A Pilot Study on Brief Motivational Lifestyle Conversations in Primary Care in Flanders

Lifestyle-related risk factors such as poor nutrition, physical inactivity and smoking are key drivers of chronic diseases and cancer. Although healthcare professionals can play a crucial role in motivating behavioural change through brief conversations, many hesitate due to limited time, lack of confidence and absence of a clear structure. KRACH-T was developed to address this gap by offering a practical, evidence-based framework to support lifestyle conversations. KRACH-T stands for: Kick off the conversation, Relevant question, Advice tailored to the individual, Create motivation, Help with next steps, Time (recognising that behaviour change is a process). Between April 2024 and May 2025, KRACH-T was piloted in six diverse healthcare and welfare organizations in Flanders. The study aimed to evaluate whether a structured, low-threshold method could empower professionals to initiate motivational lifestyle conversations and improve patient engagement. Each organization appointed an ambassador to facilitate implementation. These were supported with intervision sessions and accessible tools. Professionals received a toolkit (posters, flashcards, example questions) and skills training (e-learning and workshops). Among caregivers 92% reported satisfaction with the KRACH-T toolkit and training. They reported increased motivation and improved skills to initiate lifestyle conversations. However, time constraints and lack of clear structural procedures remained important barriers. Among patients/clients, 81% reported that the conversation helped them reflect on their lifestyle, and 71% felt motivated to make changes. Conversations were experienced as valuable and non-confrontational, although patients indicated that proactive initiation by caregivers is essential. The pilot study shows that KRACH-T is effective in motivating patients and strengthening caregivers, but structural embedding (e.g., policy support, time allocation) is crucial for sustainable implementation.

Key messages

• KRACH-T is an evidence-based, BMI-rooted method empowering primary care professionals to initiate brief, motivational lifestyle conversations.

• The pilot study confirmed KRACH-T’s feasibility, boosting caregivers’ motivation, knowledge, and skills, but time constraints and procedural gaps remain key barriers.