“Practice What You Teach” Public Health Nurses Promoting Healthy Lifestyles (PHeeL-PHiNe): Program Evaluation

T HE HIGH global prevalence of chronic diseases is an escalating challenge for health care systems and health professionals (Centers for Disease Control and Prevention, 2017; Halpin et al., 2010). Therefore, community interventions to promote healthy lifestyles are essential to reduce the main risk factors of obesity, physical inactivity, and an unbalanced diet (Jamison et al., 2006). Public health nurses are in key positions to offer counseling on healthy living among clients. However, effective implementation requires personal and professional abilities and skills (Poskiparta et al., 2010). In Israel, universal preventive health services for families with young children are provided in community-based Mother and Child Health Clinics (MCHCs) in accordance with the national health insurance law. The services are provided predominately by public health nurses who work together with pediatricians, dietitians, social workers, and other health care professionals. The activities include parental support and education, routine screening and immunizations, and the promotion of healthy lifestyles (Polak et al., 2015). A study from Finland among MCHC nurses showed their readiness to implement community-based interventions encouraging healthy lifestyles (Ilmonen et al., 2012). However, counseling clients on lifestyle issues is often insufficient for various reasons, ranging from budget and time limitations to low personal motivation (Blake & Harrison, 2013; Ilmonen et al., 2012; Ljungkrona-Falk et al., 2014) or inadequate training (Kris-Etherton et al., 2014). Thus, advanced courses and workshops aimed at public health nurses have the potential to improve counseling skills and facilitate health promotion interventions. Furthermore, such training can lead to empowerment as well as effecting personal lifestyle behaviors. Health professionals, along with educating clients about nutrition and physical activity, need to motivate and provide skills and strategies for personal management and behavioral changes (Davies, 2006). Many health care professionals have not been given sufficient training in this area (Kris-Etherton et al., 2014), and although they are quite knowledgeable regarding recommendations for a healthy lifestyle, they may lack the ability to translate this knowledge to inspire and motivate others. Therefore, it is important to provide health professionals with practical nutritional knowledge and skills (Eisenberg & Burgess, 2015) and physical activity counseling (Peterson, 2007). It should be noted that to effectively inspire positive behavior changes among clients, health professionals must have a better understanding of the complexity of barriers and motivators (Josyula & Lyle, 2013; Murimi & Harpel, 2010; Whitehead, 2001; Williams et al., 2012). Hence, physical activity and nutrition interventions must be targeted, well designed, and properly implemented to address the needs of diverse populations (Caperchione et al., 2012; Jepson et al., 2012). Motivation on several levels is critical for lifestyle changes. The health professional needs motivation to engage client