Family Practice Vol. 16, No. 4, 447-448
© Oxford University Press 1999
Book Reviews |
Changing eating and exercise behaviour: a handbook for professionals.
Lecturer in Primary Care Development, University of Leeds and Honorary Senior Research, Associate at the Human Nutrition Research Centre, University of Newcastle, with 7 years experience as a primary care dietitian
Paula Hunt, Melvyn Hillsdon. (208 pages, £17.99.) Blackwell Science Ltd, 1996. ISBN 0-632-03927-2.
Since the 1970s the importance of lifestyle change and the role of health professionals in helping people to achieve this has been recognized. However, their apparent lack of success has left many practitioners despondent. Most of us are poorly equipped to embark upon the role of behaviour change agent and it is not surprising that our attempts may be unsuccessful. Research to identify modes of intervention that would make us more successful is difficult, and only recently has the evidence of what constitutes an effective lifestyle intervention begun to emerge.
Paula Hunt is a nutritionist and state-registered dietitian, and Melvyn Hillsden is a rational emotive behaviour therapist. They do not claim that this book is based on either complete or robust evidence, rather it comes from a combination of evidence and clinical experience. Although the book was published in 1996, more recent evidence appears to reinforce the use of the techniques that they describe. The realistic and recognizable case studies are testament to the practical experience of the authors. They propose a model for helping individuals change their behaviour based largely on a trans-theoretical model, with aspects drawn from a number of counselling styles that includes motivational interviewing. It is intended to be realistic within the time constraints of primary care; indeed the authors view short consultations over a long period as an advantage.
Each chapter covers one of the stages of change and suggests techniques to use with individuals at each stage. The authors acknowledge that this division is for convenience only and that in reality the approach will need to be somewhat more fluid. The book successfully describes the counselling model without using jargon. The text is interspersed with case studies and examples of dialogue that illustrate how the techniques can be applied. Although every attempt is made to be practical, I found that this dialogue made the text disjointed and was therefore tempted to skip it, which detracts from the whole point of the book. This is a difficult subject to address in a text, and I feel that there is really no replacement for acquiring these skills in a setting where there is an opportunity to practice. However, the book should provide new insight and ideas on how to improve the quality of lifestyle interventions. We know that the public want such help and regard doctors and nurses as credible sources of lifestyle information. This book should help practitioners review their practice and improve the quality of such interventions.
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