title: Mental health clinician attitudes to the provision of preventive care for chronic disease risk behaviours and association with care provision.
abstract: BACKGROUND
  Preventive care for chronic disease risk behaviours by mental health clinicians is sub-optimal. Little research has examined the association between clinician attitudes and such care delivery. This study aimed to explore: i) the attitudes of a multi-disciplinary group of community mental health clinicians regarding their perceived role, perception of client interest, and perceived self-efficacy in the provision of preventive care, ii) whether such attitudes differ by professional discipline, and iii) the association between these attitudes and clinician provision of such care.
  
  
  METHODS
  A telephone survey was conducted with 151 Australian community mental health clinicians regarding their attitudes towards provision of assessment, advice and referral addressing smoking, nutrition, alcohol, and physical activity, and their reported provision of such care. Logistic regression was used to examine the association between attitudes and care delivery, and attitudinal differences by professional discipline.
  
  
  RESULTS
  Most clinicians reported that: their manager supported provision of preventive care; such care was part of their role; it would not jeopardise their practitioner-client relationships, clients found preventive care acceptable, and that they had the confidence, knowledge and skills to modify client health behaviours. Half reported that clients were not interested in changing their health behaviours, and one third indicated that the provision of preventive care negatively impacted on time available for delivery of acute care. The following attitudes were positively associated with the provision of preventive care: role congruence, client interest in change, and addressing health risk behaviours will not jeopardise the client-clinician relationship.
  
  
  CONCLUSIONS
  Strategies are required to translate positive attitudes to improved client care and address attitudes which may hinder the provision of preventive care in community mental health.
authors.affiliation: Population Health, Hunter New England Local Health District, Booth Building, Wallsend Health Services, Longworth Avenue, Wallsend, NSW, 2287, Australia. Kate.Bartlem@hnehealth.nsw.gov.au.|School of Psychology, Faculty of Science and Information Technology, University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia. Kate.Bartlem@hnehealth.nsw.gov.au.|Hunter Medical Research Institute, Clinical Research Centre, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW, 2305, Australia. Kate.Bartlem@hnehealth.nsw.gov.au.
authors.forename: Kate
authors.initials: K
authors.lastname: Bartlem
authors.affiliation: School of Psychology, Faculty of Science and Information Technology, University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia. Jenny.Bowman@newcastle.edu.au.|Hunter Medical Research Institute, Clinical Research Centre, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW, 2305, Australia. Jenny.Bowman@newcastle.edu.au.
authors.forename: Jenny
authors.initials: J
authors.lastname: Bowman
authors.affiliation: School of Psychology, Faculty of Science and Information Technology, University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia. Kate.Ross@uon.edu.au.
authors.forename: Kate
authors.initials: K
authors.lastname: Ross
authors.affiliation: Hunter Medical Research Institute, Clinical Research Centre, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW, 2305, Australia. Megan.Freund@hnehealth.nsw.gov.au.|School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia. Megan.Freund@hnehealth.nsw.gov.au.
authors.forename: Megan
authors.initials: M
authors.lastname: Freund
authors.affiliation: Population Health, Hunter New England Local Health District, Booth Building, Wallsend Health Services, Longworth Avenue, Wallsend, NSW, 2287, Australia. Paula.Wye@hnehealth.nsw.gov.au.|School of Psychology, Faculty of Science and Information Technology, University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia. Paula.Wye@hnehealth.nsw.gov.au.|Hunter Medical Research Institute, Clinical Research Centre, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW, 2305, Australia. Paula.Wye@hnehealth.nsw.gov.au.|School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia. Paula.Wye@hnehealth.nsw.gov.au.
authors.forename: Paula
authors.initials: P
authors.lastname: Wye
authors.affiliation: Hunter Medical Research Institute, Clinical Research Centre, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW, 2305, Australia. Kathleen.McElwaine@hnehealth.nsw.gov.au.|School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia. Kathleen.McElwaine@hnehealth.nsw.gov.au.
authors.forename: Kathleen
authors.initials: K
authors.lastname: McElwaine
authors.affiliation: Population Health, Hunter New England Local Health District, Booth Building, Wallsend Health Services, Longworth Avenue, Wallsend, NSW, 2287, Australia. Karen.Gillham@hnehealth.nsw.gov.au.|Hunter Medical Research Institute, Clinical Research Centre, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW, 2305, Australia. Karen.Gillham@hnehealth.nsw.gov.au.
authors.forename: Karen
authors.initials: K
authors.lastname: Gillham
authors.affiliation: Population Health, Hunter New England Local Health District, Booth Building, Wallsend Health Services, Longworth Avenue, Wallsend, NSW, 2287, Australia. Emma.Doherty@hnehealth.nsw.gov.au.|Hunter Medical Research Institute, Clinical Research Centre, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW, 2305, Australia. Emma.Doherty@hnehealth.nsw.gov.au.
authors.forename: Emma
authors.initials: E
authors.lastname: Doherty
authors.affiliation: Population Health, Hunter New England Local Health District, Booth Building, Wallsend Health Services, Longworth Avenue, Wallsend, NSW, 2287, Australia. Luke.Wolfenden@hnehealth.nsw.gov.au.|Hunter Medical Research Institute, Clinical Research Centre, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW, 2305, Australia. Luke.Wolfenden@hnehealth.nsw.gov.au.|School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia. Luke.Wolfenden@hnehealth.nsw.gov.au.
authors.forename: Luke
authors.initials: L
authors.lastname: Wolfenden
authors.affiliation: Population Health, Hunter New England Local Health District, Booth Building, Wallsend Health Services, Longworth Avenue, Wallsend, NSW, 2287, Australia. John.Wiggers@hnehealth.nsw.gov.au.|Hunter Medical Research Institute, Clinical Research Centre, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW, 2305, Australia. John.Wiggers@hnehealth.nsw.gov.au.|School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia. John.Wiggers@hnehealth.nsw.gov.au.
authors.forename: John
authors.initials: J
authors.lastname: Wiggers
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D001315:Australia; D002908:Chronic Disease / Q000517:prevention & control*; D003156:Community Mental Health Services / Q000379:methods*; D003430:Cross-Sectional Studies; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D008875:Middle Aged; D011314:Preventive Health Services / Q000379:methods*; D012309:Risk-Taking; D055815:Young Adult