title: Challenges of implementing routine health behavior change support in a children's hospital setting.
abstract: OBJECTIVE
  Evidence indicates that health behavior change initiatives are often not implemented successfully. This qualitative study aims to understand the barriers and facilitators to implementation of health behavior change brief advice into routine practice in an acute children's hospital setting.
  
  
  METHODS
  Semi-structured interviews were conducted with health professionals working at a UK children's hospital (n=33). Participants were purposively sampled to incorporate a range of specialties, job roles and training.
  
  
  RESULTS
  An inductive thematic framework analysis identified two emergent themes. These capture the challenges of implementing routine health behavior change support in a children's hospital setting: (1) 'health professional knowledge, beliefs and behaviors' and (2) 'patient and family related challenges'.
  
  
  CONCLUSIONS
  This study enhances findings from previous research by outlining the challenges pediatric health professionals face in relation to supporting health behavior change. Challenges include failure to assume responsibility, low confidence, prioritization of the health provider relationship with patients and families, health provider and patient knowledge, and low patient and family motivation.
  
  
  CONCLUSIONS
  Skills-based behavior change training is needed for pediatric health professionals to effectively support health behavior change.
authors.affiliation: Research and Development, Birmingham Children's Hospital NHS Foundation Trust, Birmingham, England, UK. Electronic address: laura.elwell@bch.nhs.uk.
authors.forename: Laura
authors.initials: L
authors.lastname: Elwell
authors.affiliation: Children and Families Division, Birmingham Community Healthcare NHS Trust, Birmingham, England, UK.
authors.forename: Jane
authors.initials: J
authors.lastname: Powell
authors.affiliation: Joint Commissioning, Coventry City Council, Coventry, England, UK.
authors.forename: Sharon
authors.initials: S
authors.lastname: Wordsworth
authors.affiliation: College of Medical and Dental Sciences, University of Birmingham, Birmingham, England, UK.
authors.forename: Carole
authors.initials: C
authors.lastname: Cummins
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D005190:Family / Q000523:psychology*; D005260:Female; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel / Q000523:psychology*; D006293:Health Promotion / Q000379:methods*; D006776:Hospitals, Pediatric; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009042:Motivation; D010372:Pediatrics; D024382:Professional Role; D011369:Professional-Patient Relations; D036301:Qualitative Research; D006113:United Kingdom; D055815:Young Adult
keywords: Health behavior change; Interventions; Pediatrics; Qualitative