How to do interventions with precontemplators

How to do brief interventions with precontemplators

What to do:

raise awareness by linking the persons behaviours with personal health and social well-being. Talk about the health issues/behaviour and its effect on health and social or family life
offer to share relevant information about health
offer time and support if the person wants to talk later
make efforts to get to know the person, what he or she knows and thinks, what he or she values and believes

Examples

While you are doing health checks and talking with a pregnant woman

Health staff:		Have you thought about giving up alcohol while you're pregnant?
		(Person gives no response and looks away)
Health staff:		Did you know that when you drink, your baby drinks too? You choose for your baby if you choose to drink, what do you think about that?
		(Person continues to look away)
Health Staff:		No alcohol is the best choice for you and your baby. We can talk about it next time if you like - it's up to you though, no bossing around

Health staff:		That sore on your foot is still bad isn't it?
Person:		Yeah, it hurts when I walk
Health staff:		Are you still smoking?
Person:		Yeah.
Health staff:		How do you think smoking might be affecting this foot?
Person:		(looks disinterested and says) Dunno. Nothing, it's all right.
Health staff:		You know - smoking is bad for your blood circulation. That means it takes a lot longer for sores to heal, because they're not getting enough good blood. Smoking is especially bad for diabetics. It makes the complications of diabetes worse. The best thing that you could do for your health now is to give up smoking. Maybe you can think about that?

How to do brief interventions with contemplators

People are more likely to change when:

their behaviour (for example, alcohol or tobacco use, poor diet) is causing them too many problems
there is something they want that will only be possible if they change
they do not like being the way they are now
the reasons to change are stronger than the reasons to stay the same
their situation or environment changes in a way that helps them to change
they feel strong enough to make the change
they have help and support to make the change

The brief intervention role of service providers is to help the person to reach this point, so that he or she can move towards making a change (action).

See 'Health Belief Model' in this chapter

What to do:

explore the person's concerns as expressed by the client
help the person to weigh up the good, not so good things about the health issue, or about the behaviour, using motivational interviewing techniques.
support the person's choice of action. Offer further support

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