Effects on knowledge and attitudes of using stages of change to train general practitioners on management of depression: a randomized controlled study.
OBJECTIVE
To assess the impact on knowledge and attitudes of a tailored educational intervention on depression using a modified version of the Prochaska stages of change model, compared with standard continuing medical education, for general practitioners (GPs) in primary care in Iran.


METHODS
Using a randomized controlled trial, a total of 192 GPs were evenly randomized to intervention or control arm. The topic for the educational intervention was depressive disorders. The participants were divided in to small and large groups, depending on their initial stage of change. The GPs' knowledge and skills regarding management of depressive disorders were assessed through a questionnaire with 7 multiple choice questions, 11 Likert statements, 3 case vignettes, and 1 essay question. Attitudes toward management of depressive disorders were also assessed. Both questionnaires were validated.


RESULTS
There was a significant improvement in knowledge mean scores regarding multiple choice and Likert questions (intervention effect 6%; P = 0.002), as well as for the case vignettes and essay question (intervention effect 12%; P = 0.011) in the intervention arm, in comparison with the control arm. There were significant changes in mean attitude scores in both study arms, but no difference between them.


CONCLUSIONS
A theoretical model of medical learning and behavioural change can be used to devise educational formats that suit different stages of learning. Such tailored educational formats can improve GPs' knowledge and skills regarding management of depressive disorders.
Shirazi
Mandana
M
Division of Global Health (IHCAR), Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
Parikh
Sagar V
SV
Alaeddini
Farshid
F
Lonka
Kirsti
K
Zeinaloo
Ali Akbar
AA
Sadeghi
Majid
M
Arbabi
Mohammad
M
Nejatisafa
Ali Akbar
AA
Shahrivar
Zahra
Z
Wahlström
Rolf
R
D000328:Adult; D001291:Attitude of Health Personnel; D002983:Clinical Competence; D003479:Curriculum; D003866:Depressive Disorder / Q000175:diagnosis / Q000628:therapy*; D004502:Education, Medical, Continuing; D005194:Family Practice / Q000193:education*; D005260:Female; D006801:Humans; D007492:Iran; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care; D011795:Surveys and Questionnaires