core competences for the diet component · core competences for the diet component healthy eating...

The Six Core Components for Cardiovascular Disease

Prevention and Rehabilitation

AU D IT A N D E VA L U AT ION

LONG-TERM STRATEGIES

Psychosoc

ial

healthHealth behaviour

change and education

Management

Medical Risk

Life

styl

e

risk

fact

or

man

agem

ent

BRITISH ASSOCIATION FOR CARDIOVASCULAR PREVENTION AND REHABILITATION

The British Association for Cardiovascular Prevention and Rehabilitation is an affiliated group of the

British Association for Cardiovascular Prevention and Rehabilitation Diet Working Group

Core Competences for the Diet Component: Healthy Eating and Body Composition for Cardiovascular Disease Prevention and Rehabilitation Services 2019

Document endorsed by


Contents

Introduction 1

A guide to using this document 2

The Competences 4

Competency 1: Core Knowledge 4

Competency 2: Professional Behaviour 9

Competency 3: Communication 13

Competency 4: Dietary Consultation 15

Competency 5: Delivering Group Education 18

Competency 6: Educational Material 20

Competency 7: Service Planning and Evaluation 21

Glossary 23

Acknowledgements 24

References 25

Bibliography 25

This document is the intellectual property of the British Association for Cardiovascular Prevention and Rehabilitation (BACPR).


Core Competences for the Diet Component Healthy Eating and Body Composition 1


Introduction

This competency document has been compiled to complement the following:

i. The American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR) Position Statement 2010 Update: Core competencies for cardiac rehabilitation/secondary prevention professionals.1

ii. The British Association for Cardiovascular Prevention and Rehabilitation (BACPR) Standards and Core Components for Cardiovascular Disease Prevention and Rehabilitation 2017.2

The BACPR has launched the third edition of the BACPR Standards and Core Components for Cardiovascular Disease Prevention and Rehabilitation2. One of these core components is healthy eating and body composition (weight management) which is considered integral to all the components of cardiac rehabilitation (CR). Staff who facilitate and / or deliver behaviour change and education, should be appropriately qualified, skilled and competent.

It is envisaged that this document will inform national practice and enable service providers and managers to ensure appropriate governance and safe and effective service delivery. In addition, it can be used as a useful tool to advise employers on standardised recruitment, giving a clear picture of the definition of a suitably qualified practitioner.

Competent health and exercise professionals are essential to the successful delivery of a CR service which meets the needs of the patient whilst promoting high quality CR services. This document provides guidance on the key competences required to ensure the use of best practice standards and guidelines for healthy eating and weight management. In total, seven core competences are outlined, identifying specific knowledge and skills for each core competency and a framework to assess the health professional’s ability to demonstrate their competency. This document also serves as a tool to monitor the need for continuing professional development for the health professional and supporting staff to achieve specific competences.

This document will be reviewed in 2021

This document has received British Dietetic Association endorsement until 9 November 2021

2 British Association for Cardiovascular Prevention and Rehabilitation


A guide to using this document

1. As part of the development process for this competency framework various documents were utilised by the working group in the early scoping period. Our thanks have been expressed to the organisations responsible for the development/publishing of these documents which included:

a) BACPR Standards and Core Components for CR (2017)1.

b) American Association of Cardiovascular and Pulmonary Rehabilitation. Core competencies for cardiac rehabilitation/secondary prevention professionals: 2010 update: position statement of the American Association of Cardiovascular and Pulmonary Rehabilitation2.

c) Canadian Cardiovascular Society (CCS). Canadian Guidelines for Cardiac Rehabilitation and Cardiovascular Disease Prevention: Translating Knowledge into Action. 3rd Edition. Canadian Cardiovascular Society, 20113.

d) Diabetes UK. Diabetes UK evidence-based nutrition guidelines for the prevention and management of diabetes, 2018. Diabetes Medicine 2018; 35(5):541-547. Available from: doi: 10.1111/dme.136034.

e) NHS Yorkshire & The Humber. Prevention and Lifestyle Behaviour Change: A Competence Framework. 2010. Available from: http://www.makingeverycontactcount.co.uk/media/1017/011-prevention-and-lifestyle-behaviour-change-a-competence-framework.pdf accessed 28 October 2018.5

f) Skills for Health. National Occupational Standards. 2010. Available from: http://www.skillsforhealth.org.uk/standards/item/215-national-occupational-standards accessed 28 October 20186.

2. Each competency is laid out in a table format so that the responses can be recorded easily and can be completed either electronically or on a hard copy.

3. Within each competency, there is a series of numbered performance criteria (pc) and columns against which to record:

a) The date the pc is achieved.

b) Whether the pc is essential, desirable or not applicable (E, D, N/A respectively).

c) Comments to identify perhaps, where further professional development is required to achieve the pc or to record specific exemplary areas of performance.

4. At the end of each competency there is a summary table which records:

a) A summary of performance observed: achieved/improvement required with comments/actions as appropriate.

b) Signatures of the reviewee and the reviewer to validate the recorded response and agreed outcomes.



5. Evidence to determine success of a staff member to fulfil the criteria can be achieved through various methods, e.g.:

a) Practical observation

b) Verbal communication

c) Questioning

d) Written submission e.g. case study

e) In-service training

f) Mandatory training

g) External courses

h) Other resources, e.g. BACPR standards.

6. It is not intended that observation and/or achievement of these competences should be a time consuming exercise. It is therefore recommended that reviewers and reviewees consider this document as a useful tool to monitor performance and subsequent professional development required over a period of time (to be defined internally) rather than a lengthy process that is time consuming and impacts negatively on service delivery.

7. As the document relates to the competences required for delivery of healthy eating and weight management provision across the patient’s journey through CR, not all competences will be relevant to each member of staff. Hence, not all seven competences and relating pc need to be achieved.

8. It is the responsibility of the Manager/Reviewer to determine if the competency or pc is essential, desirable and/or relevant to the member of staff.

9. The competences can be linked with the NHS Agenda for Change Knowledge and Skills Framework (KSF) and therefore used as evidence for the KSF. It is recognised that some of these competences are required to maintain professional Health and Care Professions Council (HCPC) registration, particularly in relation to competency 2 (professional behaviour). To avoid duplication, the relevant competences can be signed off if they have already been demonstrated for other purposes.

10. The reviewer ideally should be competent in assessing an individual’s ability according to the competences outlined and have a sound understanding of the skills required to deliver safe and effective health behaviour change support in CR. Whilst not essential, it is recommended that a reviewer holds a relevant assessor qualification to enable objective assessment of the reviewee’s knowledge and ability; alternatively, the Supervisor is likely to be best placed.

11. After successful completion of the competences, it is recommended that the competences will be reviewed as part of an annual appraisal to ensure competency is maintained, or in response to new published evidence and/or changes to national or local guidance.



Com

pete

ncy

1:

Core

Know

ledge

Exa

mpl

es o

f evi

denc

e in

clud

e ob

serv

atio

n in

pro

gram

me

and

wor

king

with

in a

tea

m, o

bser

vatio

n of

exp

lain

ing

to p

atie

nts

durin

g co

nsul

tatio

ns a

nd t

alks

, or

talk

ing

to o

ther

HC

Ps

and

writ

ten

subm

issi

on s

uch

as a

cas

e st

udy

No

.P

erfo

rman

ce c

rite

ria

Dat

e ac

hiev

edE

,D,N

/A*

Co

mm

ents

/ E

vid

ence

The

Car

diac

Reh

abilit

atio

n P

rofe

ssio

nal h

as d

emon

stra

ted

know

ledg

e an

d un

ders

tand

ing

of t

he fo

llow

ing

key

area

s:

1.1

Car

diov

ascu

lar:

Ana

tom

y•

Phy

siol

ogy

•

Pat

hoph

ysio

logy

of c

ardi

ovas

cula

r co

nditi

ons

and

•re

late

d si

gns

and

sym

ptom

s.

Pro

cess

of a

rter

iosc

lero

sis

and

path

ogen

esis

of

•ca

rdio

vasc

ular

ris

k fa

ctor

s.

1.2

Car

diov

ascu

lar

asse

ssm

ents

, dia

gnos

tic

test

s, in

terv

entio

ns a

nd m

edic

al a

nd s

urgi

cal

man

agem

ent.

1.3

Pha

rmac

olog

ical

the

rapy

for

CV

D a

nd r

isk

fact

or

man

agem

ent.

1.4

Life

styl

e m

anag

emen

t fo

r C

VD

ris

k fa

ctor

s an

d be

nefic

ial l

ifest

yle

chan

ges

to r

educ

e th

ese

incl

udin

g sm

okin

g ce

ssat

ion

and

incr

ease

d

phys

ical

act

ivity

.

1.5

The

com

pone

nts

of a

car

diop

rote

ctiv

e di

et,

acco

rdin

g to

the

mos

t re

cent

UK

gui

delin

es.

Kno

wle

dge

of r

elev

ant

natio

nal g

uide

lines

•

Kee

p up

to

date

on

mos

t re

cent

evi

denc

e fo

r

•di

et a

nd c

ardi

ovas

cula

r di

seas

e.

* K

ey: E

= E

ssen

tial

D =

Des

irabl

e N

/A =

Not

app

licab

le

Competency 1: Core Knowledge



No

.P

erfo

rman

ce c

rite

ria

Dat

e ac

hiev

edE

,D,N

/A*

Co

mm

ents

/ E

vid

ence

1.6

Kno

wle

dge

of w

eigh

t m

anag

emen

t on

ca

rdio

vasc

ular

hea

lth:

Prin

cipl

es o

f wei

ght

man

agem

ent

thro

ugh

the

•ba

lanc

e of

cal

oric

inta

ke a

nd c

alor

ic e

xpen

ditu

re.

Cur

rent

gui

delin

es a

nd r

ecom

men

datio

ns fo

r •

heal

thy

body

wei

ght

and

prim

ary

and

seco

ndar

y pr

even

tion

Wei

ght

loss

inte

rven

tions

tha

t pr

omot

e gr

adua

l, •

sust

aina

ble

wei

ght

loss

Pha

rmac

othe

rapy

and

sur

gica

l pro

cedu

res

for

•w

eigh

t lo

ss.

1.7

Kno

wle

dge

of n

utrit

ion

supp

ort

with

ca

rdio

prot

ectio

n:

Iden

tify

thos

e pa

tient

s at

ris

k of

mal

nutr

ition

or

•th

at a

re c

urre

ntly

mal

nour

ishe

d

Aw

aren

ess

that

app

etite

can

be

affe

cted

by

•ca

rdio

vasc

ular

eve

nts

and

surg

ery

Abi

lity

to d

iscu

ss s

trat

egie

s fo

r im

prov

ing

•nu

triti

onal

sta

tus

Kno

wle

dge

of h

eart

hea

lthy

way

s to

fort

ify fo

ods

•or

incr

ease

nut

ritio

nal i

ntak

e

Kno

wle

dge

of a

ppro

pria

te n

utrit

iona

l sup

plem

ents

•

Abi

lity

to d

iscu

ss lo

ng a

nd s

hort

term

•

cons

ider

atio

ns fo

r nu

triti

on s

uppo

rt -

ens

ure

that

if

appr

opria

te, i

ndiv

idua

ls a

re c

ouns

elle

d ov

er

suita

bilit

y of

rel

axin

g di

etar

y re

stric

tions

sho

rt te

rm.

* K

ey: E

= E

ssen

tial

D =

Des

irabl

e N

/A =

Not

app

licab

le




No

.P

erfo

rman

ce c

rite

ria

Dat

e ac

hiev

edE

,D,N

/A*

Co

mm

ents

/ E

vid

ence

1.8

Kno

wle

dge

of o

ther

die

tary

con

side

ratio

ns:

Oth

er c

ondi

tions

req

uirin

g di

etar

y m

anag

emen

t •

that

may

impa

ct o

n an

indi

vidu

al’s

abi

lity

to fo

llow

a

card

iopr

otec

tive

diet

and

may

req

uire

furt

her

advi

ce

Tim

esca

les

for

reco

very

afte

r a

new

car

diac

•

diag

nosi

s or

eve

nt o

n nu

triti

onal

req

uire

men

ts

Abi

lity

to k

now

whe

n to

ref

er a

pat

ient

to

a •

spec

ialis

t di

etiti

an fo

r fu

rthe

r in

put

rega

rdin

g th

ese

othe

r di

etar

y co

nsid

erat

ions

and

to

mak

e th

is r

efer

ral a

s re

quire

d

Con

side

r m

icro

nutr

ient

req

uire

men

ts a

nd e

nsur

e •

mic

ronu

trie

nt s

uppl

emen

tatio

n if

need

ed

Con

side

r ps

ycho

logi

cal i

mpa

cts

of e

vent

on

a •

patie

nt’s

moo

d an

d ho

w t

his

may

affe

ct d

iet

* K

ey: E

= E

ssen

tial

D =

Des

irabl

e N

/A =

Not

app

licab

le




No

.P

erfo

rman

ce c

rite

ria

Dat

e ac

hiev

edE

,D,N

/A*

Co

mm

ents

/ E

vid

ence

1.9

Dia

bete

s -

know

ledg

e of

:

Cau

ses

and

pres

enta

tion

of d

iffer

ent

type

s of

•

diab

etes

The

asso

ciat

ion

betw

een

card

iova

scul

ar d

isea

se

•an

d di

abet

es

New

ly d

iagn

osed

and

long

ter

m d

iabe

tes

patie

nts

•re

gard

ing

thei

r di

abet

es a

nd it

s m

anag

emen

t

Dia

bete

s m

edic

atio

ns -

ora

l the

rapi

es a

nd in

sulin

•

Acc

epta

ble

bioc

hem

ical

leve

ls (H

bA1c

, blo

od

•gl

ucos

e ta

rget

s, k

eton

es)

Hyp

ogly

caem

ia a

nd h

ow t

o tr

eat

•

Hea

lthy

eatin

g gu

idel

ines

for

diab

etes

•

How

phy

sica

l act

ivity

can

affe

ct d

iabe

tes

•m

anag

emen

t

The

bene

fits

of w

eigh

t lo

ss fo

r ov

erw

eigh

t •

patie

nts

and

awar

enes

s th

at t

his

may

affe

ct t

heir

med

icat

ion

requ

irem

ents

Aw

aren

ess

of:

Car

bohy

drat

e co

untin

g •

DA

FNE

/pum

p th

erap

y •

Whe

n to

ref

er t

o a

spec

ialis

t di

abet

es d

ietit

ian

or

•nu

rse

or p

atie

nt’s

doc

tor

or G

P fo

r m

ore

inpu

t.

Kee

p up

to

date

on

mos

t re

cent

evi

denc

e fo

r di

et

•an

d di

abet

es.

* K

ey: E

= E

ssen

tial

D =

Des

irabl

e N

/A =

Not

app

licab

le




No

.P

erfo

rman

ce c

rite

ria

Dat

e ac

hiev

edE

,D,N

/A*

Co

mm

ents

/ E

vid

ence

1.10

Fad

diet

s

Up-

to d

ate

know

ledg

e of

diff

eren

t di

ets

prom

oted

•

to t

he p

ublic

and

be

able

to

disc

uss

the

pros

and

co

ns fo

r th

ese

with

pat

ient

s, s

uppo

rtin

g pa

tient

ch

oice

Aw

aren

ess

of a

pat

ient

’s r

ight

to

choo

se t

heir

•ow

n pl

an

Abl

e to

dis

cuss

the

evi

denc

e be

hind

diff

eren

t di

et

•st

rate

gies

ava

ilabl

e

Dis

cuss

how

fad

diet

s m

ay im

pact

with

•

med

icat

ions

if a

ppro

pria

te

1.11

Con

side

r ps

ycho

logi

cal i

mpa

cts

of C

VD

on

an

indi

vidu

al’s

moo

d an

d ho

w t

his

may

influ

ence

se

lf-m

anag

emen

t.

* K

ey: E

= E

ssen

tial

D =

Des

irabl

e N

/A =

Not

app

licab

le

Co

mp

eten

cy a

chie

ved

:

Impr

ovem

ent

requ

ired

A

gree

d A

ctio

n

(o

utlin

e as

app

ropr

iate

)D

ate:

Yes

- c

ompe

tenc

y ac

hiev

ed

Com

men

ts:

Dat

e:

Sig

ned

Rev

iew

ee:

Prin

t N

ame:

Sig

ned

Rev

iew

er:

Prin

t N

ame:

Dat

e:




Com

pete

ncy

2:

Pro

fess

ional

Behavi

our

Exa

mpl

es o

f evi

denc

e in

clud

e a

copy

of:

HC

PC

reg

istr

atio

n, B

DA

mem

bers

hip,

por

tfolio

, app

rais

al o

r pa

tient

rec

ords

. Als

o ob

serv

atio

n in

pro

gram

me

and

wor

king

w

ithin

tea

m, o

bser

vatio

n of

exp

lain

ing

to p

atie

nts

durin

g co

nsul

tatio

ns a

nd t

alks

or

talk

ing/

educ

atin

g ot

her

HP

s w

ith ju

stifi

catio

n to

ass

esso

r

(eith

er v

erba

l or

writ

ten)

, att

enda

nce

of m

anda

tory

tra

inin

g or

sat

isfa

ctio

n qu

estio

nnai

re.

No

.P

erfo

rman

ce c

rite

ria

Dat

e ac

hiev

edE

,D,N

/A*

Co

mm

ents

/ E

vid

ence

The

Car

diac

Reh

abilit

atio

n P

rofe

ssio

nal i

s ab

le to

dem

onst

rate

adh

eren

ce to

the

high

est s

tand

ard

of e

thic

al a

nd p

rofe

ssio

nal b

ehav

iour

and

has

dem

onst

rate

d th

e ab

ility

to:

2.1

Gen

eral

Sho

w e

vide

nce

of:

Cur

rent

pro

fess

iona

l bod

y re

gist

ratio

n

•

App

ropr

iate

liab

ility

and

inde

mni

ty in

sura

nce

•

DB

S c

lear

ance

or

equi

vale

nt in

line

with

Tru

st/

•O

rgan

isat

ion’

s po

licy

Con

tinui

ng p

rofe

ssio

nal d

evel

opm

ent

incl

udin

g •

reva

lidat

ion

and

refle

ctiv

e pr

actic

e

Del

iver

ing

serv

ices

whi

ch c

ompl

y w

ith t

heir

•pr

ofes

sion

al c

ode

of c

ondu

ct &

rel

evan

t m

edic

o-le

gal a

nd e

thic

al r

equi

rem

ents

.

2.2

Wor

k in

acc

orda

nce

with

evi

denc

e-ba

sed

prac

tice

and

reco

gnis

ed b

est

prac

tice.

* K

ey: E

= E

ssen

tial

D =

Des

irabl

e N

/A =

Not

app

licab

le

Competency 2: Professional Behaviour



No

.P

erfo

rman

ce c

rite

ria

Dat

e ac

hiev

edE

,D,N

/A*

Co

mm

ents

/ E

vid

ence

2.3

Eq

ualit

y an

d d

iver

sity

Ens

ure

prac

tice

in a

non

-dis

crim

inat

ory

man

ner

•(in

line

with

the

Equ

ality

Act

, 201

0).

Be

resp

ectfu

l of i

ndiv

idua

ls a

nd o

f the

ir •

right

s, r

ecog

nisi

ng p

hysi

cal,

psyc

holo

gica

l, en

viro

nmen

tal,

cultu

ral a

nd s

ocio

-eco

nom

ic

diffe

renc

es, a

dopt

ing

good

pra

ctic

e in

ch

alle

ngin

g di

scrim

inat

ion

and

unfa

irnes

s.

2.4

Co

nfid

entia

lity

and

rec

ord

kee

pin

g

Dem

onst

rate

com

plia

nce

with

the

GD

PR

(201

8),

•In

form

atio

n G

over

nanc

e an

d C

aldi

cott

prin

cipl

es

Pro

vide

evi

denc

e of

com

preh

ensi

ve a

nd a

ccur

ate

•re

cord

kee

ping

in li

ne w

ith lo

cal p

roto

cols

as

appr

opria

te.

2.5

Info

rmed

co

nsen

t

Und

erst

and

the

impo

rtan

ce o

f, an

d be

abl

e •

to o

btai

n in

form

ed c

onse

nt (i

n lin

e w

ith G

DP

R

requ

irem

ents

) and

be

com

plia

nt w

ith lo

cal a

nd

natio

nal p

olic

ies.

2.6

Dut

y o

f ca

re

Exe

rcis

e pr

ofes

sion

al d

uty

of c

are

and

act

in t

he

•be

st in

tere

sts

of t

he in

divi

dual

at

all t

imes

Ens

ure

the

indi

vidu

al’s

priv

acy,

dig

nity

, wis

hes

•an

d be

liefs

are

res

pect

ed, w

hils

t m

inim

isin

g an

y un

nece

ssar

y di

scom

fort

.

* K

ey: E

= E

ssen

tial

D =

Des

irabl

e N

/A =

Not

app

licab

le

Competency 2: Professional Practice




No

.P

erfo

rman

ce c

rite

ria

Dat

e ac

hiev

edE

,D,N

/A*

Co

mm

ents

/ E

vid

ence

2.7

Wo

rkin

g r

elat

ions

hip

s

Con

duct

pro

fess

iona

l wor

king

rel

atio

nshi

ps w

ith in

divi

dual

s,

•si

gnifi

cant

oth

ers,

col

leag

ues

and

part

ners

/ s

take

hold

ers

Ens

ure

accu

racy

, hon

esty

, co-

oper

atio

n, in

tegr

ity, a

void

ance

•

of m

isre

pres

enta

tion

and

of a

ny c

onfli

ct o

f int

eres

t, an

d m

aint

ain

high

sta

ndar

ds o

f pro

fess

iona

l con

duct

to

avoi

d an

y in

appr

opria

te b

ehav

iour

.

2.8

Wor

k w

ithin

you

r ow

n sc

ope

of p

ract

ice

and

expe

rtis

e, a

nd if

not

, se

ek a

dvic

e or

ref

er t

o an

othe

r pr

ofes

sion

al.

2.9

Pro

fess

iona

l bou

ndar

ies

and

stan

dard

s of

oth

ers

are

resp

ecte

d.

2.10

Dev

elop

men

t of

the

nut

ritio

nal k

now

ledg

e an

d pr

actic

e of

oth

ers

incl

udin

g m

ento

r su

ppor

t fo

r co

lleag

ues

whe

n re

quire

d.

2.11

Hea

lth a

nd s

afet

y:

Be

awar

e of

and

com

plia

nt w

ith a

pplic

able

hea

lth a

nd s

afet

y •

legi

slat

ion,

incl

udin

g in

cide

nt r

epor

ting

and

be a

ble

to a

ct

acco

rdin

gly

Initi

ate

appr

opria

te p

roce

dure

tha

t is

defi

ned

in lo

cal p

roto

cols

•

in t

he m

anag

emen

t of

unw

ell p

atie

nts

Ens

ure

com

plia

nce

to c

urre

nt o

rgan

isat

iona

l inf

ectio

n co

ntro

l •

requ

irem

ents

.

2.12

Ens

ure

any

equi

pmen

t re

quire

d fo

r de

liver

y of

die

tary

•

inte

rven

tions

is m

aint

aine

d in

goo

d w

orki

ng o

rder

and

reg

ular

ly

calib

rate

d if

appr

opria

te.

2.13

Ens

ure

that

res

ourc

es a

re a

vaila

ble

and

set

up p

rior

to a

ny o

ne-

•to

-one

or

grou

p ac

tiviti

es. W

hen

not

in u

se, e

nsur

e re

sour

ces

are

stor

ed s

afel

y.

* K

ey: E

= E

ssen

tial

D =

Des

irabl

e N

/A =

Not

app

licab

le



No

.P

erfo

rman

ce c

rite

ria

Dat

e ac

hiev

edE

,D,N

/A*

Co

mm

ents

/ E

vid

ence

2.14

Rev

iew

and

eva

luat

e ef

fect

iven

ess

of o

wn

serv

ice

deliv

ery:

Use

app

ropr

iate

met

hods

to

obta

in fe

edba

ck fr

om in

divi

dual

s •

and

peer

s

Refl

ect

on o

wn

perfo

rman

ce in

rel

atio

n to

con

tent

and

del

iver

y•

Iden

tify

and

docu

men

t ar

eas

for

impr

ovem

ent

•

Impl

emen

t ap

prop

riate

cha

nges

.•

* K

ey: E

= E

ssen

tial

D =

Des

irabl

e N

/A =

Not

app

licab

le

Co

mp

eten

cy a

chie

ved

:

Impr

ovem

ent

requ

ired

A

gree

d A

ctio

n

(o

utlin

e as

app

ropr

iate

)D

ate:

Yes

- c

ompe

tenc

y ac

hiev

ed

Com

men

ts:

Dat

e:

Sig

ned

Rev

iew

ee:

Prin

t N

ame:

Sig

ned

Rev

iew

er:

Prin

t N

ame:

Dat

e:




Competency 3: Communication

Com

pete

ncy

3:

Com

munic

ati

on

Exa

mpl

es o

f evi

denc

e in

clud

e ob

serv

atio

n of

pat

ient

con

sulta

tion,

tea

chin

g se

ssio

ns, r

eflec

tive

log,

GP

Let

ter/

refe

rral

lett

er o

r ob

serv

atio

n of

han

dove

r to

ot

her

team

mem

bers

No

.P

erfo

rman

ce c

rite

ria

Dat

e ac

hiev

edE

,D,N

/A*

Co

mm

ents

/ E

vid

ence

The

Car

diac

Reh

abilit

atio

n P

rofe

ssio

nal i

s ab

le to

com

mun

icat

e ef

fect

ivel

y w

ith th

e in

divi

dual

, rel

ativ

es, c

arer

s an

d pr

ofes

sion

al o

ther

s an

d ha

s de

mon

stra

ted

the

abilit

y to

:

3.1

Com

mun

icat

e ef

fect

ivel

y in

con

side

ratio

n of

in

divi

dual

diff

eren

ces:

cul

ture

, age

, eth

nici

ty,

gend

er, r

elig

ious

bel

iefs

, soc

io-e

cono

mic

sta

tus,

ph

ysic

al, e

mot

iona

l, ps

ycho

logi

cal,

educ

atio

nal,

envi

ronm

enta

l fac

tors

and

sex

ual o

rient

atio

n.

3.2

Use

inte

rper

sona

l ski

lls a

nd a

ctiv

e lis

teni

ng

tech

niqu

es t

o en

cour

age

enga

gem

ent,

unde

rsta

ndin

g, c

olla

bora

tion,

info

rmed

dec

isio

n-m

akin

g.

3.3

Wor

k an

d co

mm

unic

ate

effe

ctiv

ely

with

indi

vidu

als,

gr

oups

and

sig

nific

ant

othe

rs:

Del

iver

info

rmat

ion

in a

man

ner

that

can

be

•un

ders

tood

by

indi

vidu

als/

grou

p m

embe

rs

Use

sim

ple,

jarg

on fr

ee la

ngua

ge a

nd c

lear

ly

•ex

plai

n an

y te

chni

cal l

angu

age,

che

ckin

g ba

ck t

o en

sure

und

erst

andi

ng

Pro

vide

adv

ice

in a

man

ner

that

ena

bles

the

•

indi

vidu

al t

o ch

oose

whe

ther

or

not

to fo

llow

it

Ada

pt c

omm

unic

atio

n m

etho

ds fo

r th

e •

indi

vidu

al’s

/ g

roup

nee

ds a

nd a

bilit

ies.

* K

ey: E

= E

ssen

tial

D =

Des

irabl

e N

/A =

Not

app

licab

le



No

.P

erfo

rman

ce c

rite

ria

Dat

e ac

hiev

edE

,D,N

/A*

Co

mm

ents

/ E

vid

ence

3.4

Est

ablis

h an

d m

aint

ain

effe

ctiv

e co

mm

unic

atio

n w

ith a

nd b

etw

een

team

mem

bers

, hea

lth c

are

prof

essi

onal

s an

d pa

rtne

rs /

sta

keho

lder

s, e

xplo

ring

diffe

ring

pers

pect

ives

to

reac

h co

nsen

sus

on

requ

ired

futu

re a

ctio

n.

3.5

Pro

vide

tim

ely

and

accu

rate

rep

orts

and

han

dove

rs

(com

mun

icat

ing

curr

ent

stat

us, p

rogr

ess

and

outc

omes

) to

ensu

re s

eam

less

tra

nsiti

on b

etw

een

agen

cies

/ s

ervi

ce p

rovi

ders

.

* K

ey: E

= E

ssen

tial

D =

Des

irabl

e N

/A =

Not

app

licab

le

Co

mp

eten

cy a

chie

ved

:

Impr

ovem

ent

requ

ired

A

gree

d A

ctio

n

(o

utlin

e as

app

ropr

iate

)D

ate:

Yes

- c

ompe

tenc

y ac

hiev

ed

Com

men

ts:

Dat

e:

Sig

ned

Rev

iew

ee:

Prin

t N

ame:

Sig

ned

Rev

iew

er:

Prin

t N

ame:

Dat

e:

Competency 3: Communication



Com

pete

ncy

4:

Die

tary

Consu

ltati

on

Exa

mpl

es o

f evi

denc

e in

clud

e ob

serv

atio

n of

pat

ient

con

sulta

tion/

tea

chin

g se

ssio

n. S

ome

aspe

cts

may

be

disc

usse

d w

ith t

he o

bser

ver

(e.g

. dru

gs, P

MH

) if t

he

diet

itian

has

rec

eive

d ha

ndov

er fr

om o

ther

mem

ber

of s

taff

No

.P

erfo

rman

ce c

rite

ria

Dat

e ac

hiev

edE

,D,N

/A*

Co

mm

ents

/ E

vid

ence

The

Car

diac

Reh

abilit

atio

n P

rofe

ssio

nal i

s ab

le t

o as

sess

the

indi

vidu

al b

y de

mon

stra

ting

the

follo

win

g st

eps:

4.1

Wel

com

e th

e in

divi

dual

and

exp

lain

the

ass

essm

ent

proc

ess.

4.2

Asc

erta

in:

Rel

evan

t pas

t med

ical

his

tory

•

Pas

t and

cur

rent

car

diac

sta

tus

•

Die

t-re

late

d co

-mor

bidi

ties

and

func

tiona

l •

impa

irmen

t

Cur

rent

sym

ptom

s•

Any

med

icat

ions

that

may

influ

ence

die

tary

adv

ice

•

Pat

ient

’s u

nder

stan

ding

of d

iet i

n re

latio

n to

ris

k •

fact

ors

Rei

nfor

ce th

e be

nefit

s of

long

-ter

m a

dher

ence

to

•di

etar

y gu

idel

ines

Any

cha

nges

that

hav

e al

read

y be

en m

ade

•

Pat

ient

’s s

tage

of c

hang

e an

d an

y ba

rrie

rs to

•

chan

ge

Ant

hrop

omet

ry: h

eigh

t, w

eigh

t, B

MI a

nd w

aist

•

circ

umfe

renc

e, a

nd e

xpla

natio

n an

d di

scus

sion

of

risk

stra

tifica

tion

with

pat

ient

Cur

rent

die

tary

hab

its: c

ompr

ehen

sive

die

t his

tory

•

(incl

udin

g di

etar

y sc

orin

g to

ol)

Dis

cuss

die

t his

tory

in li

ne w

ith c

urre

nt d

ieta

ry

•gu

idel

ines

and

evi

denc

e

Use

mot

ivat

iona

l int

ervi

ewin

g te

chni

ques

to

•co

llabo

rate

with

pat

ient

in d

evel

opin

g go

als

from

di

scus

sion

* K

ey: E

= E

ssen

tial

D =

Des

irabl

e N

/A =

Not

app

licab

le

Competency 4: Dietary Consultation



No

.P

erfo

rman

ce c

rite

ria

Dat

e ac

hiev

edE

,D,N

/A*

Co

mm

ents

/ E

vid

ence

4.2

cont

’dA

gree

an

indi

vidu

alis

ed p

lan

with

SM

AR

T go

als

•by

:

— A

ssis

ting

the

patie

nt in

iden

tifyi

ng s

hort

, m

ediu

m a

nd lo

ng t

erm

goa

ls

— M

anag

ing

expe

ctat

ions

— R

espe

ctin

g th

e pa

tient

’s p

riorit

ies

Enc

oura

ge e

ffect

ive

use

of a

ppro

pria

te

•re

sour

ces

to h

elp

the

indi

vidu

al a

chie

ve a

gree

d go

als

and

obje

ctiv

es, e

.g. f

ood

diar

y, p

ortio

n gu

ides

etc

.

Add

ress

any

furt

her

ques

tions

or

conc

erns

•

from

pat

ient

Pro

vide

any

rel

evan

t w

ritte

n in

form

atio

n or

•

sign

post

to

rele

vant

ser

vice

s

Edu

cate

indi

vidu

als

in c

arry

ing

out

self-

•m

onito

ring

in o

rder

to

enco

urag

e lo

ng-t

erm

di

etar

y m

anag

emen

t

Rev

iew

and

ada

pt t

he d

ieta

ry p

lan

in r

espo

nse

•to

the

indi

vidu

al’s

mot

ivat

ion,

nee

ds a

nd a

bilit

y

Dis

cuss

the

opp

ortu

nity

for

revi

ew w

ith t

he

•pa

tient

.

* K

ey: E

= E

ssen

tial

D =

Des

irabl

e N

/A =

Not

app

licab

le




No

.P

erfo

rman

ce c

rite

ria

Dat

e ac

hiev

edE

,D,N

/A*

Co

mm

ents

/ E

vid

ence

4.3

Iden

tify

inap

prop

riate

ref

erra

ls a

nd d

eal w

ith

thes

e ac

cord

ing

to lo

cal p

roce

dure

.

4.4

Man

age

the

asse

ssm

ent

to m

axim

ise

the

time

avai

labl

e.

* K

ey: E

= E

ssen

tial

D =

Des

irabl

e N

/A =

Not

app

licab

le

Co

mp

eten

cy a

chie

ved

:

Impr

ovem

ent

requ

ired

A

gree

d A

ctio

n

(o

utlin

e as

app

ropr

iate

)D

ate:

Yes

- c

ompe

tenc

y ac

hiev

ed

Com

men

ts:

Dat

e:

Sig

ned

Rev

iew

ee:

Prin

t N

ame:

Sig

ned

Rev

iew

er:

Prin

t N

ame:

Dat

e:




Com

pete

ncy

5:

Deliv

eri

ng G

roup E

ducati

on

Exa

mpl

es o

f evi

denc

e in

clud

e ob

serv

atio

n of

pat

ient

con

sulta

tion/

tea

chin

g se

ssio

n or

less

on p

lan

No

.P

erfo

rman

ce c

rite

ria

Dat

e ac

hiev

edE

,D,N

/A*

Co

mm

ents

/ E

vid

ence

The

Car

diac

Reh

abilit

atio

n P

rofe

ssio

nal h

as d

emon

stra

ted

the

abilit

y to

:

5.1

Pla

n an

d pr

epar

e fo

r th

e de

liver

y of

gro

up

educ

atio

n se

ssio

ns:

Use

evi

denc

e-ba

sed

diet

ary

advi

ce t

o in

form

the

•

plan

ning

and

del

iver

y of

edu

catio

n se

ssio

ns

Pro

duce

spe

cific

aim

s an

d le

arni

ng o

bjec

tives

for

•th

e se

ssio

n ba

sed

on le

arni

ng n

eeds

of t

he g

roup

Dev

elop

a s

essi

on p

lan

with

app

ropr

iate

•

stru

ctur

e, c

onte

nt, s

eque

nce

and

timin

g

Pre

pare

a r

ange

of d

eliv

ery

met

hods

and

lear

ning

•

oppo

rtun

ities

to

acco

mm

odat

e di

ffere

nt le

arni

ng

styl

es a

nd p

rom

ote

activ

e in

volv

emen

t in

lear

ning

Wor

k ef

fect

ivel

y w

ith c

o-fa

cilit

ator

s or

out

side

•

spea

kers

.

5.2

Del

iver

gro

up e

duca

tion

ensu

ring:

App

ropr

iate

intr

oduc

tions

incl

udin

g an

y ob

serv

ers

•

Exp

lain

the

aim

s an

d ob

ject

ives

of t

he s

essi

on

•an

d ho

w t

he p

lann

ed a

ctiv

ities

will

supp

ort

thes

e

A p

artic

ipat

ory

styl

e by

act

ivel

y se

ekin

g •

inte

ract

ions

Con

vey

an a

ppro

pria

te le

vel o

f con

fiden

ce a

nd

•co

mpe

tenc

e

Man

age

chal

leng

ing

situ

atio

ns e

.g. o

verly

•

part

icip

ator

y in

divi

dual

s, in

appr

opria

te b

ehav

iour

Abi

lity

to a

nsw

er q

uest

ions

and

add

ress

•

mis

unde

rsta

ndin

gs fr

om t

he g

roup

Key

mes

sage

s ha

ve b

een

com

mun

icat

ed

•ef

fect

ivel

y an

d th

e gr

oup

is a

war

e of

how

the

se

may

rel

ate

to S

MA

RT

goal

s.

* K

ey: E

= E

ssen

tial

D =

Des

irabl

e N

/A =

Not

app

licab

le

Competency 5: Delivering Group Education



Co

mp

eten

cy a

chie

ved

:

Impr

ovem

ent

requ

ired

A

gree

d A

ctio

n

(o

utlin

e as

app

ropr

iate

)D

ate:

Yes

- c

ompe

tenc

y ac

hiev

ed

Com

men

ts:

Dat

e:

Sig

ned

Rev

iew

ee:

Prin

t N

ame:

Sig

ned

Rev

iew

er:

Prin

t N

ame:

Dat

e:

Competency 5: Delivering Group Education



Com

pete

ncy

6:

Educati

onal

Mate

rial

Exa

mpl

es o

f evi

denc

e in

clud

e ob

serv

atio

n of

pat

ient

con

sulta

tion/

tea

chin

g se

ssio

n or

dis

cuss

ion

with

obs

erve

r

No

.P

erfo

rman

ce c

rite

ria

Dat

e ac

hiev

edE

,D,N

/A*

Co

mm

ents

/ E

vid

ence

The

Car

diac

Reh

abilit

atio

n P

rofe

ssio

nal h

as d

emon

stra

ted

the

abilit

y to

:

6.1

Iden

tify

the

loca

l ava

ilabi

lity

of a

ppro

pria

te s

ervi

ces

to a

ssis

t w

ith

diet

ary

goal

s, e

.g. c

omm

erci

al s

limm

ing

grou

ps a

nd a

war

enes

s of

ref

erra

l pat

hway

.

6.2

Pla

n, d

esig

n an

d pr

oduc

e re

sour

ces

to m

eet

a sp

ecifi

c pu

rpos

e.

6.3

Eva

luat

e ex

istin

g an

d ne

w m

ater

ial t

o de

term

ine

the

valid

ity,

accu

racy

, acc

essi

bilit

y an

d ap

prop

riate

ness

, and

cus

tom

ise

to

mee

t lo

cal n

eeds

as

requ

ired.

6.4

Dis

trib

ute

reso

urce

s ef

fect

ivel

y.

* K

ey: E

= E

ssen

tial

D =

Des

irabl

e N

/A =

Not

app

licab

le

Co

mp

eten

cy a

chie

ved

:

Impr

ovem

ent

requ

ired

A

gree

d A

ctio

n

(o

utlin

e as

app

ropr

iate

)D

ate:

Yes

- c

ompe

tenc

y ac

hiev

ed

Com

men

ts:

Dat

e:

Sig

ned

Rev

iew

ee:

Prin

t N

ame:

Sig

ned

Rev

iew

er:

Prin

t N

ame:

Dat

e:

Competency 6: Educational Material



Com

pete

ncy

7:

Serv

ice P

lannin

g a

nd E

valu

ati

on

E

xam

ples

of e

vide

nce

incl

ude

appr

aisa

l dat

e, s

ervi

ce p

roto

col/p

roce

dure

evi

denc

e or

aud

it re

port

s.

No

.P

erfo

rman

ce c

rite

ria

Dat

e ac

hiev

edE

,D,N

/A*

Co

mm

ents

/ E

vid

ence

The

Car

diac

Reh

abilit

atio

n P

rofe

ssio

nal h

as d

emon

stra

ted

the

abilit

y to

:

7.1

Agr

ee a

nd e

stab

lish

clea

r se

rvic

e ai

ms

and

obje

ctiv

es w

ith m

easu

rabl

e ou

tcom

es fo

r di

etar

y ad

vice

.

7.2

Pla

n, d

evel

op a

nd im

plem

ent

oper

atio

nal

proc

edur

es a

nd p

roto

cols

for

serv

ice

deliv

ery

incl

udin

g in

clus

ion

and

excl

usio

n cr

iteria

, in

line

with

lo

cal a

nd n

atio

nal g

uide

lines

, cur

rent

evi

denc

e an

d or

gani

satio

nal o

bjec

tives

.

7.3

Dev

elop

, ada

pt a

nd r

egul

arly

rev

iew

pro

toco

ls a

nd

proc

edur

es a

s re

quire

d.

7.4

Dev

elop

, im

plem

ent

and

ensu

re s

yste

ms

are

in

plac

e to

allo

w e

ffect

ive

serv

ice

eval

uatio

n an

d de

velo

pmen

t:

Acc

urat

ely

colle

ct a

nd r

ecor

d ke

y se

rvic

e da

ta,

•in

clud

ing

refe

rral

info

rmat

ion,

upt

ake,

att

enda

nce

and

adhe

renc

e re

cord

s an

d ou

tcom

e m

easu

res

on a

car

diac

reh

abilit

atio

n da

taba

se (e

.g. N

AC

R)

to e

nabl

e lo

cal a

nd n

atio

nal a

naly

sis

Dra

w v

alid

con

clus

ions

, mak

e re

com

men

datio

ns

•ba

sed

on t

he e

vide

nce

and

impl

emen

t se

rvic

e im

prov

emen

t, as

app

ropr

iate

.

7.5

Ens

ure

reco

rd k

eepi

ng a

nd m

anag

emen

t is

in li

ne

with

clin

ical

and

info

rmat

ion

gove

rnan

ce.

* K

ey: E

= E

ssen

tial

D =

Des

irabl

e N

/A =

Not

app

licab

le

Competency 7: Service Planning and Evaluation



No

.P

erfo

rman

ce c

rite

ria

Dat

e ac

hiev

edE

,D,N

/A*

Co

mm

ents

/ E

vid

ence

The

card

iac

reha

bilit

atio

n pr

ofes

sion

al h

as d

emon

stra

ted

the

abilit

y to

:

7.6

Ens

ure

that

the

ser

vice

pro

mot

es e

qual

ity a

nd

dive

rsity

in a

ccor

danc

e w

ith le

gisl

atio

n, p

olic

ies,

pr

oced

ures

and

rel

evan

t st

anda

rds.

7.7

Be

acco

unta

ble

for

impl

emen

tatio

n of

hea

lth &

sa

fety

legi

slat

ion

and

any

secu

rity

polic

ies

and

proc

edur

es.

7.8

Pro

vide

evi

denc

e of

effe

ctiv

e co

nsul

tatio

n w

ith

serv

ice

user

s w

hen

plan

ning

and

dev

elop

ing

the

serv

ice.

7.9

Con

trib

ute

to t

he d

evel

opm

ent

of o

ther

s by

fa

cilit

atin

g a

wid

e ra

nge

of C

PD

opp

ortu

nitie

s as

ap

prop

riate

to

fulfi

l ser

vice

nee

ds a

nd o

bjec

tives

.

7.10

Man

age

indi

vidu

al p

erfo

rman

ce t

hrou

gh a

ran

ge

of r

ecog

nise

d m

etho

ds in

acc

orda

nce

with

loca

l po

licy

(e.g

. app

rais

al, p

eer

revi

ew, m

ento

ring)

.

7.11

Pre

sent

rel

evan

t in

form

atio

n in

app

ropr

iate

form

ats

(e.g

. rep

orts

) inc

ludi

ng c

urre

nt s

ervi

ce d

eliv

ery

for

man

ager

s /

com

mis

sion

ers

/ st

akeh

olde

rs t

o in

fluen

ce fu

ture

ser

vice

del

iver

y.

* K

ey: E

= E

ssen

tial

D =

Des

irabl

e N

/A =

Not

app

licab

le

Co

mp

eten

cy a

chie

ved

:

Impr

ovem

ent

requ

ired

A

gree

d A

ctio

n

(o

utlin

e as

app

ropr

iate

)D

ate:

Yes

- c

ompe

tenc

y ac

hiev

ed

Com

men

ts:

Dat

e:

Sig

ned

Rev

iew

ee:

Prin

t N

ame:

Sig

ned

Rev

iew

er:

Prin

t N

ame:

Dat

e:

Competency 7: Service Planning and Evaluation



Glossary

AACVPR American Association of Cardiovascular and Pulmonary Rehabilitation

ACPICR Association of Chartered Physiotherapists in Cardiac Rehabilitation

Adult Learning Principles

Key principles on how adults learn and how best to support such learning.

BACPR British Association for Cardiovascular Prevention and Rehabilitation

Caldicott Principles These were developed as a result of recommendations in Dame Fiona Caldicott's 1997 report on how patient information was used in the health service. They are a set of six general principles that health and social care organisations should use when reviewing the use of individual information.

Cardiac Rehabilitation Professional

Those people who deliver any stage of cardiac rehabilitation who, as part of the service and in the context of these competences, are giving advice and information on healthy eating and weight management.

CPD Continuing Professional Development

CVD Cardiovascular Disease

DAFNE Dose Adjustment for Normal Eating - an educational course for managing Type 1 Diabetes

DBS Disclosure and Barring Service

Equality Act 2010 An Act of Parliament that covers nine protected characteristics, which cannot be used as a reason to treat people unfairly. The Equality Act sets out the different ways in which it is unlawful to treat someone, for example direct and indirect discrimination, harassment, victimisation or failing to make a reasonable adjustment for a disabled person.

GDPR The General Data Protection Regulation standardises data protection law across all 28 EU countries and imposes strict new rules on controlling and processing personally identifiable information (PII). GDPR replaces the 1995 EU Data Protection Directive, (May 25, 2018)

HbA1c The main clinic blood test used for monitoring long term blood glucose, measuring average blood glucose levels for the last two to three months

Health Behaviour Any behaviour that a person engages in that can affect their health in either a positive or negative way.

Health Care Professional An individual, who for the purposes of these competences, provides health services to individuals as part of a cardiovascular prevention and rehabilitation programme.

Individual Those participating in the cardiac rehabilitation programme during any stage/phase and covering a broad range of terms including individuals, patients, relatives, carers, significant others and service users.

Individualised The ‘tailoring’ to suit the individual based on their specific needs.

Information Governance Information governance ensures necessary safeguards for, and appropriate use of, patient and personal information.

Intervention An action to help an individual or group with a behaviour that may affect their health.

Motivational Interviewing

A communication style that activates an individual’s own motivation to change behaviour

NACR National Audit of Cardiac Rehabilitation – a national dataset and management system



Outcome Measures The standard against which the health professional evaluates health behaviour change.

Pump therapy also known as continuous subcutaneous insulin infusion (CSII), involves wearing a device (insulin pump) which provides a steady stream of insulin into your body.

Scope of Practice Taking into account legal and ethical responsibilities, work within the boundaries set by an individual’s qualifications, knowledge, skills and experience in order to practice safely and effectively.

SMART Specific, Measurable, Agreed, Realistic, Time bound

Acknowledgements

Consultation Groups

We acknowledge and thank the following organisations who reviewed this Competency Document as part of the consultation process:

• Bradford Teaching Hospitals NHS Foundation Trust

• Croí, the West of Ireland Cardiac and Stroke Foundation

• Health & Social Care Northern Ireland

• Imperial College Healthcare NHS Trust

• Leeds Community Healthcare NHS Trust

• Norfolk & Norwich University NHS Foundation Trust

• NHS Scotland.

We thank the British Dietetic Association’s members who reviewed the draft document as part of the consultation process.

The Dietetic Competency Working Group

Acknowledgements for their contribution to the completion of this competency document:

• Registered Dietitians and Working group members: Alison Atrey, Sandra Ellis, Alison Hornby, Lisa Gaff & Katherine Paterson (Authors)

• Annie Holden, Chair & Competency Projects Co-ordinator (Author/Editor)



References

1 British Association for Cardiovascular Rehabilitation & Prevention. The BACPR Standards and Core Components for Cardiovascular Disease Prevention and Rehabilitation 2017. 3rd Edition. Available from: http://www.bacpr.com/resources/BACPR_Standards_and_Core_Components_2017.pdf accessed 28 October 2018

2 American Association of Cardiovascular and Pulmonary Rehabilitation. Core competencies for cardiac rehabilitation/secondary prevention professionals 2010 update: position statement of the American Association of Cardiovascular and Pulmonary Rehabilitation 2010. Available from: https://www.aacvpr.org/Portals/0/resources/professionals/Core_Competencies_for_Cardiac%202010.pdf accessed 28 October 2018

3 Canadian Cardiovascular Society (CCS). Canadian Guidelines for Cardiac Rehabilitation and Cardiovascular Disease Prevention: Translating Knowledge into Action. 3rd Edition. Canadian Cardiovascular Society, 2011.

4 Diabetes UK. Diabetes UK evidence-based nutrition guidelines for the prevention and management of diabetes, 2018. Diabetes Medicine 2018; 35(5):541-547. Available from: doi: 10.1111/dme.13603

5 NHS Yorkshire & The Humber. Prevention and Lifestyle Behaviour Change A Competence Framework. 2010. Available from: http://www.makingeverycontactcount.co.uk/media/1017/011-prevention-and-lifestyle-behaviour-change-a-competence-framework.pdf accessed 28 October 2018.

6 Skills for Health. National Occupational Standards. 2010. Available from: http://www.skillsforhealth.org.uk/standards/item/215-national-occupational-standards accessed 28 October 2018.

Bibliography

Dixon, D., & Johnston, M. Health Behaviour Change Competency Framework: Competences to deliver interventions to change lifestyle behaviours that affect health. Scottish Government. Available from: http://www.healthscotland.com/documents/4877.aspx accessed 28 October 2018.

Michie, S., Ashford, S., Sniehotta, F.F., Dombrowshi, S.U., Bishop, A., French, D.P., et al. A refined taxonomy of behaviour change techniques to help people change their physical activity and healthy eating behaviours: The CALO-RE taxonomy. Psychology and Health, 2011, 26: 1479-98. Available from: doi: 10.1080/08870446.2010.540664

For more information please visit the BACPR websitewww.bacpr.com

BRITISH ASSOCIATION FOR CARDIOVASCULAR PREVENTION AND REHABILITATION

“Promoting excellence in cardiovascular disease prevention and rehabilitation”

The British Association for Cardiovascular Prevention and Rehabilitation

British Cardiovascular Society

9 Fitzroy Square, London, W1T 5HW

Email: [email protected]

Direct Line: +44 (0)20 7380 1919

Fax: +44 (0)20 7388 0903

Website: www.bacpr.com

Registered Charity Number 1135639

Company limited by guarantee. Registered in England 5086964

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