Evaluating the Values, Experiences, Training and Behaviours of Nursing Students in Promoting Healthy Lifestyles using the ‘Making Every Contact Count (MECC) Initiative: A Mixed Methods Study
Creators: name: Tindale, Vanessa
Publisher: name: University of Lincoln
Year: 2023

description: It is widely recognised that an increased demand on health and social care systems in England is partly attributable to increasing incidence and prevalence in avoidable illnesses resulting from lifestyle choices and behaviours. Smoking, drug and alcohol use, poor diet, obesity and low physical activity are linked to many poor health conditions including heart, liver and respiratory diseases, and stroke and cancers, which are the leading causing for early mortality in England. In acknowledgement of this, Public Health England and Health Education England launched the ‘Making Every Contact Count’ (MECC) initiative in 2010 to support all healthcare professionals to maximise the delivery of public health messages in everyday interactions with patients/service users with the aim of embedding health promotion into organisational culture. MECC is widely cited as being an evidence-based initiative despite there being very limited published research regarding its impacts on professional practice and patient outcomes. This is in part due to there being no national standard in England for MECC and the emergence of two fundamentally different and potentially incompatible approaches to delivery (the Wessex and Yorkshire approaches) and hybrids thereof. There is limited published quantitative research around MECC in practice and evidence rarely relates to the role of the nurse in public health promotion. A mixed methods design comprising a survey followed by interviews and focus groups was used to evaluate the values, experiences, training and behaviours of student nurses at a University in the East Midlands who received training in a hybrid MECC model. Three questionnaires were completed by the first-year students (n=137) before and after training and paired statistical analyses were undertaken to evaluate whether there were any differences in population mean ranks in the students’ values, perceptions and actions in practice. Due to time restrictions, the qualitative component was undertaken with second year students (n=7) who had received the same hybrid MECC training and involved thematic analysis of transcripts from interviews and focus groups and was used to enrich and add insight to the quantitative data in the interpretation of the results. Results showed that students had similar pre and post training perceived levels of opportunity and motivation to MECC. Students reported improved perceived capability to hold a MECC conversation following training, however they held MECC conversations less frequently in practice. Emerging themes from the thematic analysis showed that personal identity, their student role, the placement environment and its inherent culture and the complexities of interacting with patients in the clinical setting all influenced the students’ actions in practice. This research demonstrates that whilst knowledge of MECC is important, difficult conversation skills and confidence are required by the student nurses to enable them to practice MECC. The current academic teaching and the organisational influences including from role models and issues of power and hierarchy in practice appear to be contributing to the dissonance noted between perceptions and actions in practice. The findings improve the evidence base relating to MECC nursing practice and may help to inform future MECC academic training provision.