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If the health check feels like a one off quick intervention it may not be motivating for clinicians. Thinking about the health check like this as a must do 10 min intervention can seem tokenistic. However if the health check is felt to be part of a coherent care process it will potentially feel more valuable and an important start point to life saving and quality of life improving work.

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Some populations may be perceived to be less likely to engage and / or less likely to have better outcomes, and this may mean that clinicians offer less or different options based on preconceptions

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Knowing lead times are long into wrap around services

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Knowing lead times are long into wrap around services

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 The focus on the optimism of behaviour change could be too much with the practicioner... is there enough focus, capacity in an appointment to delve deeper into the optimism of the patient

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 The focus on the optimism of behaviour change could be too much with the practicioner... is there enough focus, capacity in an appointment to delve deeper into the optimism of the patient

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Bad experience of dealing with a provider for example alcohol services

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Bad experience of dealing with a provider for example alcohol services

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Not understanding or knowing detail of the onward pathway

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Not understanding or knowing detail of the onward pathway

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Clinician often doesn't get information on attendance or outcome of behaviour change unless the patient comes back and tells them. Notes aren't on clinical systems, may be an outcome letter but not as obvious on the system or entered.

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Smoking advice can be quite straight forward 'clinically', whereas other areas such as alcohol use or carrying excess weight is more 'socially' acceptable or even 'encouraged'. Clinical v Social tension. 

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Smoking advice can be quite straight forward 'clinically', whereas other areas such as alcohol use or carrying excess weight is more 'socially' acceptable or even 'encouraged'. Clinical v Social tension. 

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Both on part of the patient and the staff member who often isn't clear on how hard to push or how much time to allocate to the test vs advice and guidance

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Practical experience of the services that they are referring onto, do they work locally, what people should expect, would 'I' personally recommend it to a friend!

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Practical experience of the services that they are referring onto, do they work locally, what people should expect, would 'I' personally recommend it to a friend!

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Confidence about talking about a sensitive subject such as weight or activity levels when conscious of their own weight etc

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Confidence about talking about a sensitive subject such as weight or activity levels when conscious of their own weight etc

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Uncertainty on how to relay behaviour change to the patient 

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Uncertainty on how to relay behaviour change to the patient 

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Concerns around being paternalistic or judgemental. Moving beyond factual medical information on health to lifestyle changes which are much more grey.

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People have come for a check voluntarily so are often looking for something. 

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People have come for a check voluntarily so are often looking for something. 

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Uncomfortable talking to people about difficult subjects and reaction from the person. Time allocated often not very long for a full conversation, not time to explore. 

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Uncomfortable talking to people about difficult subjects and reaction from the person. Time allocated often not very long for a full conversation, not time to explore. 

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Unconscious Biases projected by society or even by senior practice staff within the culture of the practice

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Unconscious Biases projected by society or even by senior practice staff within the culture of the practice

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the way Health Check is a tick box exercise 

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the way Health Check is a tick box exercise 

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link to all of them - training on behavioural science