degree to which BCTs and IFs addressed the key TDF domains of influences on MECC delivery in the TSE were examined using prespecified tools. Results Seven key TDF domains of influences in MECC delivery were identified. Overall, only 9/31 linked BCTs were utilised within MECC training, with percentage utilisation of relevant BCTs for each domain ranging from 0% to 66.7%. Training adequately addressed 2/7 key domains. Conclusion The TSE and healthcare share many common key TDF domains, although there are differences in how each are relevant. Limitations and recommendations for MECC training are discussed.

Mapping regional implementation of ‘Making Every Contact Count’: mixed-methods evaluation of implementation stage, strategies, barriers and facilitators of implementation

BackgroundThe Making Every Contact Count (MECC) programme provides training and materials to support public-facing workers to encourage health-promoting behaviour change by using the day-to-day interactions between organisations and individuals. This...

INDIVIDUAL STRENGTH CHANGES FOLLOWING A VERY BRIEF INTERVENTION ON NATIONAL STRENGTH TRAINING GUIDELINES IN ADULTS AGED 50 - 75 YEARS

BACKGROUND There is little evidence that the public or healthcare practitioners are aware of and implementing the strength training component of the United Kingdom’s (UK) Chief Medical Officers’ physical activity guidelines in practice. Our study aimed to objectively measure strength following a very brief intervention with the strength component to determine if this practice could increase muscle strength. METHODS This was a mixed method, one-arm, pre-post six-month study. Thirty adults aged 50-75 years had hand grip (upper) isometric strength and ankle plantarflexion (lower) isometric strength measured. The average of two trials on the dominant limb were recorded. Participants were provided a physical copy of the guidelines and were asked to follow the strength recommendations. The very brief intervention (five minutes) included information on why and how to follow the strength guidelines, example exercises, along with a proven behaviour change technique (providing a journal to record training sessions). Strength was tested after six-months. RESULTS The group average indicated that there was no change in upper or lower body strength from baseline. However, when data were viewed individually, upper body strength was gained in 21 of 30 participants and lost in 9 (range: -4.5 to +6 kg). 42% of participants gained more than 2 kg in hand strength after six-months. Lower body strength was gained in 15 participants and lost in 15 (range: -12.4 to +8.65 kg). 43% of participants lost more than 2 kg. Qualitatively participants took the opportunity to ‘procure some new weights’ as they found their weights at home ‘too easy.’ Participants had a new-found realisation that ‘strength training is vital to muscle strength.’ Some mentioned that ‘strength training is now part of my life.’ On the other hand, other participants wanted more, noting that ‘there should be more publicity, information about [strength training] to the general public’ and found it unnecessarily ‘hard to find [follow up information] online.’ CONCLUSIONS In the movement to make ‘every contact count,’ a very brief intervention has been shown to raise awareness and change strength training behaviour. Healthcare practitioners should focus on lower body exercise examples alongside progression techniques to avoid rapid loss in lower body strength. Public health stakeholders need to work together to provide easily accessible strength training resources.

Opportunities for Making Every Contact Count approaches in workplaces.

There is now evidence that widespread adoption of the Making Every Contact Count (MECC) approach developed in the United Kingdom can have a significant impact on health. Even though there are important reasons explaining why such an approach is scarcely applied in workplaces, MECC might be of interest in some specific cases, such as healthcare settings or large companies. It could be considered, organized and evaluated in such workplaces.

ALERT study: Attitudes, Lived ExpeRience and Treatment in MS bladder and bowel

Objectives: To gain more understanding of the real-world lived experience of neurogenic bladder and bowel among people with multiple sclerosis (PwMS). Few studies have explored this important perspective. Methods: Qualitative and quantitative methods were applied for data collection. A total of 16 PwMS were recruited into the qualitative phase. The themes emerging from these interviews were used to develop a questionnaire. An online survey was hosted on the Enalyzer platform with the link promoted by The MS Trust. In total, 1148 PwMS took part in the survey. Results: The authors dentified key personal impacts of bladder and bowel symptoms, and varying levels of patient satisfaction with their care and the information they received. Conclusions: Two themes were identified as needing to continue to be explored in order to improve the care landscape for PwMS: ‘breaking the loo taboo’ – encouraging PwMS to talk about their bladder and bowel problems and ‘making every contact count’ – encouraging the multidisciplinary team to be proactive in asking questions. Neurogenic bladder and bowel should be prioritised and championed both at a national and local level in terms of policy and service delivery, to ensure that PwMS have timely access to person-centred pathways and treatments.

Optimal hippocampal targeting in responsive neurostimulation for mesial temporal lobe epilepsy.

The aim of this study was to identify features of responsive neurostimulation (RNS) lead configuration and contact placement associated with greater seizure reduction in mesial temporal lobe epilepsy (MTLE). A single-center series of patients with MTLE treated with RNS were retrospectively analyzed to assess the relationship between anatomical targeting and seizure reduction. Targeting was determined according to both the preoperatively conceived lead configuration and the actual placement of RNS contacts. Three lead configurations were used: 1) single bilateral, with 1 depth lead in each hippocampus; 2) single unilateral, with 1 hippocampal depth lead and another implant outside the mesial temporal lobe; and 3) dual unilateral, with 2 leads in 1 hippocampus. Contact placement on postoperative imaging was measured according to the number of hippocampal contacts per targeted hippocampus (contact density) and per patient (contact count), distribution throughout the hippocampus, and proximity to the anteromedial hippocampus. Dual unilateral lead placement resulted in significantly higher hippocampal contact density compared with the single hippocampal approaches, but only showed a nonsignificant trend toward a higher rate of response. However, those patients with more than 4 contacts in a single hippocampus, achievable only with dual unilateral leads, had a significantly higher rate of response. The higher likelihood of response was poorly explained by more widespread hippocampal coverage, but well correlated with proximity to the anteromedial hippocampus. Dual unilateral hippocampal implantation increased RNS contact density in patients with unilateral MTLE, which contributed to improved outcomes, not by stimulating more of the hippocampus, but instead by being more likely to stimulate a latent subtarget in the anterior hippocampus. It remains to be explored whether a single electrode targeted selectively to this region would also result in improved outcomes.

‘Making Every Contact Count' in dental practice

‘Making Every Contact Count' in dental practice

Establishing an updated consensus on the conceptual and operational definitions of Making Every Contact Count (MECC) across experts within research and practice: an international Delphi Study

ObjectivesThe Making Every Contact Count (MECC) initiative is broadly defined as an opportunistic approach to prevention by making use of the thousands of conversations service providers have with service users every day. However, since its conception, the application of MECC has diverged and developed considerably. Thus, the current study aimed to revise the definition according to current research and practice to better describe what is and is not included. Study designA consensus building classic Delphi methodology, completed by an expert panel. MethodsRound 1 asked open questions around the definition of MECC. Content analysis of round 1 identified statements that were rated for agreement in round 2. Statements achieving ≥80% agreement were included in a short, long, or operational definition of MECC that were rated for agreement in round 3 (the minimum number required). An agreement of ≥80% indicated consensus. ResultsForty out of 100 contacted experts completed three rounds. Experts in practice and research were recruited internationally although most were from England. From round 1, 274 statements were generated, of which 96 achieved consensus and were included within round 3. The short and long definition received consensus in round 3, the operational definition required four rounds to reach consensus. ConclusionsMECC is a person-centred approach to health behaviour change that, provided an individual possesses the relevant skills, can be delivered by anyone and anywhere. The distinguishing feature of MECC is not in its duration, target behaviour, or conditions for delivery, but rather in the approach taken and the mechanisms applied to conversations. Implications for research and practice are discussed, and the limits for applicability acknowledged.

Make every contact count

Miranda Steeples discusses the upcoming BDIA Dental Showcase.

Impacts of the COVID-19 public health emergency on healthcare professional delivery of opportunistic behaviour change interventions: a retrospective cohort study

BackgroundThe public health policy “Making Every Contact Count” (MECC) compels healthcare professionals to deliver health behaviour change interventions during routine consultations. As healthcare systems continue their recovery from the impacts of the COVID-19 public health emergency, supporting people to modify health behaviours is more important now than when the policy was introduced. The present study aims to: (a) examine changes in healthcare professionals’ awareness of, and engagement with the policy over a five-year period, (b) examine the psychosocial drivers associated with delivering behaviour change interventions, and (c) identify targets to increase healthcare professionals’ delivery of interventions.MethodsComparison of data from two independent representative surveys of NHS healthcare professionals working in the UK. In both surveys (July-September 2017; N = 1387, and February-March 2022; N = 1008), participants were asked to report: (1) awareness of the MECC policy, (2) the prevalence of MECC-related practice (perceived patient benefit, how often interventions were delivered, and time spent delivering interventions), and (3) perceptions of capabilities, opportunities and motivations to deliver behaviour change interventions. T- tests (independent-samples), MANOVA, multiple linear regression, and chi-square analyses were used to generate comparisons between the surveys.ResultsAwareness of the policy increased from 2017 (31.4%) to 2022 (52.0%). However, in 2022 compared with 2017, healthcare professionals reported (a) fewer patients would benefit from behaviour change interventions (49.1% versus 55.9%), (b) they delivered behaviour change interventions to a lower proportion of patients (38.0% versus 50.0%), and (c) they spent a lower proportion of the consultation time delivering interventions (26.5% versus 35.3%). Further, in 2022, compared with 2017, healthcare professionals reported fewer physical opportunities, fewer social opportunities, and fewer psychological capabilities to deliver behaviour change interventions. In the 2022 survey, perceptions of patient benefit and delivery of interventions was associated with greater perceptions of opportunities and motivations.ConclusionsHealth behaviour change interventions remain an important part of routine healthcare in the continued recovery from COVID-19 public health emergency, however reported engagement with MECC-related practices appears to have reduced over time. Future research should consider how healthcare professionals identify patients who might benefit from opportunistic behaviour change interventions, and to increase capabilities, opportunities, and motivations to deliver interventions during routine consultations.

2075 Systematic review of ‘Ageing well’ interventions to improve and maintain independent living for community housebound populations

Abstract Introduction The housebound population are growing in number, with a large proportion living rurally or in coastal areas, which increases the risks of isolation and health inequalities. This population are an under researched and underserved group (Public Health England, 2019). Being unable to leave the home is a factor for living in the poorest of health, which contributes to advancing levels of frailty, Curtis et al (2018). Considering the current focus of empowerment to ‘age well’ (NHS England Long Term Plan, 2019), a granular understanding of community focused ageing well interventions is the focus of this systematic review to empower clinicians to ‘make every contact count’ (NHS England 2020). Method A narrative evidence review of findings has been completed entitled ‘ageing well interventions to improve and maintain independent living for community housebound populations.’ The review was registered with PROSPERO international prospective register of systematic reviews (CRD 42022371047) and reported according to the Preferred Reporting Items for Systematic reviews and Meta-analysis (PRISMA). Data screening was undertaken by two reviewers at each stage to ensure accuracy, quality, and reliability. Results The results have identified key health interventions designed and delivered by community clinicians, including benefits of exercise, medication review, oral health, and health empowerment to improve outcomes for the housebound population. The results have outlined a total of twenty-nine outcome measures, which have been examined intrinsically and extrinsically to explore greatest impact for housebound health. Conclusion At the time of the Autumn conference, the research study will have completed the systematic review and be able to present findings to illustrate areas of intervention synthesized for the target population. Key to this will be understanding application, effectiveness, and generalizability for community delivery. The poster presentation will share progress of the wider study with opportunities to take part in the next Delphi panel stage.

Strategies for integrating the Making Every Contact programme for the prevention and management of chronic disease across Irish Health Service

Introduction: The Irish Health Service Executive (HSE) Making Every Contact Count (MECC) Programme1 aims to integrate lifestyle behaviour interventions by health professionals to patients targeting health behavioural risk factors (e.g. physical activity, diet, smoking and drug and alcohol use. The MECC programme (implemented since 2019) is a key element of the Integrated care programme for the prevention and management of Chronic disease in Ireland (ICP CD)2 . I will present recent research which has identified key strategies for upscaling implementation and integrating brief interventions in the Irish Health Service.
 Aim, Objectives, Theory or Methods: The research team worked collaboratively to develop an evidence-based implementation strategy to optimise and scale up MECC. The implementation strategy was informed by three studies:
 1.Study 1: Survey study of 357 healthcare professionals who had completed MECC e-Learning training to determine barriers and enablers to MECC intervention delivery.
 2.Study 2: Qualitative interview study with 36 healthcare professionals and those involved in MECC implementation to understand the individual and organisational level enablers and barriers to the implementation of MECC.
 3.Study 3: Consensus study to achieve stakeholder consensus on strategies to address identified barriers and enablers .
 
 Highlights or Results or Key Findings: Using the Theoretical Domains Framework3 barriers and enablers to Implementation were identified under the following domains: environmental context, goals and intentions, knowledge, professional role, beliefs about consequences, beliefs about capabilities and skills practice. 
 A consensus process identified and refined the following nine implementation strategies.
 1.Provide dedicated time to practitioners to attend training and use MECC
 2.Empower and engage management/senior staff to take responsibility for MECC
 3.Implement a user-friendly and integrated system of recording MECC
 4.Develop service directories for healthcare professionals to refer patients
 5.Have local MECC champions to model best practice and share experiences
 6.Create a dedicated resource centre on the MECC website with information regarding MECC training courses and contacts
 7.Have a HSE national communications campaign to promote MECC
 8.Generate and highlight evidence for the impact of MECC on patients
 9.Enhance integration of MECC with undergraduate healthcare professional education
 Conclusion: In this programme of research we have worked with key stakeholders to understand barriers and enablers to MECC implementation and develop recommendations to enhance the implementation and scaling-up of the MECC programme.
 Implementation of the MECC programme remains a key priority for the Irish Health Service. 
 Implications for applicability/transferability, sustainability, and limitations: The outputs from this research provide strong evidence based strategies to support the ongoing implementation of the MECC programme. The dissemination of the findings to key policy and strategic stakeholders and the development of an implementation plan will further embed Making Every Contact Count in services.
 

Adolescents, parents, and providers' experiences of triadic encounters in paediatric diabetes clinics: A qualitative study.

Adolescents with Type 1 diabetes are a cohort whose self-management of their diabetes care often declines during adolescence which can lead to adverse health outcomes. Research indicates that providers find it challenging to engage adolescents in communication exchanges during triadic encounters in diabetes clinics. Our study aimed to explore adolescents, parents, and providers' experiences of clinic encounters. A qualitative study was conducted with a convenience sample of 13 adolescents with Type 1 diabetes (aged 11-17), 14 parents, and seven providers. Participants were recruited from two outpatient diabetes clinics in two urban children's hospitals, Ireland. Data were obtained using a combination of interviews and focus groups. Data were analysed thematically. Adolescents and their parents appeared to hold both positive and negative experiences of diabetes clinic encounters. Providers reported challenges associated with engaging adolescents in communication exchanges. The structure, focus and style of clinic encounters created barriers that potentially led to suboptimal adolescent participation and impaired provider-adolescent communication during clinic visits. The findings provide insights into the challenges associated with adolescents' engagement in communication encounters in diabetes clinics. Healthcare providers could encourage adolescents to be more actively involved in their diabetes management, by taking an adolescent-centred approach and creating a nonjudgemental milieu. Focusing on adolescent's agenda could lead to more meaningful and relevant discussions between providers and adolescents and ensure more tailored education in the time available. Adolescence is a risky period for nonadherence and adverse health complications; therefore, it is critical that providers make every contact count in diabetes clinic encounters. The study's design and delivery were guided by two advisory groups, comprising (1) five adolescents living with Type 1 diabetes (T1D)and (2) five parents of an adolescent with T1D.

Can you help us to make Every Contact Count and eliminate avoidable pressure?

Can you help us to make Every Contact Count and eliminate avoidable pressure?