Training needs for (UK) professional standards authority accredited register and regulated traditional, complementary and integrative medicine professions for supporting patients to make lifestyle and health behaviour changes: a rapid narrative review

Abstract

Introduction: improving healthy lifestyles is a public health priority. Traditional, Complementary and Integrative medicine (TCIM) providers, and certain professions on the UK Professional Standards Authority (PSA) Accredited Registers (AR) may be well-placed to contribute - some TCIM professions already support patients to make behaviour changes. We aimed to map the landscape of training for PSA AR and regulated TCIM practitioners working with individuals to support lifestyle changes, including current provision, gaps and training needs.Methods: we conducted a rapid narrative review of training within PSA AR and regulated TCIM professions. We searched research databases for articles exploring perceptions, experiences and responses to training (for supporting behaviour change) and searched websites of UK professional bodies for educational guidelines for pre-qualification education. We conducted systematic data searching and extraction, quality appraisal and produced a narrative synthesis of research and guidelines which identified patterns across professions.Results: we identified 24 education guidelines (4 were unlocated). A total of 548 research studies were identified from database searches, and we identified 5 further studies. A total of 20 full-text articles were retrieved, 7 were excluded, leaving 13 in the review. While 22 of 24 guidelines mentioned lifestyle or health behaviour, only 4 (chiropractic, nutritional therapy, osteopathy and acupuncture) provided any detailed recommendations about how to support patients to make health behaviour changes (e.g. providing written information or recording/monitoring progress). Eight of the 13 research studies focussed on chiropractic; most studies focussed on physical activity, two on smoking cessation, and several looked at training in broad techniques including motivational interviewing. Practitioners in research studies were generally positive about training in lifestyle and health behaviour change and there was some evidence that such training enhances practitioner self-efficacy or skills.Conclusions: most evidence of engagement with supporting lifestyle/behaviour change is within four professions: chiropractic, osteopathy, nutritional therapy and acupuncture. To build on existing knowledge and practice, future training for chiropractors, osteopaths, nutritional therapists and acupuncturists could target the capabilities (e.g. knowledge, skills, decision-making), opportunities (e.g. resources) and motivations (e.g. social/professional role) of practitioners. Future research should also evaluate the impact of practitioner training on patients’ lifestyle and health behaviours