Evaluation of a training programme for primary care providers to offer brief behaviour change counselling on risk factors for non-communicable diseases in South Africa.
OBJECTIVE
To evaluate the effect on clinical practice of training primary care providers (PCPs) in an approach to brief behaviour change counselling (BBCC), integrating the 5As (ask, alert, assess, assist, arrange) with a guiding style derived from motivational interviewing in the South African context. BBCC was focused on the four risky behaviours (unhealthy eating, tobacco smoking, physical inactivity, harmful alcohol use) for non-communicable diseases.


METHODS
It was a before-and-after design, recording BBCC skills at baseline, directly after training and 6-weeks later. We evaluated each recording for adherence to the guiding style and delivery of the 5As using the Motivational Interviewing Treatment Integrity 3.1.1. tool, and a tool based on the 5As training design.


RESULTS
123 recordings were collected from 41 PCPs. Results showed a significant improvement in adoption of the guiding style (e.g. global score at baseline 2.0 (2.0-2.6) and in clinical practice 3.0 (2.7-3.3) p<0.001) and completion of the 5A steps (e.g. assist score at baseline 1.26 (1.12-1.4) and in clinical practice 1.75 (1.61-1.89) p<0.001).


CONCLUSIONS
Training PCPs in this approach to BBCC is effective at changing their clinical practice in the short term.


CONCLUSIONS
The training programme should be integrated into the curricula of PCPs, and used in continuing professional development.
Family Medicine and Primary Care, Stellenbosch University, Box 19063, Tygerberg 7505, South Africa. Electronic address: zmalan@sun.ac.za.
Zelra
Z
Malan
Family Medicine and Primary Care, Stellenbosch University, Box 19063, Tygerberg 7505, South Africa. Electronic address: rm@sun.ac.za.
Bob
B
Mash
Chronic Diseases Initiative in Africa (CDIA), Faculty of Health Sciences, University of Cape Town, P/Bag X 3, Observatory, Cape Town 7935, South Africa. Electronic address: kmurphy@uct.ac.za.
Katherine
K
Everett-Murphy
D002983:Clinical Competence; D037001:Directive Counseling / Q000379:methods*; D004502:Education, Medical, Continuing / Q000379:methods*; D015438:Health Behavior; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D062405:Motivational Interviewing / Q000379:methods; D011320:Primary Health Care / Q000379:methods*; D015397:Program Evaluation; D013019:South Africa
Brief behaviour change counselling; Clinical nurse practitioners; Motivational interviewing; Primary care physicians; Training programmes