Increasing health-promoting behaviours among healthcare professionals in a UK national health service (NHS) workplace: Developing a novel context-based intervention

Interventions to increase health-promoting behaviours among healthcare professionals generally take a linear, individualistic approach. Individual behaviour change is dependent on a permissive context, and different contexts are conducive to different behaviours. Enabling change in healthcare professional's health behaviours within a complex system such as a healthcare workplace setting requires a context: receptive to behaviour change, and supportive of behaviour change in a particular direction (i.e. toward healthier behaviour). Using a framework developed from complexity principles, we set out to characterise behaviours on an NHS ward which limit or promote staff health and wellbeing; and to develop an intervention to: 1) enable behaviour change, and 2) guide it toward ‘healthier' behaviour. Methods: Working with an NHS hospital, an inpatient ward was identified and 15 staff agreed to be interviewed. A thematic analysis identified themes which were interrogated from the perspective of the ward as a complex adaptive system. Results: We identified structural and cultural aspects of the hospital ward that limited behaviours conducive to staff health, and which an intervention would need to address in order to bring about ‘healthy' system-level behaviour change. These included simple specific changes in the physical ward environment, as well as interaction quality and quantity between the wider management and ward staff. Conclusion: We identified the conditions on an NHS ward that limited health-promoting behaviours; and we are developing an intervention to: enable change in the current patterns of ward behaviour and communication, and guide and support the ward and management towards healthier patterns of behaviour.