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Australian Journal of Primary Health Australian Journal of Primary Health Society
The issues influencing community health services and primary health care
RESEARCH ARTICLE

Middle-aged Australians’ perceptions of support to reduce lifestyle risk factors: a qualitative study

Christine Ashley https://orcid.org/0000-0003-0559-9553 A , Elizabeth Halcomb https://orcid.org/0000-0001-8099-986X A C , Susan McInnes https://orcid.org/0000-0003-3113-2930 A , Karin Robinson B , Elizabeth Lucas B , Susan Harvey B and Sarah Remm A
+ Author Affiliations
- Author Affiliations

A School of Nursing, University of Wollongong, Northfields Avenue, Wollongong, NSW 2522, Australia.

B Grand Pacific Health, PO Box 1198, Wollongong, NSW 2500, Australia.

C Corresponding author. Email: ehalcomb@uow.edu.au

Australian Journal of Primary Health 26(4) 313-318 https://doi.org/10.1071/PY20030
Submitted: 10 February 2020  Accepted: 19 May 2020   Published: 13 July 2020

Abstract

Increasingly, middle-aged people are demonstrating lifestyle risk factors that increase their risk of developing chronic disease. Reducing lifestyle risk in middle age can significantly reduce future morbidity and mortality and improve quality of life. Understanding peoples’ perceptions of health support is important to inform health professionals and policymakers regarding strategies to support lifestyle risk reduction. This paper seeks to explore middle-aged Australians’ perceptions of support for lifestyle risk reduction. Thirty-four middle-aged Australians were interviewed using a semi-structured interview schedule. Interviews were audio-recorded, transcribed and analysed using thematic analysis. The overarching theme ‘support for healthy lifestyles’ comprised three subthemes. ‘Engagement with general practice’ highlighted gender differences in why people attend and what impacts their access to general practice. ‘Providing information’ emphasised participants’ experiences of lifestyle risk communication in general practice. Finally, ‘Sources of support’ revealed participants’ current health advice-seeking behaviours. Findings highlight a need for general practices to better engage middle-aged people in behaviour change and educate them about the role of general practice in prevention and health promotion. Consistent messaging across the community and strategies that focus on gender-specific concerns are likely to ensure that middle-aged people are able to make informed choices about seeking support for lifestyle risk reduction.

Additional keywords: health promotion, health risk behaviours, lifestyle modification/health behaviour change, nursing, prevention, primary care.


References

Australian Health Ministers’ Advisory Council (2017) National Strategic Framework for Chronic Conditions. Australian Government, Canberra, ACT, Australia.

Australian Institute of Health and Welfare (2017) Trends in cardiovascular deaths. (AIHW: Canberra, ACT, Australia) Available at https://www.aihw.gov.au/getmedia/2ba74f7f-d812-4539-a006-ca39b34d8120/aihw-21213.pdf [Verified 4 June 2020]

Australian Institute of Health and Welfare (AIHW) (2018) Australia’s health 2018. AIHW, Canberra, ACT, Australia.

Braun V, Clarke V (2006) Using thematic analysis in psychology. Qualitative Research in Psychology 3, 77–101.
Using thematic analysis in psychology.Crossref | GoogleScholarGoogle Scholar |

Brennan J, Bourke M, O’Donnchadha R, Mulrooney A (2019) What really matters to you? A study of public perspectives on general practice in Ireland. Irish Medical Journal 112, 854

Copeland L, McNamara R, Kelson M, Simpson S (2015) Mechanisms of change within motivational interviewing in relation to health behaviors outcomes: a systematic review. Patient Education and Counseling 98, 401–411.
Mechanisms of change within motivational interviewing in relation to health behaviors outcomes: a systematic review.Crossref | GoogleScholarGoogle Scholar | 25535015PubMed |

Eggleston J, Gallagher J, Gallagher M, Hares T, Murray E, Naroz N, Owen T, Price P, Pym L, Reed L (1995) Who should give lifestyle advice in general practice and what factors influence attendance at health promotion clinics? Survey of patients’ views. British Journal of General Practice 45, 669–671.

Elmore N, Burt J, Abel G, Maratos FA, Montague J, Campbell J, Roland M (2016) Investigating the relationship between consultation length and patient experience: a cross-sectional study in primary care. The British Journal of General Practice 66, e896–e903.
Investigating the relationship between consultation length and patient experience: a cross-sectional study in primary care.Crossref | GoogleScholarGoogle Scholar | 27777231PubMed |

Forhan M, Risdon C, Solomon P (2013) Contributors to patient engagement in primary health care: perceptions of patients with obesity. Primary Health Care Research and Development 14, 367–372.
Contributors to patient engagement in primary health care: perceptions of patients with obesity.Crossref | GoogleScholarGoogle Scholar | 23237022PubMed |

Halcomb E, Ashley C (2019) Are Australian general practice nurses underutilised? An examination of current roles and task satisfaction. Collegian 26, 522–527.

Halcomb EJ, Peters K, Davies D (2013) A qualitative evaluation of New Zealand consumers’ perceptions of general practice nurses. BMC Family Practice 14, 26
A qualitative evaluation of New Zealand consumers’ perceptions of general practice nurses.Crossref | GoogleScholarGoogle Scholar | 23433311PubMed |

Hedelund Lausen L, Smith SK, Cai A, Meiser B, Yanes T, Ahmad R, Rowlands G (2018) How is health literacy addressed in primary care? Strategies that general practitioners use to support patients. Journal of Communication in Healthcare 11, 278–287.
How is health literacy addressed in primary care? Strategies that general practitioners use to support patients.Crossref | GoogleScholarGoogle Scholar |

Hibbard JH, Green J (2013) What the evidence shows about patient activation: better health outcomes and care experiences; fewer data on costs. Health Affairs (Millwood) 32, 207–214.
What the evidence shows about patient activation: better health outcomes and care experiences; fewer data on costs.Crossref | GoogleScholarGoogle Scholar | 23381511PubMed |

James S, Halcomb E, McInnes S, Desborough J (2019) Integrative literature review: lifestyle risk communication by nurses in primary care. Collegian 26, 183–193.
Integrative literature review: lifestyle risk communication by nurses in primary care.Crossref | GoogleScholarGoogle Scholar |

James S, McInnes S, Halcomb EJ, Desborough J (2020a) Lifestyle risk factor communication by nurses in Australian general practice: understanding the interactional elements. Journal of Advanced Nursing 76, 234–242.
Lifestyle risk factor communication by nurses in Australian general practice: understanding the interactional elements.Crossref | GoogleScholarGoogle Scholar | 31576578PubMed |

James S, Desborough J, McInnes S, Halcomb EJ (2020b) Nonverbal communication between registered nurses and patients during chronic disease management consultations: observations from general practice. Journal of Clinical Nursing 29, 2378–2387.
Nonverbal communication between registered nurses and patients during chronic disease management consultations: observations from general practice.Crossref | GoogleScholarGoogle Scholar | 32222006PubMed |

Keyworth C, Epton T, Goldthorpe J, Calam R, Armitage CJ (2019) ‘It’s difficult, I think it’s complicated’: health care professionals’ barriers and enablers to providing opportunistic behaviour change interventions during routine medical consultations. British Journal of Health Psychology 24, 571–592.

Lenzen SA, Beurskens A, Van Bokhoven MA, Van Der Weijden T, Daniëls R (2018) Development of a conversation approach for practice nurses aimed at making shared decisions on goals and action plans with primary care patients. BMC Health Services Research 18, 891

Lu S, Harris MF (2013) Prevention of diabetes and heart disease: patient perceptions on risk, risk assessment and the role of their GP in preventive care. Australian Family Physician 42, 328–331.

Mallya G, Pollack CE, Polsky D (2008) Are primary care physicians ready to practice in a consumer-driven environment? The American Journal of Managed Care 14, 661–668.

Martin LR, DiMatteo MR (2017) Social influence and health. In ‘The Oxford handbook of social influence’. (Eds SG Harkins, KD Williams, J Burger) pp. 381–394. (Oxford University Press: Oxford, UK)

National Vascular Disease Prevention Alliance (2009) Guidelines for the assessment of absolute cardiovascular disease risk. National Stroke Foundation, Melbourne, Vic., Australia.

Ricciardelli L, Mellor D, McCabe M (2012) The quiet crisis: challenges for men’s health in Australia. InPsych 34,

Royal Australian College of General Practitioners (RACGP) (2015) Vision for general practice and a sustainable healthcare system. (RACGP: Melbourne, Vic., Australia) Available at https://www.racgp.org.au/FSDEDEV/media/documents/RACGP/Vision%20and%20strategy/Vision-for-general-practice-and-a-sustainable-health-system.pdf [Verified 4 June 2020]

Schlichthorst M, Sanci LA, Pirkis J, Spittal MJ, Hocking JS (2016) Why do men go to the doctor? Socio-demographic and lifestyle factors associated with healthcare utilisation among a cohort of Australian men. BMC Public Health 16, 1028
Why do men go to the doctor? Socio-demographic and lifestyle factors associated with healthcare utilisation among a cohort of Australian men.Crossref | GoogleScholarGoogle Scholar | 28185596PubMed |

Stephen C, McInnes S, Halcomb E (2018) The feasibility and acceptability of nurse-led chronic disease management interventions in primary care: an integrative review. Journal of Advanced Nursing 74, 279–288.
The feasibility and acceptability of nurse-led chronic disease management interventions in primary care: an integrative review.Crossref | GoogleScholarGoogle Scholar | 28880393PubMed |

Stephen C, Halcomb EJ, McInnes S, Batterham M, Zwar N (2019) Improving blood pressure control in primary care: The ImPress study. International Journal of Nursing Studies 95, 28–33.
Improving blood pressure control in primary care: The ImPress study.Crossref | GoogleScholarGoogle Scholar | 31005677PubMed |

Swerissen H, Duckett S, Moran G (2018) Mapping primary care in Australia. (Grattan Institute: Melbourne, Vic., Australia) Available at https://grattan.edu.au/wp-content/uploads/2018/07/906-Mapping-primary-care.pdf [Verified 4 June 2020]

Thomas H, Best M, Mitchell GJA (2020) Whole-person care in general practice. Australian Journal of General Practice 49, 54–60.

Verdon DR (2013) Patient engagement remains cornerstone of primary care’s future. Medical Economics 90, 20

World Health Organization (2017) Chronic diseases and health promotion: part two. The urgent need for action. WHO, Geneva, Switzerland.

Zomahoun HTV, Guénette L, Grégoire J-P, Lauzier S, Lawani AM, Ferdynus C, Huiart L, Moisan J (2017) Effectiveness of motivational interviewing interventions on medication adherence in adults with chronic diseases: a systematic review and meta-analysis. International Journal of Epidemiology 46, 589–602.

Zwar N, Hermitz O, Halcomb E, Davidson PM, Bodenheimer T (2017) Improving blood pressure control in general practice: quantitative evaluation of the ImPress intervention. Australian Family Physician 46, 306–311.