Making Every Contact Count

Question 1

What percentage of the UK’s disability adjusted life years lost are attributable to tobacco, hypertension, alcohol, being overweight or being physically inactive (i.e. behavioural patterns)?

Answer 1

40%

Question 2

Define the Making Every Contact Count (MECC).

Answer 2

An approach to behaviour change that utilises the millions of day-to-day interactions that organisations + individuals have with other people to support them in making positive changes to their physical & mental health + wellbeing

Question 3

What does Making Every Contact Counts (MECC) mainly enable healthcare professionals to do?

Answer 3

Opportunistic delivery of consistent + concise healthy lifestyle information enabling individuals to engage in conversations about their health at scale across organisations + populations

Question 4

What is the responsibility of organisations in the Making Every Contact Counts (MECC) initiative?

Answer 4

Provide staff with leadership, environment, training + information to deliver MECC

Question 5

What is the responsibility of staff in the Making Every Contact Counts (MECC) initiative?

Answer 5

Have the competence + confidence to deliver healthy lifestyle messages, encourage people to change behaviour + direct them to support services

Question 6

What is the responsibility of patients in the Making Every Contact Counts (MECC) initiative?

Answer 6

Seek support + take action to improve own lifestyle

Question 7

How does Making Every Contact Counts (MECC) encourage people to make healthier choices for their health?

Answer 7

• Systematically promoting the benefits of healthy living
• Asking individuals about their lifestyle + responding appropriate
• Taking appropriate action i.e. give information, signpost or refer to support service

Question 8

Why is Making Every Contact Counts (MECC) a brief intervention?

Answer 8

It could just be a short conversation that may just put someone of the first step to better health + wellbeing - a ‘chat for change’

Question 9

What lifestyle issues does Making Every Contact Counts (MECC) cover?

Answer 9

• Healthy eating/maintaining healthy weight
• Taking regular physical activity
• Smoking cessation
• Drinking alcohol within recommended limits
• Mental health + wellbeing
• Sexual health

Question 10

What is Making Every Contact Counts (MECC) not meant to be?

Answer 10

• Another job in busy working day
• Being a specialist
• Being a counsellor or providing ongoing support
• About telling somebody what to do + how to live their live

Question 11

What is the main point of Making Every Contact Counts (MECC)?

Answer 11

Help other people to know how they can improve their own health + wellbeing

Question 12

Why does the Making Every Contact Counts (MECC) intervention mean you save time?

Answer 12

You spend less time discussing a subject as you can refer to a service that has the time + skills to go into more depth

Question 13

What are the benefits of Making Every Contact Counts (MECC)?

Answer 13

• Most serious illnesses caused/perpetuated by unhealthy lifestyles
• Adopting healthier lifestyles can have a huge +ve effect on people’s health
• Can be the trigger to change
• Ideal for most settings
• Skills needed are generic
• Quick + cost-effective
• Evidence based
• Effects persist for 2-4 years afterwards
• Reduced acute admissions/A&E attendance
• Improved + quicker outcomes from treatments e.g. wound healing

Question 14

How much can positive health behaviours impact a person’s health?

Answer 14

Being a non-smoker, keeping within alcohol limits + having recommended vitamin C from fruit/veg -> 14 year difference in life expectancy compared with patients that done the opposite

Question 15

What effect will being poor have on an individuals health?

Answer 15

People living in the poorest areas will, on average, die 7 years earlier than people living in richer areas + spend 17 more years living with ill health

Question 16

The commitment to reduce health inequalities is a priority for the health system drawing upon the ___ __ to address the wider health determinants.

Answer 16

Marmot Review

Question 17

How can Making Every Contact Counts (MECC) aid health inequalities?

Answer 17

Preventing poor health + promoting healthy living is essential to reduce health inequalities + sustain the NHS for future generations

Question 18

Why does Making Every Contact Counts (MECC) fit in with the NHS’s roles?

Answer 18

NHS organisation has a responsibility to protect + improve overall health + wellbeing of staff + service users

Question 19

What is the main case for Making Every Contact Counts (MECC)?

Answer 19

Duty of care

Question 20

How long does a Making Every Contact Counts (MECC) intervention have to be to have an impact?

Answer 20

30 seconds

Question 21

Why is Making Every Contact Counts (MECC) beneficial for patients?

Answer 21

• Most people want to be healthy + improve health
• Patients welcome opportunity to talk to staff about lifestyle issues but don’t start conversations themselves/think staff are too busy to talk
• Makes it easier for people to make those changes

Question 22

Why is Making Every Contact Counts (MECC) beneficial for staff?

Answer 22

• Satisfaction of making a difference to patient’s life
• Increased confidence in patient contacts
• Improve own lifestyle
• Enhance skillset

Question 23

What is the key to understanding patient’s behaviour?

Answer 23

The behaviour change wheel

COM-B model

Question 24

What are the 3 circles of the behaviour change wheel?

Answer 24

Innermost: sources of behaviour
Middle: intervention functions
Outer: policy

Question 25

What does the COM-B model say influences behaviour?

Answer 25

Capability Opportunity Motivation (key one)

Question 26

How can you put behaviour change into practice?

Answer 26

1. Define behavioural problem 2. What target behaviour will address the problem? 3. Clear plan of what, when + how patient will do the target behaviour (consider others involved) 4. Assess using COM-B if they have the 3 factors needed to change behaviour 5. Reflect, evaluate, monitor + adapt if necessary

Question 27

What questions could you ask to start the Making Every Contact Counts (MECC)conversation?

Answer 27

- How do you feel about your health + wellbeing today? - What could you change to make your lifestyle healthier? - On a scale of 1-10 how important is it for you to make your lifestyle healthier?

Question 28

What can you do if a patient does not want to change a health behaviour?

Answer 28

DO NOT force them, leave the door open + perhaps send them away with some information in case they change their mind

Question 29

What can you do if a patient is ready to change a health behaviour?

Answer 29

Offer them a package of support

Question 30

How do you continue the Making Every Contact Counts (MECC) conversation?

Answer 30

- Listen to what client tells you - Reflect back: "so what you are saying is..." or "can I just check..." - Take action: provide info, signpost or make a referral

Question 31

How can you provide very brief Making Every Contact Counts (MECC) advice?

Answer 31

A - Ask A - Advise A - Act/refer

Question 32

How can you provide brief Making Every Contact Counts (MECC) advice?

Answer 32

``` A - Assess A - Advise A - Agree A - Assist A - Arrange/refer ```

Question 33

What should you remember when you are delivering Making Every Contact Counts (MECC) intervention?

Answer 33

``` L - Look interested I - Involve yourself by responding S - Stay focused on info giving T - Test your understanding E - Evaluate what is not being said N - Neutralise your feelings ```

Question 34

Who can Making Every Contact Counts (MECC) interventions be carried out on?

Answer 34

``` Patients/clients Colleagues Carers/family Family Friends ``` ANYONE

Question 35

When can you raise a lifestyle issue?

Answer 35

- As part of existing assessment/info gathering - Any day-to-day contact with patient/client - When you hear someone mention a lifestyle problem - When you can see that support with a lifestyle issue may be of help

Question 36

How can you monitor the impact of Making Every Contact Counts (MECC)?

Answer 36

- Record intervention where possible - Ask again if you see patient again - Refer to evidence base

Question 37

If you do a Making Every Contact Counts (MECC) intervention, patients may:

Answer 37

- Appreciate that you encouraged them to make changes they had been considering for some time - Be grateful you have taken the time to talk to them - Make connections between lifestyle + what they want from life - Live longer + healthier lives because of what you did