Behaviour change strategies in primary health care: evidence, effectiveness and implementation lessons

Vysochyna, I.L. and Kramarchuk, V.V. and Yashkina, T.O. (2026) Behaviour change strategies in primary health care: evidence, effectiveness and implementation lessons. Перспективи та інновації науки, 63 (5). p. 2217. ISSN 2786-4952

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Abstract

Patient behaviour change is one of the core clinical technologies of primary health care (PHC), directly influencing prevention, risk factor control, treatment adherence, and long-term outcomes in the management of chronic diseases. It is at the PHC level that smoking, hazardous alcohol consumption, unhealthy diet, insufficient physical activity, poor self-management, and low medication adherence are most commonly identified. At the same time, international practice convincingly demonstrates that the simple provision of information rarely translates into sustained behaviour change; clinically meaningful effects usually occur when behavioural support is embedded within the patient’s routine care pathway and reinforced by repeated contacts, digital reminders, team-based care, and clear action algorithms. The aim of this article was to synthesise international experience regarding patient behaviour change strategies in PHC, to identify approaches supported by the strongest evidence base, and to outline the conditions under which they are genuinely effective in everyday clinical practice. The analytical review was based on international clinical guidelines, systematic reviews, meta-analyses, and key randomised controlled trials addressing motivational interviewing, brief interventions, digital tools, group education, self-management, and multicomponent support models. It was shown that brief interventions for smoking and hazardous alcohol use have a robust evidence base in PHC settings: very brief advice from a healthcare professional increases the likelihood of smoking cessation, while brief alcohol interventions are associated with reduced alcohol consumption after 12 months of follow-up. Motivational interviewing retains clinical value but is not a universal solution: its effectiveness is moderate, context-dependent, and largely determined by practitioner training, contact intensity, and fidelity to the method. Digital tools, particularly SMS reminders, are most useful as enhancers of face-to-face counselling; stand-alone mobile applications more often improve self-reported adherence than‘hard’ clinical endpoints.For chronic conditions, structured group education and self-management programmes are promising; however, the greatest clinical gains are demonstrated by multicomponent models combining behavioural support with self-monitoring of indicators, action algorithms, repeated follow-up, and organisational implementation tools. The main barriers remain lack of time, competing clinical priorities, insufficient staff training, weak digital integration, absence of referral pathways for patients, and limited incentives for the care team. It was concluded that the most effective model for PHC is a stepwise behaviour change approach: from universal screening and brief structured advice to the selective use of motivational interviewing, digital follow-up, group programmes, and more intensive forms of support

Item Type:	Article
Additional Information:	DOI:10.52058/2786-4952-2026-5(63)-2217-2228
Uncontrolled Keywords:	primary health care, behaviour change, motivational interviewing, brief interventions, digital interventions, treatment adherence, smoking, alcohol, self-management, implementation
Subjects:	Family Medicine
Divisions:	Departments > Family Medicine, Propaedeutics of Internal Medicine and Laboratory Diagnostics
Depositing User:	Аліна Чеботарьова
Date Deposited:	04 Jun 2026 12:57
Last Modified:	04 Jun 2026 12:57
URI:	http://repo.dma.dp.ua/id/eprint/10039

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