title: Sustainability of change with quality general practitioner education in adolescent health: a 5-year follow-up.
abstract: OBJECTIVE
  To determine whether improvements gained in general practitioners' (GPs') self-perceived competency, attitudes and knowledge after an intervention in adolescent health care designed with evidence-based strategies in continuing medical education, are maintained longterm, 5 years post intervention. The intervention was designed with evidence-based strategies in continuing medical education.
  
  
  METHODS
  We carried out a follow-up postal survey of the cohort of metropolitan Australian GPs trained in the intervention 5 years previously. Measures Subsets of the original measures, used in the randomised controlled trial of the intervention, were selected to re-assess the GPs by postal survey. Self-perceived competency, attitude and knowledge were measured. Doctors were also asked about further training in adolescent health over the 5 years since the intervention and about self-reported practice.
  
  
  RESULTS
  A total of 46 of 54 (85%) of the original intervention group returned a questionnaire. Scores at 5 years were all higher than at baseline (P < 0.01) and improvements were sustained in all measures from 12 months to 5 years after the intervention. In all, 25/46 (54%) doctors had received further training in related areas over the 5 years, but this did not improve sustainability. A total of 45/46 (98%) reported maintaining their clinical approach to youth and 22/46 (46%) reported maintaining practices to address systemic barriers to adolescent health care access.
  
  
  CONCLUSIONS
  Quality education designed according to evidence-based strategies of effectiveness has advantages for longterm sustainability.
authors.affiliation: Department of General Practice, University of Melbourne, Victoria, Australia. l.sanci@unimelb.edu.au
authors.forename: Lena
authors.initials: L
authors.lastname: Sanci
authors.forename: Carolyn
authors.initials: C
authors.lastname: Coffey
authors.forename: George
authors.initials: G
authors.lastname: Patton
authors.forename: Glenn
authors.initials: G
authors.lastname: Bowes
mesh_terms: D000293:Adolescent; D016497:Adolescent Health Services / Q000592:standards*; D002983:Clinical Competence / Q000592:standards*; D004503:Education, Medical, Graduate / Q000592:standards*; D019317:Evidence-Based Medicine / Q000592:standards*; D005194:Family Practice / Q000193:education* / Q000592:standards; D006801:Humans; D014739:Victoria