Delivering Health Promotion Advice in Urgent Care and Emergency Departments: Insights from the promotED Study - a sequential explanatory mixed-methods study

Background: Emergency department nurses and paramedics have contact with millions of people and could use these contacts as opportunities to help people improve their health. These two professional groups could identify people with modifiable risk factors and provide information, brief interventions, and signposting to locally provided services. This study aimed to investigate if and how health promotion is delivered by emergency department nurses and paramedics, and its acceptability to both the staff and patients in these settings. Methods: A mixed methods study consisting of an online survey with paramedics and emergency department nurses and semi-structured telephone interviews with staff and patients. The setting was the emergency departments in three NHS Hospital Trusts and four Ambulance Service Trusts in England. Results: Three hundred and thirty-one online survey responses, 21 virtual interviews with staff and 14 virtual interviews with patients were analysed. Three main themes emerged from the data: (1) role and relevance of health promotion provision; (2) needs and support for health promotion provision; (3) trust and receptiveness for health promotion provision. Conclusions: The findings of this study indicate that staff often refrain from engaging in health promotion activities due to uncertainty about whether it falls within their job responsibilities and a lack of confidence in their ability to perform these activities. Further research is needed to identify effective strategies to encourage, empower, and support staff in integrating health promotion activities into their daily routines in ways that are acceptable to both patients and staff.