Lifestyle counselling by Dutch occupational health professionals and its determinants: a cross-sectional study

Lifestyle medicine has received increasing attention in recent decades, not only in general healthcare but also in occupational health. As part of prevention, Dutch occupational physicians are encouraged to provide lifestyle counselling and refer to lifestyle interventions, such as the Combined Lifestyle Intervention (CLI). However, we do not know to what extent occupational physicians and other occupational health professionals (OHPs) currently practise lifestyle counselling. This study aims to assess the current lifestyle counselling practices of Dutch OHPs and identify the determinants of these practices and of referrals to CLI in particular.

A cross-sectional survey was conducted among 266 OHPs from two large occupational health centres in the Netherlands. The survey consisted of items and scales based on the Assess, Advise, Agree, Assist, Arrange (5 A) framework for lifestyle counselling and the Attitude, Social norms, Self-efficacy (ASE) model. Data were analysed by means of descriptive statistics, correlational analyses and hierarchical regression analyses.

The majority of OHPs (70.3%) assessed their clients' current lifestyle, while 49.1% assessed their clients' motivation to change. 65% of OHPs would like to discuss or advise about lifestyle more often. Stress and physical activity were the most frequent topics covered in the advice for setting of goals (Agree). 59% of variance of lifestyle counselling practices was explained, with self-efficacy and attitude of the OHPs as the most important determinants. More time, training and tools are considered facilitators for lifestyle counselling. Regarding CLI referrals, 28% of OHPs reported referring clients to CLI, with self-efficacy being the key determinant. Also, professional-based barriers (e.g. lack of time, preference for referral to well-known professionals) were determinants of CLI referral.

While a significant number of Dutch OHPs practise lifestyle counselling, there is room for improvement by addressing barriers and enhancing self-efficacy. Training and structural support are recommended to increase the prevalence and quality of lifestyle counselling and referrals to CLI. This study highlights the importance of integrating lifestyle medicine into occupational health to prevent chronic illnesses such as obesity, and improve employee health outcomes.