title: Do English healthcare settings use 'Choice Architecture' principles in promoting healthy lifestyles for people with psoriasis? An observational study.
abstract: BACKGROUND
  The influence of environmental factors in shaping behaviour is becoming increasingly prominent in public health policy, but whether health promotion strategies use this knowledge is unknown. Health promotion is important in the management of psoriasis, a long-term inflammatory skin condition, and health centre waiting areas are ideal places to promote health information to such patients. We systematically examined patient information materials containing either general, or specific, health messages for patients with psoriasis.
  
  
  METHODS
  An observation schedule was used to record the frequency and quality of leaflets and posters addressing lifestyle behaviour change in health centre waiting areas. Content analysis was used to analyse: frequency, characteristics and standard of the materials.
  
  
  RESULTS
  Across 24 health centres 262 sources of lifestyle information were recorded (median per site = 10; range = 0-40). These were mainly: generic posters/displays of lifestyle support (n = 113); and generic materials in waiting areas (n = 98). Information quality was poor and poorly displayed, with no high quality psoriasis-specific patient materials evident.
  
  
  CONCLUSIONS
  There is little attempt to promote healthy lifestyle as an important aspect of psoriasis management in the clinic environment. Evidence about using environmental cues/techniques to prompt behaviour change in people with psoriasis does not currently inform the design and display of such information in standard health centre settings, which are prime locations for communicating messages about healthy lifestyle. Future research should test the efficacy and impact of theory-informed, high quality health promotion messages on health outcomes for patients with psoriasis.
authors.affiliation: Centre for Dermatology Research, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK. chris.keyworth@manchester.ac.uk.|Manchester Centre for Health Psychology. University of Manchester, Manchester Academic Health Science Centre, Manchester, UK. chris.keyworth@manchester.ac.uk.
authors.forename: Chris
authors.initials: C
authors.lastname: Keyworth
authors.affiliation: Centre for Dermatology Research, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK. Pauline.nelson@manchester.ac.uk.
authors.forename: Pauline A
authors.initials: PA
authors.lastname: Nelson
authors.affiliation: Centre for Dermatology Research, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK. Christopher.griffiths@manchester.ac.uk.|Dermatology Centre, Salford Royal Hospital, Manchester Academic Health Science Centre, Manchester, UK. Christopher.griffiths@manchester.ac.uk.
authors.forename: Christopher E M
authors.initials: CE
authors.lastname: Griffiths
authors.affiliation: Centre for Dermatology Research, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK. lis.cordingley@manchester.ac.uk.|Manchester Centre for Health Psychology. University of Manchester, Manchester Academic Health Science Centre, Manchester, UK. lis.cordingley@manchester.ac.uk.
authors.forename: Lis
authors.initials: L
authors.lastname: Cordingley
authors.affiliation: Centre for Dermatology Research, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK. Christine.bundy@manchester.ac.uk.|Manchester Centre for Health Psychology. University of Manchester, Manchester Academic Health Science Centre, Manchester, UK. Christine.bundy@manchester.ac.uk.
authors.forename: Chris
authors.initials: C
authors.lastname: Bundy
mesh_terms: D000328:Adult; D002755:Choice Behavior; D003695:Delivery of Health Care; D004739:England; D005260:Female; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D011565:Psoriasis; D040242:Risk Reduction Behavior