title: Effects on knowledge and attitudes of using stages of change to train general practitioners on management of depression: a randomized controlled study.
abstract: 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.
authors.affiliation: Division of Global Health (IHCAR), Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Mandana
authors.initials: M
authors.lastname: Shirazi
authors.forename: Sagar V
authors.initials: SV
authors.lastname: Parikh
authors.forename: Farshid
authors.initials: F
authors.lastname: Alaeddini
authors.forename: Kirsti
authors.initials: K
authors.lastname: Lonka
authors.forename: Ali Akbar
authors.initials: AA
authors.lastname: Zeinaloo
authors.forename: Majid
authors.initials: M
authors.lastname: Sadeghi
authors.forename: Mohammad
authors.initials: M
authors.lastname: Arbabi
authors.forename: Ali Akbar
authors.initials: AA
authors.lastname: Nejatisafa
authors.forename: Zahra
authors.initials: Z
authors.lastname: Shahrivar
authors.forename: Rolf
authors.initials: R
authors.lastname: Wahlström
mesh_terms: 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