Patient motivation and preferences in changing co-occurring health risk behaviors in general hospital patients

Abstract

Objectives: More than 60% of general hospital patients report ≥ 2 health risk behaviors (HRBs), i.e. tobacco smoking, at-risk alcohol use, unhealthy diet, and/or insufficient physical activity. This study investigates a) the association between numbers of HRBs and motivation to change, b) patient preferences for receiving feedback on HRBs, and c) patients' expected gain in quality of life if behavior change made.

Methods: In 2020/2021, 256 18-64-year-old general hospital patients (72.1% of eligibles) reported on their motivation to change each of their HRBs. Associations between HRB number and motivation were assessed using multivariate linear regressions. Participants ranked HRBs concerning their interest in receiving feedback and concerning their expected gain in quality of life if behavior change occurred.

Results: Higher HRB number was negatively related to motivation among at-risk alcohol users (p = 0.034); 24.6% expected gain in their quality of life from behavior change. Participants overall appeared more favorable to feedback about vegetable/fruit intake and physical activity.

Conclusions: Unhealthier lifestyle may be accompanied by decreased motivation to change in at-risk alcohol users. In case of co-occurring HRBs, asking patients for expected gain in quality of life may help guiding intervention target.

Practice implications: Relying on patient selection only, may often leave substance-use unaddressed.

Keywords: Alcohol; Diet; General hospital; Health risk behaviors; Motivation to change; Multiple health behavior change; Patient preferences; Physical activity; Prevention; Smoking.