Exploring the process of making health behaviour changes in traditional acupuncture: a longitudinal qualitative study

Health behaviours (e.g. exercise/diet/alcohol/smoking) are a major public health concern and traditional complementary and integrative medicine providers such as traditional acupuncturists could make an important contribution. We explored the support for health behaviour change provided to and experienced by traditional acupuncture patients to understand the ways in which traditional acupuncturists may contribute to their patients making changes to their health behaviours.

Longitudinal qualitative research methods were used to capture experiences as they change over time with nine patient‒practitioner dyads (8 female patients and 1 male, aged 23-55, and 3 female traditional acupuncturists, aged 35-63). Consultations were audio-recorded and in-depth qualitative interviews were conducted with patients (twice) and traditional acupuncturists (once). Experiences were explored with primary focus on the patients; data were coded both deductively and inductively and themes were produced using reflexive thematic analysis.

Patients at different stages of readiness to change need different types of support-those overwhelmed by symptoms/stress needed help to gain control, patients more ready to change needed help sustaining motivation. Acceptance of lifestyle/behaviour advice was related to establishing a cycle of trust, in practitioner, explanations and treatment. Decisions to enact behaviour change were based partly on changes in feelings/mood as well as reasoned understanding (e.g. of behavioural contribution to symptoms).

Patients' response to behaviour change support in traditional acupuncture may vary according to their symptom control and stress. For some, support for symptoms/stress may need addressing before any behaviour change intervention. Therapeutic trust, coherent explanations and positive feeling from treatments were important in supporting change. These findings link to concepts from the trans-theoretical model and stages of change, social cognitive theory, and the common sense model of self-regulation and dual process theories of behaviour.