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Table 1 Healthy Conversation Skills (HCS) training description

From: Southampton PRegnancy Intervention for the Next Generation (SPRING): protocol for a randomised controlled trial

Communication is enhanced through practitioners developing the skill of asking open-ended questions, known as Open Discovery Questions: those that generally begin with ’how’ and ’what’. Such Healthy Conversations allow a patient or client to explore an issue, identify barriers and generate solutions that can be reviewed with the practitioner. Training aims to increase self-efficacy and a sense of control of both practitioners and their patients and clients.
The five core skills are:
 1. To be able to identify and create opportunities to hold Healthy Conversations
 2. To use Open Discovery Questions to support someone to explore issues, barriers and priorities; problem-solve; generate solutions; and set goals for change
 3. To reflect on practice and conversations
 4. To spend more time listening than giving information or making suggestions
 5. To support someone to make a SMARTER (Specific, Measurable, Action-oriented, Realistic, Timed, Evaluated, Reviewed) plan.
Healthy Conversation Skills training generally consists of two 3–4 hour group sessions over a week or so to allow time for practising and reflecting on skills between sessions. Training is delivered by an HCS trainer experienced in group work and behaviour change to a group of about 8 to 15 trainees. This can be followed by a period of ongoing support, which might include a phone call or face-to-face visit from one of the trainers to find out how skills are being implemented in practice. The phone call and visit allow trainees to reflect on the training, how they have implemented new skills, any barriers to their implementation and plans for continued or increased use, including embedding self and peer reflection as part of normal practice. Both follow-up activities are also opportunities to collect evaluation data to assess the effectiveness of the training in changing staff practice, using customised tools developed by the HCS team.