Health eLiteracy for Prevention in General Practice

The intervention consists of: 1. Three training modules of approximately 3 hours duration. These will be offered on an on-line platform (Smart Sparrow) which is an interactive eLearning courseware used at the University of NSW. Both GPs and practice nurses will access these modules in their own time. These will focus on the principles of health literacy and clinical weight management. The modules will also overview study protocols and processes including patient enrolment , the process for conducting health assessments, registering patients with the lifestyle app (My SNAPP), and procedures to ensure patients are followed up and referred to Get Healthy telephone counselling. 2. A medical record audit of practice data performed using Doctors Control Panel (DCP) software. We will use a de-identified audit to illustrate the completeness of practice recording of risk factors and the same variables will be collected on eligible, consenting patients at baseline, 12 months and 18 months. This will be managed by the Field Research Officer (FRO) . 3. Three practice facilitation visits will be provided by a trained facilitator from a local Primary Health Network (PHN). Each face to face visit will be of 1-1.5hrs duration and provided at intervals during the 6-month intervention period. The aim of the practice facilitation is to support general practices in the intervention arm of the HeLP trial to implement effective preventive care which is tailored to the needs of, and develops the knowledge and skills of overweight patients with low health literacy. Facilitators will receive training on the delivery of the sessions and will document these using a facilitator diary. 4. A health check visit for eligible and consenting patients will be undertaken within 4 weeks of recruitment performed by the Practice Nurse. This will utilise the 5As framework (assess, advise, agree, assist and arrange) and cover the following: Assess - Review baseline BMI, waist circumference, diet and physical activity, cardiovascular and diabetes risk, language and health literacy. Advise/ Agree - Provide brief advice using video vignettes; check patient understanding using teach-back method; download and log into My SNAPP (an app developed for the trial available on smart phone and tablet); work with each patient to register for the app, set up their profile and instruct them on the use of the app. Assist - Introduce the Get Healthy telephone coaching program to the patient, (outline purpose of the program and details about participation). If the patient wants to participate, ‘assisted referral’ is made to the program in the presence of the patient. Get Healthy will provide tailored patient lifestyle coaching over 10 one-hour sessions. Coaches are trained by Get Healthy to deliver coaching sessions. Arrange - Arrange follow up communication and a second visit with the practice nurse at 6 weeks and with the GP at 12 weeks. A 12 month review will be provided by the GP. Fidelity of the intervention will be assessed by the following measures: • % of intervention patients who receive health check at baseline, 6 week reviews by the practice nurse and 12 week review by the GP • Usage of My SNAPP determined by Healthy.me captured analytics (% of patients with documented goals related to lifestyle change; usage data including number of times app accessed; number of pages accessed) • % who received ‘assisted referral to the Get Healthy telephone counselling service (English speaking/Arabic speaking) • % of patients who take up (one or more sessions) of the Get Healthy telephone coaching program (English speaking/Arabic speaking) • % of patients who complete the Get Healthy program (English speaking/Arabic speaking). Completion is defined as completing six of the 10 allocated sessions)