ImpENSA eHealthy Conversation Skills training for healthcare professionals aimed at improving micronutrient status during the first 1000 days in South Africa

Individuals' lifestyle behaviours determine health. Improving Early Nutrition and Health in South Africa ("ImpENSA"), an EU Erasmus+ co-funded project, aims to tackle the triple burden of malnutrition in South Africa through equipping healthcare professionals (HCPs) with knowledge and skills to effectively support healthy nutritional choices among pregnant women and mothers/infant caregivers. Healthy Conversation Skills (HCS) is a behaviour change intervention utilising open discovery questions, active listening, reflection on practice and goal-setting support through SMARTER (Specific, Measured, Action-oriented, Realistic, Timed, Evaluated and Reviewed) planning as core competences. We integrated HCS training delivered online (eHCS training) as practical skills training for HCPs following two eLearning modules on micronutrient nutrition and person-centred behaviour change support. In a programme pilot (2021-22) we investigated participant training experiences, application of HCS and changes in clinical practice using assessments, questionnaires, and interviews at baseline, pre- and post-training and at 3-month follow-up. Of 36 participants (mainly dietitians) initially enrolled, 27 completed eHCS training and 24 participated in the follow-up evaluation. All applied open discovery questions and listened to their patients more actively (spending less time giving information) during consultations. Many participants (63%) reported that they frequently supported their patients using SMARTER planning for a behaviour change. All reflected on their practice and how they consulted their patients. Participants gave very positive feedback on eHCS training, finding it relevant and enjoyable. Contextual (micronutrient nutrition) and theoretical (person-centred behaviour change and HCS) knowledge established prior to eHCS training enabled participants to focus during the training on practising and mastering HCS and observing others. This facilitated reflection, deepened understanding of patient-centred care and accelerated the application of HCS to implement person-centred care in their practice. We conclude that eHCS training delivered online, integrated with knowledge-based modules, can effectively enhance the way HCPs support their patients to ultimately optimise early life nutrition.