Guidance for health professionals on how to provide advice to New Zealand adults on healthy lifestyles, including weight management and healthy eating.
This section provides health professionals with information about:
- features of a healthy lifestyle
- working in partnership
- person-centred care and support
- starting a conversation about healthy lifestyles
- practical discussion examples on healthy eating and body weight
- useful websites and publications for further reading.
Living a healthy lifestyle can prevent or delay the onset of long-term conditions (LTCs) such as cardiovascular disease, type 2 diabetes and some cancers. Healthy lifestyles can include:
- eating healthy food
- being physically active
- attaining and maintaining a healthy weight
- being tobacco free
- mental wellbeing
- limiting alcohol intake
- adequate sleep.
Working in partnership
Supporting people to make changes to their lifestyle should be undertaken in partnership. This means involving people as equal partners in planning, developing and monitoring their care.
Person-centred care can be demonstrated through shared decision making. It’s about services being more flexible to meet people’s needs in a manner that is best for them.
Person-centred care can be described as:
- respecting people’s culture and values and putting people at the centre of care
- taking into account people’s preferences and expressed needs
- coordinating and integrating care
- working together to make sure there is good communication, information and education
- making sure people are physically comfortable and safe
- providing emotional support
- involving family and friends
- making sure there is continuity between and within services
- making sure people have access to appropriate care when they need it.
Mental health support
Assessing mental wellbeing and providing psychosocial support is also an important component of healthy lifestyle support.
Cultural competence can be defined as the attitudes, skills and knowledge to be aware of cultural diversity and the ability to function effectively and respectfully when working with and treating people with different cultural backgrounds. Cultural competence is necessary to deliver person-centred care.
Person-centred healthy lifestyle support
Healthy lifestyle support for people with long-term conditions can include:
- peer support
- self-management education
- health coaching
- group activities
- asset-based approaches (time-banking, microenterprise schemes).
Starting a discussion about lifestyle
Raising the topic of healthy lifestyles and making changes to adopt healthy behaviours can be difficult. These discussions can be powerful catalysts of change for some people but can be challenging to initiate.
A person’s health literacy, (that is, their capacity to obtain, process and understand basic health information and services to make informed health decisions) needs to be taken into account when talking about healthy lifestyles. (Read more about health literacy.)
When initiating the discussion with a person about making lifestyle changes:
- be sensitive and empathetic – 'walk in their shoes'
- approach the conversation with respect
- ask them how they are doing
- listen – let people talk and let them know you hear them. Be open to asking questions and hearing the complete answer before offering an opinion or advice.
Example 1: Tips to start a conversation about eating healthy food
Follow these steps:
1. Find out what the person knows about eating healthy food and why it is important.
2. Ask them to identify changes they could make to improve eating patterns.
3. Work together to identify small changes, such as:
- decreasing frequency and/or amount of unhealthy fast food or takeaways
- swapping unhealthy snacks for healthy snacks
- slowing speed of eating down, and really tasting and savouring the food
- noticing when you start to feel full and stop eating when you feel physically full
- drinking water instead of sweetened drinks
- eating more vegetables and fruit.
For more ideas and examples, read the Eating and Activity Guidelines for New Zealand Adults.
4. Encourage development of a goal / plan for change. (See the following Template resources listed).
5. Offer help or support by asking open questions, such as:
- ‘How can I help you to make the changes to eat healthy food?’
- ‘What is the hardest thing about eating healthy?’
- ‘What can I do to support you?’
Example 2: Approaching the conversation about healthy weight
Many people are willing to talk about weight issues with health care professionals who offer respect and empathy for their journey with weight management.
5-A Model to framing the conversation
The 5-A Model is commonly used for smoking cessation counselling and can be applied equally well with many other types of behavioural modification.
- Ask: Start with the person’s perceptions of his or her health conditions and body image or goals.
- Advise: Give the person his or her body mass index number, explain what it means, and offer specific advice on an initial weight goal.
- Assess: Assessing the person for his or her goals, willingness to discuss body weight, and interest in addressing it constitute the next step. Goals should be realistic.
- Assist: Assistance should be person-centred and may include a referral to nutrition counselling, physical activity programs, and/or follow-up discussions.
- Arrange: Arranging a follow-up, even if it is only getting the person’s agreement to discuss the topic, provides the message that you think the issue is important and worth discussing.
Generic person-centred resources
Websites and documents on patient-centred tools to help co-design care plans for people with long term conditions who request support with lifestyle change:
- Shared decision making – Health Navigator website
Video examples of shared decision making.
- Supporting people to manage their health (pdf 332 KB) – King’s Fund website
An introduction to patient activation.
- Stanford self-management programme – Health Navigator website
Self-management education 6-week course to maximise your health and wellbeing.
- Healthy living toolbox – Health Navigator website
Tried and tested tools and techniques to help people deal with life’s challenges and succeed with change.
- Learnings from a project to develop a generic care plan for long term conditions June 2014 (pdf 2.4 MB) – Health Improvement and Innovation Resource Centre website
- My plan for change to stay well (p74)
- One page plan for change (p77)
- My support team (p73)
Online resources about these lifestyle topics:
- Alcohol resources – Health Promotion Agency
- Eating and activity guidelines
Guidelines on eating and activity for a healthy lifestyle.
- Health literacy
Resources to use with patients to help improve health literacy.
- Wellbeing – Heart Foundation
- Mental wellbeing – Health Promotion Agency
- Nutrition and physical activity – Health Promotion Agency
- Self-management support for health providers – Health Navigator website
- Sleep advice – Health Navigator website
- Tobacco control – Health Promotion Agency
- Weight management – Health Improvement and Innovation Resource Centre website