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Improving Health:
Changing Behaviour
NHS Health Trainer Handbook

DH INFORMATION READER BOX
Policy
HR / Workforce
Management
Planning /
Clinical

Estates
Commissioning
IM & T
Finance
Social Care / Partnership Working

Document Purpose

Best Practice Guidance

Gateway Reference

9721

Title

Improving Health: Changing Behaviour, NHS Health
Trainer Handbook

Author

British Psychological Society Health Psychology Team:
Susan Michie, Nichola Rumsey, Anna Fussell, Wendy Hardeman,
Marie Johnston, Stanton Newman, Lucy Yardley

Publication Date
Target Audience

Health Trainers and Health Trainer service providers

Circulation List

Description

Handbook to support Health Trainers in facilitating behaviour change

Cross Ref

N/A

Superseded Docs

N/A

Action Required

No action

Timing

N/A

Contact Details

Rachel Carse
Health Trainer Programme
healthtrainers@dh.gsi.gov.uk

For Recipient’s Use

Improving Health:
Changing Behaviour
NHS Health Trainer Handbook
Written by the British Psychology Society Division
of Health Psychology team:
Susan Michie, Nichola Rumsey,
Anna Fussell, Wendy Hardeman,
Marie Johnston, Stanton Newman
and Lucy Yardley

Contents
Sections

Page

Introduction and the role of a Health Trainer

3

How to use this handbook

5

Sample meeting structure

5

Meeting scripts

9

How to assess clients

11

Finding out about your client

12

Encouraging people to change behaviour

14

Health Trainer competences checklist

15

Thinking about changing behaviour

16

Choosing a behaviour to change

16

Health Benefit Cards

17

Health Behaviour Check

19

Deciding to change

24

Balance Sheets (client worksheets)

25

Increasing confidence to change

28

Planning the behaviour change

30

Goal setting

30

SMART goals

31

SMART goals (client worksheet)

32

ABC forms

33

ABC example and blank form

34

Rewards

36

Rewards (client worksheet)

38

Action planning

39
1

Improving Health: Changing Behaviour – NHS Health Trainer Handbook

Sections
Personal Health Guide (client worksheet)

41

Barriers and facilitators (client worksheet)

42

Recording and reviewing behaviour change

44

Using the Behaviour Change Diary and other diaries

44

Behaviour Change Diary (client worksheet)

46

Food Diary (client worksheet)

47

Physical Activity Diary (client worksheet)

48

Smoking Diary (client worksheet)

49

Alcohol Diary (client worksheet)

50

Reviewing behaviour change

51

Maintaining behaviour change

52

Preparing for setbacks

52

Difficult situations and ‘if-then’ plans (client worksheet)

54

Dealing with setbacks (client reminder sheet)

55

Building habits

57

Building habits (client worksheet)

58

Becoming your own Health Trainer

59

Becoming your own Health Trainer (client worksheet)

60

References and theoretical explanations

63

Appendix

71

Evaluation forms

71

Feedback form

2

Page

77

Introduction
There is good evidence that a range of
approaches grounded in psychological
science can help people in changing
habits and behaviour. These sorts of
approaches help people:

The 2004 Department of Health White Paper
Choosing Health: Making healthy choices
easier proposed the development of a new
role for improving health and reducing health
inequalities – accredited Health Trainers.
Health Trainers will be drawn from local
communities28 and will be trained to reach
those who want to adopt healthier lifestyles,
but who have little contact with services.
Behaviours are a major cause of ill-health and
premature death. For example, unhealthy
eating habits, physical inactivity, smoking,
alcohol use, unsafe sex, driving habits and
violence contributed to 48% of deaths in the
US in 2000.1 By setting personal goals...
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